He needs seven teeth extracted for new upper and lower dentures. As his wife and caregiver I do not know if he can withstand oral injections much less the amount of pain, and pain meds. Has anyone had similar situation?
I have been preparing soft food but existing denture and partial cannot be repaired. Appreciate any insight. He will need medical clearance from Primary Care and Cardiologist. However, I have found more advice and answers here.

I am a retired dental hygienist and have also taught in the dental program at the university. Have worked in the field for 35 years.
people on here are right that dental infections are serious. The same circulatory system runs through our tooth and gum blood supply that goes through our heart. That bacteria can cause lots of problems in the heart, liver etc. if he has infected teeth or they are loose due to periodontal (gum) disease they need to come out. Since he sees a cardiologist, he may be on a blood thinner which would be stopped for a short time to cut down on surgical bleeding so he will clot after as well. An oral surgeon would be the best person to extract. They can provide either just local anesthesia which given by an expert after using topical numbing gel is hardly felt. Sometimes they can use a mild sedative like Valium. I would not let them give him Versed which is IV sedation, because in older adults it can cause cognitive issues after and affect memory.

once he heals and the tissues shrink he can then have the dentures made. These will be made by either a general dentist or you could have them made by a specialist called a Prosthodontist. For me, I would see the specialist. Well made dentures are not cheap…usually running around $3-5000. Do not go to a place like Aspen Dental which are usually run by recent graduates. Mind you this will take several visits and after he gets them he will need further adjustments. Getting used to new dentures is not easy and will rub sore spots on the tissues until they develop a "callous". So the dentist will grind away some of the acrylic where the denture is placing undue pressure.
Having teeth for appearance and for function such as eating and talking is important for social as well as health. However, only you know if your dad can tolerate the visits required. My dad had full dentures for over 60 years. He was in the NH and had lost so much weight they wouldn’t stay in. I did take him to get a new set and he could not adjust. With his dementia he was also an awful patient. Finally he wore his old set until they tossed away his upper in a napkin on his tray. After that he just would eat a soft diet.
Helpful Answer (9)
Reply to Harpcat
LNReason Sep 5, 2021
I'm going to try to print your response to take to both doctors. My husband
does have periodontal disease, all teeth are rotted and not even in his mouth straight. He's on antibiotic but the x ray also showed sinus infection. Waiting for appointments. I went to dentist "doc in a box" - wasn't impressed at all. I have to get my $2300 prepaid money back.
My dad had 14 teeth surgically removed at one go.

I recommend giving him all the ice cream he will eat for the first week. This keeps the swelling down and helps minimize pain.

My dad was on blood thinners and the oral surgeon wanted instructions from his cardiologist. Pretty simple instructions, when to stop thinners, what to watch for and when to restart.

Oral infection can be deadly. I would get them pulled, even if he doesn't ever get dentures, you can work around that.

Prayers for a successful surgery and a speedy recovery.
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Reply to Isthisrealyreal

When my mom needed several teeth extracted (she had avoided the dentist for 20 years!) her dentist referred her to a dental surgeon to have them removed under sedation and that concerned me because at the time she was just beginning to show signs of some mental and physical decline due to several TIAs. I called around for second opinions and found a dentist who had worked extensively in nursing homes and was well aware of the problems older people face. He he advised saving 4 lower front teeth because a partial lower denture was much more stable, and he was able to remove mom's teeth with a local - sorry I can't remember if he did that in more than one appointment. Mom healed well and was able to adapt to the partial.
Helpful Answer (6)
Reply to cwillie
ckrestaurant1 Sep 5, 2021
Seems that having multiple visits rather than doing all the extractions in one visit however given the undesirable ability to transport these elder patients I can understand the hesitation...pulling one tooth at a visit certainly should lessen the Uncle had his daughter take him to the dentist or oral surgeon I believe and extracted multiple teeth perhaps at the urging of the doc or herself wanting to finnish with the task of preparing for dentures but my Uncle had a fatal heart attack weeks after the prodecure. So a conscienous dentist or not wanting multiple visits perhpaps exacerbated the trauma to the body. Teeth are an immensely diificult geriatric problem...checking on a seniors teeth earlier is paramount..NH regularly misplaces dentures and from my experience do not like the job of placing the dentures in the mouth everyday....this is true as one day I asked about it for my father because i was so preoccupied with observing everything else that was going on like bathing,changingsheets,transfers for eating,feeding at the bed by someone and I found the NH does its best but think of all the jobs that need to be done by multiple workers for the declining of their it my case I did not know that dementia patients should be in a different part of the NH requiring much more attentivness....I mean its hard to feed someone three times a day yes?..and you are better off with a pureed diet...or health drinks with vegetables and fruit...
Update: The teeth have to come out because they are causing infection and are broken. Found dentist who took time to explain everything. They bill as the work is done. Over 3x the cost from the "drive thru" dentist. They were professional, took extra good care of him during initial visit. They are accustomed to working with seniors and dementia. The cardiologist is allowing laughing gas to help my honey. Still haven't gotten a refund on the $2,225 put down at the other place. Put it in dispute with credit card company. Thanks for all the help - it helped me ask right questions at our appointment. Extractions will be done third week in October. Again - thanks.
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Reply to LNReason
Grandma1954 Sep 29, 2021
Thanks for the update.
It is nice to know that there are some professionals that will do what is best for the patient.
Hope all goes well for the refund!
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It really doesn't matter what we say. If the Cardiologist does not give clearance, the dentist won't do it.

Me personally have had extractions, not on this scale, and only once have had pain and that was a dry socket that was corrected. Anything discomfort I had I used over the counter pain killers.

If ur husband is on blood thinners there could be problems too.

This is really something the dentist and the Cardiologist need to discuss.
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Reply to JoAnn29

Harpcat’s response is right on. Many dentists will not deal with a patient who suffers from dementia and behavioral problems. Also many seniors will not tolerate the procedures and follow-ups for dental work and dentures. My only additional comment is that you need to determine if is it worthwhile to extract the remaining teeth or wait until they fall out, and then let dad eat with just his remaining teeth.
Helpful Answer (4)
Reply to Ricky6

Is he on blood thinners? He will need to be off blood thinners for a while before any oral surgery, but this will pose a stroke risk. I know a senior who had a stroke in this scenario. Must be considered very carefully if this is your husband's case.
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Reply to Geaton777

I didn't know anything about dentures and last year my husband started to say they were lose but due to health reasons we couldn't get to dentist (Covid precaution). So I bought orajel and he never complained. Last week he pulled teeth out at supper and they were mixed with coleslaw. It appeared that they were broken. When I got to dentist, the uppers are worn completely down and the ones on the bottom, the plate couldn't be fixed either. The xray shows he has severe gum infection, sinus infection and the remaining seven teeth will have to be pulled because none of the teeth can be saved. He is on an antibiotic for 7 days.

He's using the broken partial now and the same upper dentures. I just make sure food is in small pieces and soft (I've been doing for years - I shouldn't have given him this store brand of coleslaw because it wasn't fine).

He has a problem with varicose veins and that discomfort and pain set him in fretful behavior and he also has arthritis in hip and back and the primary does not agree with a hip replacement.

He is on blood thinner and our cardiologist knows the last surgery he had to repair hernias a few years ago affected dementia a lot. He doesn't react to pain or discomfort well. Other than that, we are on year 11th year of this journey. He does not recognize many every day items and together we find ways to find things he can help with.

I just wanted to know if he can keep what he has in his mouth now if I continue to give him soft foods. I took him to a place where he got his dentures in 1987 and they advertise for their affordability.

The dentist said it would take 9 to 12 months to heal before he gets permanent dentures. If it takes that long to heal - I thought he might experience a lot of pain and discomfort. He couldn't find words to tell me about his mouth problems and I just didn't know. I felt so bad for him. When I prepaid $2,300 he really got upset.

I feel like it is important the best be done for him. I checked with our regular dentist and he couldn't advice.
Helpful Answer (3)
Reply to LNReason
Tothill Sep 5, 2021
Here in North America we have a belief that people need to have a full set of teeth, natural, partials, full dentures or implants.

I used to hold this belief too. But in reality if there are no infections, or sharp edges that could cut the inside of cheeks or tongue, teeth do not need to be replaced.

Dad had 6 teeth pulled about 6 years ago. They had broken at the gum line and he had several small abscesses. The dentist discussed removing his remaining teeth so he could be fitted with dentures, but Dad said no.

Over time his remaining teeth have mostly broken or fallen out, but no infection. Dad cannot eat steak, but mostly eats canned food or frozen food and manages to gum/chew it.

Dad used to be proud of his appearance, but does not care that he has a snaggle tooth smile now.
Does he have current infections?
Are his intact teeth painful?
Can he eat without the current dentures?
If he has no infections, If his teeth are not painful and he can eat I would not put him through a protracted dental procedure.

The problems with anesthesia are one thing. Difficult to recover from, may not return to baseline cognition
The problems with dealing with open wounds in the mouth that he will try to pick at, having him comply with oral care after surgery. And the potential for infection, dry socket after. THEN getting him to sit still or having to undergo anesthesia again for them to put that "goop" in your mouth in order to make the mold.
I would not put him through a procedure like that.
As the disease progresses he will go from soft food to pureed food just as a result of disease progression. You may put him through all this and in a few months he may not be able to eat anything but pureed foods anyway.

I may be biased but I, as the wife, caregiver, guardian for my Husband elected NOT to do any dental work as long as he was not in pain nor had any infections.
Helpful Answer (3)
Reply to Grandma1954

With clearance and a good oral surgeon, and with perhaps prophylactic antibiotics he is likely to do well with just a bit of nitrous has to relax him. I don't know that I would have them done all at once, and I would consult with MD and with dental oral surgeon for guidance. Can you tell me why these need extracting? Is there gum disease with pockets or is this decay? Has there been dental pain now?
Helpful Answer (2)
Reply to AlvaDeer
ckrestaurant1 Sep 5, 2021
assuming he is preparing to have dentures made...remember alot of dentists want all the teeth extracted for a a matter of fact alot of dentists prefer all teeth removed for implants as well its not the money but the fit...working around existing teeth seems to be more problematic think of putting a floor down in a room...u need to clear it all out...working around exisiting teeth has always been the problem for the failing elder trying to fix t6he mouth problem. add on that dentures are 5000 and up implants are 2500-4500...each..
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