Dentist visit for dementia and stroke patient?

My mother (96) said "here's a jaw tooth that I don't want any more" as she held out a molar that had broken off at the gum line.

I called the dentist and he said that her roots are probably calcified by now and unless she complained of pain or had any swelling, to leave it alone. I did that and it's been fine for almost a year.

My husband had severe dementia but he could tell me if he was in pain. When he lost 2 caps, his dentist and I decided that as long as he was not in pain, it was best to leave it as it was. At that point, he was not cooperative for even a dental cleaning. As you will often hear on this website - there may be no good options, only a less bad option. (It wasn't too long after that when his body started to shut down - no more walking, gradually stopped eating and then unable to drink. At that point, Hospice took over.) I'll pray that God will help you as you make these hard choices.

My gut reaction is if she is not in pain do not subject her to a dental visit.
She would probably be resistant to any work and she would probably have to have general anesthesia or at least heavy sedation.
This is difficult to recover from anesthesia even the heavy sedation is difficult. And she will be more of a fall risk for several hours if not days after.

Is there pain?
We are told often that anything "left unaddressed" could cause infection, sepsis and death. And this is TRUE. But quite honestly, as this point in her life, she IS going to "go" of something at some point. It becomes a matter of what hill you wish to die upon.

I say this as someone who was worried for her brother as regards his car accident and subsequent dx of probably early Lewy's dementia. He said he wished he had gone in the accident, and to be honest, that is a rational wish in my book.

Yet and all he had a teeny open sore on his shin, and THAT is what took him. He went septic, and was gone within two weeks when antibiotics didn't touch it . He requested the fight stop, and he go home to his lovely ALF with hospice, and be allowed to go. It is what he wanted.
Whether it is a fall that is the beginning of the end, or an illness, or a tooth? At some point, compared to the difficulties of addressing something like dental hygiene with someone, I just kind of throw up my arms.

I personally love nitrous. But even it takes cooperation. They will tell you to take a deep breath to send you a bit deeper. You have to kind of "be there" for it.

Why not call her dentist and discuss. Because I sure don't have the answer you need, and only wish I did.

If a dentist could do a quick peak at the tooth, you might find out if leaving it "as is" could cause pain or lead to an infection. If it needs sealing, the least involved action probably is best.

Thanks all! It's more or less as I feared...no magic wand!
It's hard to tell if she's in pain or not..her pain tolerance is high and she cant really express herself, but I can tell something is wrong...just not sure if it's teeth, something else, or just a general poor condition due to an otherwise lovely winter weather.
I'll make some calls and try to capture one of those "roving" dentists :)
Thanks again.

at least for an initial exam, there are roving dentists who will come to you. If its at home, would she resist a basic exam?

You need to find a dentist who has experience in working with dementia patients and have a discussion. My very elderly Aunt with mod/adv dementia stopped tolerating dental visits. It was hard to see her teeth in that condition but she was still able to talk, eat, chew most foods, etc. She passed 1 month shy of 101.

If your Mom is on Medicaid, this is another challenge: finding a dentist who will accept Medicaid recipiets.

Another question is whether your Mom can physically sit back in the chair far enough for the dentist to actually look into her mouth. My 94-yr old Mom has pretty bad osteoarthritis in her back and can't straighten up any more... she is barely able to be lowered far back enough.

And then, can your Mom tolerate any pain from being in 1 position for any length of time? My MIL with chronic pain from a broken back could only do 30-ish minutes then had to sit up and recover.

We had the same problem with my 93 yo mother in a memory care home. Cap fell out, needed dentist and denture repair. We searched online and found services that would come to the home. Unfortunately, our mother refused to cooperate when the people showed up, but that is just a symptom of her dementia. Look online and see if you can find similar services.

My mom was at stage 5 Alzheimers when she needed to have a tooth extracted. The dentist we used was recommended from our palliative care agency and was wonderful. He had a great deal of experience working on patients with dementia, as well as swallowing issues. We actually had two appointments. The first was so that he could spend 30 minutes with my mom to ascertain her level of cognition and to evaluate how to work on the extraction. At the 2nd visit, in view of her inability to swallow, he had the equipment that positioned my mother to face somewhat downward, while he worked at her side and under her. This hugely facilitated her not gagging on her saliva. He also let me hold her hand and be a soothing voice in the room while he worked on her. With plenty of numbing and mild sedation, he was not only able to extract the tooth but replace it well. The whole procedure took 20 minutes. Although mom was agitated, it was the best I could do to alleviate the excruciating pain she was enduring. Please see if you can contact your local or state dentistry association and inquiry as to dentists that have experience working with dementia patients in your area.