Thoughts? Husband, 81, was advised from heart and medical doctor to not have any procedures that require anesthesia. Now I need to know.....

I don't suppose his cardiologist would be too keen on the risk of infection from so many extractions all at once, either. What's the justification for them?

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.

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?

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.

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.

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.

If he has gum desease he needs them removed. The poison that is given off by the infection can cause problems. I would say, don't worry about the dentures. Some people do well with gumming it.

Really, this needs to be discussed with the Oral surgeon and the Cardiologist. Not a dentist, an Oral Surgeon.

LNReason, I was on a soft diet for about 2 months recovering from a fractured jaw (in 2 places) after a negative encounter with a tree that didn't want to be cut down.   Six teeth were knocked loose; nerves of 3 teeth were almost severed, and a titanium plate inserted in my jaw.    All I could eat was soft or pureed foods.   I was sedated for the surgery, but there were no other medical issues, so I'm sharing the post-surgical issues for what they're worth.

I don't specifically recall the type of dentist who handled the surgery but I believe it was a periodontist and performed in a hospital, with an overnight stay.  He did prescribe a special mouthwash as I couldn't brush my teeth either. especially with the entire lower level wired.

You're definitely on the right track with soft food.  

When my father needed dental work in his 90's, our regular dentist recommended a Endodentist.   It was quite an experience, very tailored, considerate and compassionate.   I don't recall what anesthesia or meds were administered, but Dad had no issues other than just sitting in the chair for so long.

The anesthesia did not knock him out though; he was conscious throughout.

I also don't believe he had to get clearance from any other doctor, but of course his situation was different.

I mention these only as potential alternatives to anesthesia which could be more compromising for your husband.  

Do stick with the soft foods though; a dysphagia diet could offer some suggestions as to how to make food tasty and presentable.

Good luck, and I hope everything works out well for you and your husband.

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.

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.

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.

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.

Can the dentist/oral surgeon administer gas?

Talk to an oral surgeon. They can do "conscious sedation" where he is awake but groggy. Usually, he receives anti-anxiety medications so he relaxes through the entire procedure. There is oral (surface) medications to numb the gums so that he won't feel oral injections to locally anesthetize the areas of surgery. Afterwards, he can be given liquid pain medication and will need a liquid diet until the surgeon says he can have firmer foods. Conscious sedation shouldn't be a problem for his heart or other health issues.

You are right to be very careful about this. His doctors instructions are clear. Talk to the oral surgeon and tell them what his doctors advise.

My hubby is 81, with A-fib, CHF, pulmonary hypertension, and dementia. Last year he had 14 teeth pulled to fit a lower denture. He had no problems, either with the novacaine or Tylenol.
We went to a geriatric dentist, who required a comprehensive medical history, and a clearance from his PCP and his cardiologist. It might serve you well to find a geriatric dentist in your area to evaluate your husband. Hugs.

Edited: The geriatric dentist made a "healing" lower denture which my hubby wore out of the office after the extractions. He ate soft foods for a week until he went back for a follow up appointment to check healing. He had to rinse his mouth and denture with warm salt water after every meal. After one week, he could eat whatever he wanted. He wore the "healing" denture for 9 months, with monthly checkups, until he got his permanent denture. He has had no problems after a couple minor adjustments.

Commenting on HarpCat's excellent advice, as to temporary blood thinner as opposed to something like Warfarin, it's been my experience that doctors recommend and use Lovenox, which is fast acting and doesn't remain in the body as long as the usual blood thinners.   My father's had Lovenox on more than a few occasions, with no side effects.   

It was administered by a shot in the upper abdomen close to the waist.  I couldn't do it though; I just can't put a needle in my parent.  It might be that the dentist or whoever monitors your husband's PT/INR could see him before the procedure and administer the shot, but going to 2 doctors in one day might be a bit difficult and unsettling.

Pretty clear here, New Chompers won't do hubby any good if he's dead.

Follow Dr's suggestion and don't have him get any anesthesia!

If you were told that regarding yourself, would you go ahead and chance a heart attack or death verses some shots?

Have you called around to see if anyone can make new dentures just using his old ones as a model instead of his mouth.

Juse curious, what are your husband's thoughts?

Prayers

Hapcat has the best answers.

You, as his wife, know what he can or can't tolerate as far as pain, and I completely understand your reluctance to put him under anesthesia, given his medical history. You also have to think about the long recovery period as Hapcat outlines.

Can you get a 2nd opinion from another dentist on whether or not they can make partial dentures, bridges or any workaround without extracting his existing teeth? A skilled dentist may be able to find alternate ways to circumvent these issues rather than go the traditional, easier way. Push them to try.

Keep us posted!

I would do what his doctors recommend. I think the procedure would be too much for your husband and he does not want it. Good oral mouth care with a gentle mouthwash after meals, perhaps a water pic might be beneficial. Good he is on a soft diet. He should have a consultation with an oral surgeon to see what he/she thinks is best for your dad and have them discuss it with his doctors. Tough decision but the infection can progress and cause serious health issues and a lot of discomfort.

find out from the dentist what they will be using for numbing and then speak with the heart doctor to see if okay. and normally for only 7 teeth he would not have to be put under, just the numbing stuff. can they do 3 one time, then wait a week then do the other 4? each place might be different, but run it past the doctors to see what is best and keep after them until you get an answer as they are the professionals, which none of us are. wishing you and hubby luck.

if he has rotted teeth........get with the doctors and get them removed asap. an infection in the gum area can lead directly to the heart (as I was told by my dentist and doctor)............plus the bad teeth will put that poison thru out the rest of his body.

Please be careful. That’s a lot going on. My uncle was in his late 70s and went to the doc and they pulled out to many teeth at one time and he caught an infection and unfortunately passed away. He was going to get implants. Just get a whole set of false teeth and eat soup chew slowly sometimes we make things to be worse

It’s true u can have the teeth removed but not all at once.

Plus he can’t take all that pressure in one setting.

Check out (POCD) from anesthesia

What about the laughing gas?
I had that after an implant failed and I needed it removed.
Can he tolerate that?

I had 11 teeth pulled in one sitting without anesthesia; with just novocaine, in the dentist's chair, without issue. But, if your DH has dementia/Alzheimer's, I'm sure he would not sit still in the chair for such a procedure.

If it's absolutely required that these teeth be pulled, I'd look into having it done under twilight sleep sedation vs. full-on anesthesia. See what his doctors have to say about that sort of medication, and go from there. Be aware, however, that new dentures take A LOT of getting used to. And, a person with dementia may not be compliant with such a thing. There's also quite a few 'adjustments' necessary for a proper fit with new dentures, where DH will have to tell the assistant where it hurts, where the filing down needs to happen, etc. I don't know how advanced his dementia is, but some level of cooperation and cognizance will be required on his part for a successful end result.

BEST OF LUCK!!!

It was the general anesthesia that provoked my husband into dementia according to his cardiologist. The dentist who removed his teeth for upper dentures did not supply antibiotics. Little did I know then. That was a couple of months before his heart attack.
So when he needed teeth removed last week, he got antibiotics, antibiotic rinse and ibuprofen (also hydrocodone, but that is another story). So far so good.
The local injection of novocaine or whatever it is, is not a general anesthesia, so no dementia worries there.

Get an opinion from his doctors for each particular procedure. Cardiologist work with dentists on a regular basis as tooth infections can cause serious problems with the heart. The strain of the extractions could also affect his heart. Doctors often think only of the organs in their specialty and forget about the other organs. As one of my Dad’s doctors said: “We tend to root for our own organs and forget about the rest.” This is why the primary care doctor is so important as they look at the whole patient, not just the specific organs, and they look at the mental well-being of the patient.