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Routine dental appointments are becoming a nightmare for my elderly FIL. The office isn't wheelchair accessible and is risky for us to get him in a chair. The exams themselves exhaust him. Plus his dementia is just bad enough that he can't manage any kind of post dental care, and parkinson's is affecting his ability to swallow. Does anyone have suggestions?

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I took my husband who had frontotemporal degeneration and in long-term care to our dentist of many years for as long as possible. He had a "Joy for All" plush cat that responded to built-in sensors by purring, turning head, meowing, and even turning over for a belly rub. Our dentist and hygienist let me accompany my husband into the exam room and he could keep the cat on his lap. Oral care (and not needing to pull teeth) is so important. The long-term care center had a dentist visit periodically, but his exams were so cursory as to do little or no good.
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As others say, skip the DDS appointments.
See if you can find a DDS to come to the house (google 'DDS house calls' in your area)
* Call a DDS school ...
- Would be a good experience for a DDS student to do (come to the house). ...
- And DDS schools 'should' include this option in their teaching / training programs - as baby boomers continue to age, there will be more need for 'house calls' - every institution / business / organization needs (will need) to adapt to our country's aging population.

You want to prevent infection.
Losing his teeth is secondary.

Gena / Touch Matters
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Kelanor: Perhaps someone (not a dental professional) can at least clean his mouth with a water pik appliance.
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Skip the dental appointments.
My Husband was non compliant with his dental appointments.
Any dental work would have resulted in open wounds in his mouth that would have been impossible to care for.
Any dental work would have necessitated anesthesia and that would have been a nightmare itself.
Even a medication to calm him would have been impossible for me to manage him, he would have been a fall risk, I would not have been able to safely get him back into the house.
And the decline after any sedation would have been bad.
Since he was sticking pretty much to soft foods, pureed or thickened liquids chewing was not a problem.
I still did oral care and watched for any spots that might have been a problem. I figured if there were sore area I would have dealt with them with numbing or "teething" ointments.
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You may want to see if "360care" if available in your area. The licensed dentist comes to your home or the facility to see your loved one.
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My mom at 97 with dementia does a rather poor job of brushing her teeth. I think her regular cleanings help keep her teeth reasonably healthy (though she has 5 teeth they tell me they would remove in a younger patient). For us, the visits are not difficult to manage, the office is close and convenient and she tolerates the procedures well. You must judge the benefits vs the stresses in your own situation.
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I think if he can not handle it I would skip the routine appts. If any pain then a dental visit..Personally even at 72 I find dental visits too long and too many xrays etc. They have made it way too complicated for dementia patients..
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swmckeown76 Apr 2023
So sorry to hear that. I'm a few years younger than you, but have a friend close to 80 that still keeps her dental appointments. Losing teeth is disfiguring and can lead to eating difficulties. I'll keep going to the dentist until I die.
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Check out ARIA dental partners.
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I tend to agree with others here. If you can at least get his teeth brushed, unless there is something painful in his mouth, I’d skip the dentist.

Since he’s 94 yrs old, unless he’s in pain, I wouldn’t put him through the stress of a dental visit.
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I have a similar situation with my husband. It is very difficult to get him to the dentist (in/out of car) and then in the dentist chair. It is not safe and very exhausting for him. So, I started brushing and flossing his teeth myself to insure I was looking in his mouth. He can use his right hand. He brushes his own teeth twice a day and I do it the third time and floss. I have yet to find a mobile dentist in my area so this is my only way to insure his teeth and mouth stay clean and gives me the opportunity to see if anything is going on in his mouth. Good luck.
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Is it possible to at least find a different dentist whose office is wheelchair accessible? That would be one frustration off your list? Perhaps call some other dentists in your area, explain your situation and see if they have the ability to better accommodate your FIL’s special needs. With dementia he can’t be expected to remember the aftercare. His caregiver would have to do that for him.
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I was able to find a dentist that would come to our home and his services were covered by Medicare! Look into this in your area. Good luck!
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my mom just passed away last month at 91 and i took her to dentist 4x per year but last year she became too weak and the dentist agreed that as long as we were practicing good dental hygeine at home, it wasnt critical - with that said in NYC there is a Home Visit Dental clinic that i found but it was highway robbery ie $850 for a cleaning at home! Dental care is important since you can get infections etc ...
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i have a 96 year old mom who needs lots of dental work (cavaties/teeth pulled). I came on this forum for advice as she has dementia and I have the same issues as yourself. The wonderful people on the forum told me not to take her unless she has a real issue...so I am backing off.

However, at our assisted living the director is looking into a mobile dental office that does routine things and pulls teeth. That would be a godsend for me. Perhaps there is something like that out your way too!

Good luck. We all try to do our best for our family, and sometimes you have to know when to let certain things go.

I am sorry!!!
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swmckeown76 Apr 2023
Why would you pull teeth unless they can be replaced w/dental implants or crowns? Sounds barbaric and ageist.
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I wouldn’t put him through all that/ the fear he experiences there w the dementia along with the physical strain ant discomfort it’s a care where any “cure” is 10 times worse than the possible ailment
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At his age, why put him through these appointments? Instead I would just wait if he has any issues down the road and address them then.
If he is having trouble swallowing, the water and teeth polish that is used could easily go into his lungs, instead of his stomach and cause aspiration pneumonia and that can be very deadly.
I'm hoping that he is now just on either a pureed or soft food diet and that his drinks are being thickened with a product like Thick It, since he's having swallowing issues.
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Igloocar Apr 2023
Just a probable point of fact. My dental hygienist does the polishing primarily because I want to have it. The scaling is much more important in terms of health care. There are plenty of reasons for him not to have his teeth cleaned, but if cleaning is decided upon, it could be only scaling/going between teeth with the scaling tool/flossing. That being said, I suspect the dentist would know whether or not polishing is actually dangerous for him. I would imagine having patients with swallowing deficits is not an uncommon problem.
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From what I have read, researched and experienced there is no reason for dental visits unless there is pain or infection.

The swallowing issue from his Parkinson's needs to be addressed with his neurologist. Maybe a medication can help.
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Thank you all so much. We are able to assist him with brushing and flossing so fortunately his teeth are in decent (for 94) condition.

Hospice care is likely eminent soon, he has had three extended hospitalizations in less than a year and we just want his last time to be as calm as possible for him
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squirrel13 Apr 2023
Well then, there is no need for a dentist. You didn't mention he had assistance with brushing and flossing already and his teeth are in decent condition for 94. My mother is 92, brushes her teeth, but no longer flosses. She will see a dentist only if she has any problems. I do pray your loved one passes on in peace and good care.
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I don't know but that, without any signs of dental pain, you need to get him in for exams very frequently at all.
I think were I you I would discuss with his dentist.

The swallow problem should be taken care of by those nifty suckers, but I sure understand the rest of it At some point, with little decay happening in latter years, you have only gum disease to worry over, and at his age it is unlikely to be a problem.

Isn't it a shame there isn't a visiting dentist, one to just take a look without xays, and talk to seniors? But that I know of there isn't such a thing. Yet.
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Routine cleanings prevent gum disease. I have had my gums cut so the bone could be scraped. The bacteria that causes gum disease eats the bone away. Thats what causes the loss of teeth. And the bad breath it causes only goes away when the gum disease its taken care of. Your breath smells like rotten eggs and no amount of brushing or mouth wash helps. I went for 5 yrs without cleanings and I brushed 2x a day.

For your FIL, I would not worry. Get those sponges on a stick with toothpaste in them. At least he will get brushed.

https://www.amazon.com/ZIZNBA-Disposable-Unflavored-Sponge-Swabs%EF%BC%8CTooth/dp/B077W223MF/ref=asc_df_B077W223MF/?tag=hyprod-20&linkCode=df0&hvadid=241948599983&hvpos=&hvnetw=g&hvrand=11867037612623266493&hvpone=&hvptwo=&hvqmt=&hvdev=t&hvdvcmdl=&hvlocint=&hvlocphy=9003829&hvtargid=pla-406776595429&psc=1
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Mrsd123 Apr 2023
SPONGES on a stick! I never heard of them, but have now ordered them for my 94 yr old aunt with dementia in ALF. Thank you!
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"Routine" suggests preventative, so maybe these appointments can indeed be skipped. My mother is years younger than your FIL and decided on her own that she no longer wants routine cleanings. Her dentist doesn't hassle her about this. He does see her when stuff happens, like when a crown falls off. 

Recently he referred her for an extraction. Same issue as you at the dental surgeon's office: it was if they'd never encountered an elderly person before (which is so confusing, because I would assume that older people often need extractions?). 

Anyway, the prep for the extraction made her very dizzy and she fell, ended up in the hospital for a night, and never fully recovered from that episode (and never had the extraction).

Now I cook everything until it is mushy and that seems to be okay (for now).
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Exactly what Dolly said. He's 94 skip the dental treatments all together.

I think it's hard for people to stop taking parents for things like eye doctor appointments or dentist visits when they have dementia or a terminal illness because it can feel like they are giving up on them.

But I like to think of it as not giving up but accepting where they are at in their disease and pivoting accordingly.

I tried to suggest to my parents that at 80 maybe dad didn't need to do the routine colonoscopy anymore. They were appalled at not doing preventative tests so I backed off because they are still in good health and active.

Yet both agree they probably wouldn't do chemo if they had colon cancer. I did get them to agree that if mom or dad had dementia they wouldnt be taking each other for a colonoscopy.
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MJ1929 Apr 2023
I'm surprised a doctor would do a colonoscopy on an 80-year-old. Seventy-five is about the oldest they're supposed to go, because thinning skin makes a colonoscopy more dangerous than useful.
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All I can say is Why? At 94 is this really necessary?

No matter how you cut it, he is at the final term of his life, why upset him? Let him be.

My mother is 98, losing some teeth, she has most of her mindset, she is not interested in doing anything. She says "I don't need a full set of teeth when I die". I agree!
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