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I recently inherited the care of my nearly 93 year old dad who was living with my brother who told me to "come get him". Obviously assisted care living is something I'm avoiding right now but hope things will get better with visiting so we can do that. In the meantime, he is here. We are in another state so the past month has been getting new doctors and a many years over due dental exam. He has a heart issue that the cardiologist says he can't fix without an angiogram and that dad is too old and weak and if it was his dad he wouldn't put him through it. He has pulmonary fibrosis that has reduced his lung efficiency to 65%. He has sleep apnea that was untreated so I'm working on that (he will balk but I will try). He has moderate dementia and has been tested and can't make informed choice. And the dentist wants to do two crowns. Its not the cost of the two crowns ($1K each) but is it worth it to put him through the procedure (I personally hate dental work so I cringe at the thought). The dentist says his teeth are decaying around and under the crown but dad isn't good about brushing. He is independent about getting himself dressed and shaved etc... so me standing over him to brush is teeth is not something I want to do (is that bad?) I'm putting it off for now getting the doctors and PT and visiting nurses and sleep study first. I am overwhelmed. Ironically, I was the first of the three kids to say I never wanted him to live with me... and now, here I am!

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I would not put him through any aggressive treatment or crowns. I would not put my elderly mother through such an invasive procedure. Water pic would be a good choice to clean out the debris in his teeth, an electric toothbrush and a mouthwash rinse.
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If decaying, have them pulled. He would probably need a root canal eventually and thats worse than a crown. My Aunt had ALZ and was in her late 80s on Medicaid in a NH. They wanted to do crowns on her and my cousin said no. Just pull them.
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My mother hasn't been to a dentist in at least 15 years. I wouldn't put her through anything like that. One of her bottom teeth flat-out broke off at the base, and we left it alone after talking to a dentist who said he wouldn't bother doing anything about it.

That's not what's going to kill my mother or your dad. They're at the age where you decide which treatments are worth doing and which aren't.
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Just went through a situation 1 1/2years ago similar to the one you describe with my then Stage 6 Alzheimer husband. Had to hire a new dentist because our long-time dentist retired. We always kept up with husband's teeth--every six months without fail--but new dentist said he needed $20,000.00 (Yes! I did say Twenty Thousand Dollars) worth of work. My antennae went up! Estimated time to be spent in dental chair? Six to eight hours! A couple of bridges, two root canals, renew existing crowns. New dentist even said his teeth would abscess in no time and cause tremendous pain and deadly infection. Hasten his death.
We did NOTHING. We decided if the teeth started giving trouble, we would have them pulled. Husband lived another 1 1/2 years before he died this past July. His teeth never gave trouble and weren't a factor when he died.
Dentistry is sometimes a racket for older people in this day and time. They know you probably have the money and they just assume you're an easy target. If I were you, I'd have those teeth pulled IF IT'S ABSOLUTELY NECESSARY. Don't put your dad through anything he doesn't have to go through. Life is hard enough. Enough is enough! Just keep him comfortable.
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A few years ago, my dad's dentist wanted to pull all of his teeth and replace them with implants or dentures. He is in his 90's and neither he or I thought that was a good idea. We found a geriatric dentist who said we would take them one at a time as needed which is what we have done.
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At this age either gum disease or decay is going to take teeth one at a time, and I am one to kid about my tooth "fractures". They literally split. At his age the loss of the tooth will be enough to worry about. Pulling is often as much of a problem as crowning them if it is a back tooth, They can crumble during removal, break off from the root. So get a really good dentist, tell him the concerns of pain versus age, and take his advice.
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