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Atlasshrugged: Sedation dentistry should be discussed with his DDS.
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My 95 year young had tooth pain. On inspection, our dentist said she had 8 teeth needing extraction. Having dementia, it was common not not feel pain.
our oral surgeon recommended sedation. I talked to her doctor and she said as long as mom is monitored, it should be ok.
Well afterwards, mom gave a thumbs up! She was on antibiotics for 7 days and pain relief (Tylenol) as needed. She did great, no issues and able to eat regular foods. She still had some molars so chewing was good.
It was pricey, Medicare paid very little. We paid out of pocket, $7000.
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NeedHelpWithMom Feb 6, 2024
$7,000! Wow! Not cheap!

Glad your mom did well.
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I do not have Dementia myslef, but I go to a full sedation dentist for dental surgery. Dementia patients ar a large part of his practice.

There are various levels of sedation. I have only used the full, IV type like you get for other surgery.
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Yes, it was very easy
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Yes, all my dental work is done via sedation.
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It got to the point with my Husband that he was noncompliant at the dentist. I chose not to have dental work done because:
1. He was not showing signs of pain.
2. It would have been a nightmare for me to do wound care in the mouth of a person with dementia that did not understand .."don't bite me"
3. Any work would have had to be done undersedation and I did not want to put him through that. Not just the fact that he would probably have declined further, faster but he would have been more of a fall risk for several days if not weeks after.

If he is not in pain do not worry about it. (if it does bother him there are oral gels that will numb the gum)
If he does begin to show signs of pain or if you do decide to go ahead with dental work have the tooth extracted do not do a root canal and crown it just is not worth it.

All that said if it does become abscessed then extracting the tooth might have to be done.
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If the broken tooth doesn't hurt, why fix it? When my mother had advanced dementia, the only time I got dental help for her was when she was in pain. The anxiety associated with the ordeal was otherwise more than she could handle. We always chose to have the problem teeth extracted with Novocaine. Once with an oral surgeon and we said never again, between the wheelchair, her crying on the car ride, my hubby having to take a day off of work etc.

The other times I called a traveling/mobile dentist to do the extraction in her room at the Memory Care Assisted Living, in her recliner, with an Ativan prior and Novocaine during. No issues, just a big expense. Had I been able to take her out of the building, I would not have hesitated to give her sedation dentistry. The goal with dementia, imo, is to keep them relaxed at any cost.

Good luck to you.
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Worriedspouse Feb 6, 2024
This is very helpful feedback. My husband is has advanced dementia and home-cared. He also bedbound and cannot talk. In other words, he cannot move; he cannot communicate; and he cannot understand instructions. What shall I do for extractions? I guess traveling/mobile dentist is the only way to go.
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Is a root canal being suggested or just a cap? If the tooth is a molar in the back, I would just have it pulled.
I had a cracked tooth and they wanted to do a rootcanal and then cap. Problem was, Dr was not sure if crack had gone to the root if it had it would be pulled. I have been thru root canals and caps and didn't want to go thru it again. Called my dentist and told him I want the tooth pulled, back tooth. He pulled it and got it all out at once but when he placed the tooth on the tray it fell apart in 2 pcs. It had been cracked down to the root.
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First of all, what has been recommended to fix this tooth.
Nextly, Yes. Had very good luck with difficult extraction of curved root wisdom tooth. Very good spiral xrays. Nitrous Oxide used. No pain. Excellent healing. Was recommended to the specialist by my dentist. Had also the choice of more sedation. Nitrous worked great for me, but I was able to "cooperate" in taking deep breaths when asked, and remaining still. Would recommend deeper sedation for someone with dementia. It is still light enough that there is little chance of anesthesia side effects.
Discuss with the dentist.
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NeedHelpWithMom Jan 31, 2024
Oh gosh, I wish that I could tolerate Nitrous Oxide. I felt like I was floating around the room. Very strange experience for me.
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