My 85 yr. old mom with dementia has an abscess under an old root canal, can it be drained instead of removed? I am nervous about the risks.

Years ago, I was put under to have impacted wisdom teeth removed. It’s the easiest way for difficult removal.

When I went for my follow up appointment, my oral surgeon said, “Did you finish your antibiotics?” I said, ‘What antibiotics?’

The surgical procedure was done well but he forgot to prescribe the antibiotics.

So, my surgeon says, “Oh no! Didn’t I prescribe those for you?” I said, ‘Nope!’ He checked to see if I had an infection due to not being given antibiotics and fortunately I didn’t.

Hopefully, you won’t have a forgetful surgeon!

I hurt so badly after the surgery and was so swollen. I had no appetite and couldn’t eat. I was told not to drink through a straw but I can’t remember why.

I hate taking pain pills because they upset my stomach. I finally relented and took something for the pain but because I had an empty stomach my stomach was upset even more.

I ended up drinking chicken broth to get something in my stomach. I am not good about eating if I feel funky.

No fun having dental surgery!

As a Registered Dental Hygienist for over 50 years, I would recommend Nitrous Oxide( laughing gas) for the extraction. It only takes minutes to administer through a nose piece , prior to the procedure and 5 minutes after in which oxygen is given to clear the lungs.It relaxes the patient and is totally safe. I would check with her Dr. to make sure it would be safe for your Mother.Unfortunatley, draining will not treat the abscess, it will only come back. She will probably need an antibiotic prior to the surgery. I would request to be with her during the procedure ! Good luck and hope she does well!

MommaDina: Pose your question to your endodontist; however, if the tooth cannot be salvaged, to your oral surgeon.

Yes, I would put her under. with all appropriate monitoring with sedation. Probably oral surgeon. Get everything done that needs done at one time. Not just the extraction. Cleaning and any other restorations. Get is all done at once. It will cost some money but hopefully avoid problems for many months if not years down the line. . make sure to tell the about the dementia and need to get Everything taken care of while sedated. And tell them of the concerns as a caregiver so they don't think this is just like anyone else who is fully functional. you need their support.

If there is a dental school nearby, they might have a program for people w/dementia. It's up to you, but I'd do everything possible to preserve the tooth. I'm nowhere near her age and in excellent health, but I have crowns over the two root canals I've had.

My late mother at age 93 had several infected teeth because dental caries was neglected for several years because she did not like dentists. She had a heart condition and could not take sedation for oral surgery that may have killed her. Only local Novocain for comfort was used for extraction(s) to ease discomfort as needed.

Find an oral surgeon. Difficult extractions are what they are skilled in. Prior to the procedure, contact the surgeon and explain your mother’s dementia, and can you be in the room with her. Sedation sounds like a good idea.

Good Afternoon,

These things are tricky but I would consult with an Oral Surgeon.

A similar situation happened late last week, mother broke a tooth during dinner at the independent living. Due to age, A-fib and also on a blood thinner as well as Dementia (86-years-old) I found an "in-network" dentist/Oral Surgeon who extracts teeth (under sedation) at the hospital.

It's a tough call since you can't let these things go and you have to know what insurance will and will not cover. The placement of my mother's tooth is no easy feat to remove the remaining part but with Dementia my mother's is antsy to begin with and can't sit long. The dentist is fine for cleanings, etc. but I opted for an "Oral Surgeon" that is covered under my mother's insurance.

I also accompany my mother to the dentist and wait inside the room; but for an extraction I waited outside the office but always remain on the premises while mother was sedated.

We can share what works for us but consult your mother's primary care and perhaps an oral surgeon with regards to your mother's limitations. I know it's hard these things need to be thought out since I don't want anything to go wrong.

Also, with Dementia make sure your mother's ears are cleaned out for all the wax build up especially if she wears hearing aids.

All the questions you are asking should be directed to her
primary care medical doctor i.e. Internist and any specialists she has on her care team… DENTAL HEALTH is very closely connected to heart health. So the concerns are weighing
treating the infection vs extraction, probably necessitating
mild pain killer possibly just for the region. Do necessary
prep work FIRST with her care team & ask for appointment on an emergency basis if the abscess is ALSO painful 🙆

My husband 77 , w moderate dementia and Parkinson’s and 2 abscessed teeth , had them removed with Novocain at dentists office. No pain what so ever. Infection can cause worsening of dementia symptoms and multiple other issues. Please have her doctor prescribe something to calm her before procedure, imo sedation would be last resort. Discuss all this with PCP and dentist. Weigh risk / benefit.
good luck .

I had an abcessed tooth & 8 shots of Novacaine still didn’t numb the pain to extract it. I had to go back the following day to be put under sedation.

Have her put under sedation so she doesn’t feel any pain……it’ll also be easier on her & the dentist if she’s under sedation

I have an 80 year old family member that required several extractions. Several of the teeth shattered during the procedure.

He said he would not wish that pain on his worst enemy. In retrospect he should have been sedated for the procedure. It truly traumatized him.

good luck.

Personally I wouldnt put her under. But, if the doc recommends it, do it. Either way, that abscess will cause a substantial amount of danger to her health if it is not taken care of immediately. Wish you both well.

With an abcess, it drains once the tooth is pulled and antibiotics should be given.

Well I answered this hours ago and commented that this was a duplicate.
So here I go again with my response since the first one seems to have disappeared.
I doubt that the dentist/oral surgeon will allow you to be with your mom during the procedure.
ANY sedation will have an effect on the dementia and it may take days, weeks, months to get back to her "baseline"
If the tooth is pulled how well will she do at leaving the oral wound alone while it heals?
Will she allow you to tend to it?
If the infection is taken care of and she is not in pain is that an option rather than putting her through the surgery.
With dementia there is a constant weighing of care when it comes to the "Benefit VS Burden"

Yes. You should have your mother put under so the abscess can be properly dealt with. They can give her some sedation while you are with her before she's taken in also.

She may feel alone and scared for a few minutes until the drugs take effect. Then she'll be fine. Get that abscess taken care of because your mother is probably in a world of pain from it.

I had an abscessed tooth once and there is no pain like it.

My mother had molars pulled at the oral surgeons office at 92 years old with just Novocaine, and with moderate dementia at play. She was fine. The reason you're taking her to an oral surgeon in the first place is because s/he has the experience to extract such a tooth safely and w/o pain to your mom. The main thing is to have her on antibiotics for at least a week beforehand to get that abscess under control before the tooth is pulled, thus reducing any excess pain associated with the extraction. Root canals only last so long, then the tooth is toast.

Mom also had the mobile dentist come to her room in Memory Care Assisted Living to extract a tooth with Novocaine, in her recliner, and stitches put in her gum, all without pain or incident. I did have her take an Ativan before each dentist appointment.

Good luck to you.

The root canal went bad. Just get it pulled. A oral surgeon should be able to give her a local and pull it inva few minutes. I had two wisdoms pulled in 15 min. One was impacted.

I would not put and elderly person under especially if already suffering from Dementia.

This is a tough one. I would follow the advice of the oral surgeon. The tooth needs to come out for sure, fragments and all. I don't know he will risk putting her out in office but I would let you know anything can happen to anyone and her age and debility makes his more risky from standpoint of any sedation. I had nitrous (laughing gas) and it went VERY HAPPILY for me. I wasn't out and could cooperate but I can tell you right now I was in heaven and they could have done anything to me and I wouldn't have cared. And sure wouldn't have needed you in the room. It is also something they can withdraw if monitoring shows any risk, almost at once. Discuss with the dental surgeon as an option.

So sorry. My brother, 85, died of a sepsis from a scratch on his shin that didn't heal and that he kept putting ointment on and kept hidden. So there you go. At this age, expect the unexpected, and on you go the best you can, but this infection surely WILL KILL if not addressed.

You can't be in the room. The last thing they need is more germs and an anxious family member. So that's that. There are times in life "we can't be in the room". And we just accept that and worry. The waiting room is what I always call "the worst room in the house".

Good luck. Hope you will tell us how it goes.

Yes, for her sake, let them put her under.

IF your mom is really anxious, ask the dentist to please allow you to accompany her back to the procedure room. Then once they get her sedated, you can leave.

my mother hated to go to the dentist... And if this dentist is stating that it is going to be painful... yes have them put her under

Duplicate question.