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My mother is 89. She has a host of health issues. The dentist wants a lot of money to deal with all her lower teeth. Not only is there the financial factor but I don't know how well she can handle all the treatment. Last week she didn't feel up to going to a check up with the eye doctor. I fear dentures possibly being lost from stories here. He wants to do more permanent work. I just don't know what approach to take with this matter.

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I don't think you have to choose either option, it's surprising how well people can eat with very few teeth or none at all.
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I think this is a case of Less is better.

Dentist wanted to pull all my mom’s teeth at age 86 and have her fitted for dentures. There was no infection or problem at the time other than one broken , jagged tooth. I found her old dentist and he simply ground off the sharp edges on the one tooth. Took 5 minutes.

Mom died just a few months later. I’m so relieved I didn’t put her through all those horrible procedures.
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This depends on whether the person has infected gums which in turn can break free and migrate to the valves in the heart. Then extractions become a priority.
My mom had about 8 decayed lower teeth and developed an infection. She got them pulled out in 2 visits to a dentist.
I definitely understand your dilemma.
Implants imo are excessive at this point. They may not be able to do implants if mom has no bone tough enough to withstand the implant screw.
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needtowashhair Jan 2020
Or to the brain. The bacteria that's common in an oral abscess is found in the brains of people with dementia. It's one of the possible causes of dementia.
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Riverdale I forgot to mention that if your mom's on any blood thinners she should not have teeth pulled. My friend's elderly dad had his tooth pulled (or a root canal -- can't remember which) and staff forgot to ask him (or he forgot to tell them) he was on blood thinners and he had a stroke shortly after.
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Riverdale Jan 2020
Yes she is on blood thinners as well as an arsenal of other medications. I am through with this dentist. All of you here as well as others I know with aging parents say that spending that and putting her through all of that is ridiculous. She gets tired just going for a basic check up with any doctor. She is never without her walker.

I have cousins she is close with who might possibly fault me as they did when I had her placed in AL but they only talk to her and don't see the slow decline. It would be a big hit financially as we are doing our best to preserve money for when her LTC policy expires later this year. But beyond that I truly believe anesthesia and all the appointments would be very physically overwhelming for her. Anyway I do appreciate hearing from all of you.
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Has the dentist reviewed exactly the steps involved in these implants? My friends Mom got them and it was a huge undertaking even having to reinforce some of the bone, and then temporaries implanted. It was painful and took over a year to complete. If it were me, and we’re only talking about the bottom teeth, I would investigate just pulling the bad ones. My Moms roommate eats quite well with just her upper teeth.
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A good dentist should make recommendations based on the situation. What's good for a 20 year old, may not be good for a 90 year old. I respect our dentist for doing exactly that. He could go full bore all the time. Financially, that's what's best for him. He doesn't. He asks first if the person can tolerate a procedure and second if the person can maintain it through oral hygiene. There's little reason to do a root canal to try to save a tooth if it won't be maintained and will need to be pulled anyways. At a certain point, the best thing that can be done is if a serious problem shows up then pull the tooth. Otherwise leave it alone.
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You know what I like to call teeth? God's big mistake. 😂

I signed mother up for the mobile dentist that comes to her Memory Care ALF. Right away they came out without letting me know, took a ton of xrays, and put together a treatment plan that looked like a roadmap for a new highway system, and at a similar cost. They sent me a bill for $400 for the check up, the xrays and the treatment plan.

I called their office number right away, told the gal there must have been a misunderstanding. I did not agree to mother having a check up or xrays, nor was I informed of an upcoming visit. Had I been informed, I would have nixed the visit and saved everyone the aggravation. She removed the charges, I thanked her, and that was that. I went on to let her know I'd be in touch when and if mother has an issue and needed a tooth pulled. That would be the ONLY reason for their visit, because at 93 and with a fear and hatred of sharp instruments, drills and pain of any kind, we'd only be using this service in case of an emergency.

The mobile dentist charges about $100 a pop for pulling a tooth, plus a trip fee, DEAL.

And that's how I'm treating mother's dental issues, if and when they arise. On an as needed basis with no extra torture of any kind. It's a miracle she has ANY teeth left at 93, that's how I look at it.
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Countrymouse Jan 2020
God's big mistake indeed! - Arguably alongside the lamentable decision to limit us to two hands apiece.
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Riverdale, 35 THOUSAND????No way. Even if dentures are lost, you can buy an awful lot of replacements for that amount and never gave anesthesia.

When mthr was diagnosed with 5th stage Alzheimer's, we asked the owner of her memory care about her dental needs. She was going in for surgery to remove a cancer blocking her colon and the surgeon said she would lose hair and possibly teeth because of her fragility. The owner has a doctorate of nursing with geriatric certificate; she said the staff would make sure she brushed and rinsed, but in my shoes, she would not do anything with her teeth unless there was an obvious infection or she had pain. Mthr was not expected to live more than a year or two.

Mthr has lived 8 years, lost several teeth, but faculty doc says that she has no foul smells and everything healed ok. I know it would have been traumatic to take her to a dentist as much as she hated them when she was younger. I know my lack of concern may ruffle feathers, but people have been living without a few teeth for eons.
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Riverdale Jan 2020
Yes we were shocked as this same dentist has chosen to not be agressive for the past few years and now my mother is of course older with more ailments and he is stating this is the best method and she won't like dentures.
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My dad has several broken teeth and the dentist just recommended pulling them. He had to take antibiotics two times for infection and cannot eat any meat except meatloaf or similar. We couldn't see spending a small fortune. I have an elderly relative did have two implants - but the teeth showed and they had no problems with the procedure.
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My dad has top dentures and bottom real teeth. Recently broke tooth off in front row of dentures. I've made appointment but we agreed it would be just as easy for me to bring dentures in office without him.
Last time we went it was so embarrassing because his old dentures were corroded black on plate from lack of soaking and brushing. I can't lead a horse to water, just suggest with the efferdent and glass sitting out.
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I would not do permanent dental work on an 89 year old with age related decline. I would stick to deep cleanings once, preferably twice, a year. Pull any tooth if it's got an abscess and treat the infection with antibiotics. If she can't keep her teeth clean now then that's not going to change if she gets permanent dental work.
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Good answers here already.  You said to Geaton777 that dentist wants to do implants.  In your question you said dentist wants a lot of money to deal with all her lower teeth; implants for all her lower teeth!?  I'd be skeptical of any dentist who wants to do that or any extensive dental work, especially at her age, 89, unless it's medically necessary like an abscess.  Maybe you might consider another dentist for another opinion that offers better options.

She definitely should be checked and ok'd by dr. for any dental work/surgery, like pulling teeth.  It's not unheard of for people to have dental surgery that caused other physical problems. 
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Riverdale Jan 2020
Yes I am going to consider another dentist and speak to the physician who treats her at the AL facility. Today when I took her to the urologist I discussed all the anesthesia that would be involved. She is not in favor of that. And the amount of money the dentist wants is 35,000. I appreciate all the replies.
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I agree with Tohill. If there is an abcess then just pull the tooth. I have gone thru the root canal/crown thing. I think I have a tooth with 3k amount of work done to it. I am with Geaton, may start getting permanent ones. Seems like with every crown I need a root canal.

I like talking to her doctor. Actually the dentist should consult with her doctor getting a complete health background. Early stages of gum desease just need a special cleaning but later the gum has to be cut open and the bone scraped to get rid of deseased bone. I had it done at 34 four different times. Not sure if I would do it at 89.

Dentist are all for saving a tooth. Especially if there is insurance involved.
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Riverdale, I have posted several times about Dad's teeth.

Dad is almost 91. he started to lose teeth around age 85/86, they were either falling out or breaking apart leaving some of the tooth in his gums.

Dad does not have dementia. He has no interest in getting dentures. He still has some teeth, but is missing many. Including front teeth, so he now has a snaggle toothed smile, He does not care.

Dad still prepares his meals and mostly eats canned or frozen goods that are easy to gum/chew with few teeth.

I did strongly encourage Dad to go to the dentist about 4 years ago. He had several of the tooth roots removed from his gums and at the time he had a couple mild abscesses which were treated. I do not think he has been back to the dentist since then.

So our family has accepted Dad's choices and do not stress about his teeth.

Dad does get regular medical check ups.

So going by our experience with Dad, I would only have the dentist deal with any potential infection in her mouth, but not worry about any missing or loose teeth. Dentures are a luxury item that are available to a very small percentage of the worlds population. They are not a necessity.
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Riverdale, yours is a legitimate concern. I'm not sure about the "more permanent work" part -- does the dentist mean implants? This is very, very pricey but then you don't have to ever have dentures but requires pulling out the entire tooth, putting in a metal post and waiting 6 months for it to completely heal and then they put permanent tooth on. It was painful and required a special diet for a week. My 90+ -yr old uncle went this route (this past year) because he had the finances to do it, the health to support it, the mental capacity to understand it and the desire to eat steak ;-) But he is a tough old bird circa WWII vet!

Getting dentures will also require removing the teeth and she must have good bone health underneath in order to be able to support the dentures and keep them in place. If dental issues are not addressed, it can lead to a bone and then systemic infection that can go to her heart. For the reasons above I have decided to replace any teeth with implants so that this never becomes an issue for my family to deal with.

My 90-yr old mom had a root canal earlier this year. They gave her clindamycin antibiotic as is routine. Well, it does not play well with elders and caused significant swelling of her feet and ankles. It took months for the swelling to subside but her legs did eventually go back to normal. The doctor figured this out after all other causes were discounted and we read that this was a known side-effect. Also, you must be wary of anesthesia and the elderly.

In the end no one can give you a clear "right decision" or "wrong decision" answer. You may want to consult her physician to see if she's even physically up for the rigors of dental work. If you do go the denture route make sure you know what can be done if she loses them (or hides them or throws them out). They require hygiene care so also consider this. And, if she has any dementia this may also be a factor in her ability to cooperate in a dental chair for long stretches of time. You may find that you need to choose the "better" of bad options. Others will soon post their knowledge and wisdom on this matter so I'm hoping this will make your choices more clear. Blessings!
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Riverdale Jan 2020
Thank you for such a thorough reply. She certainly has memory issues. I do like the idea of asking the physician. I myself had a terrible situation with osteomylitis because I was not given antibiotics during or after a root canal and then the endodontist tried to save the tooth for over a week. Anyway that is a long story I have shared. However I am 63 and in decent health and am proactive about it. My mother has a host of health issues. Yes he wants to do implants. I will discuss this with her further. Today I have to take her back to the urologist. She isn't able to really make clear decisions. She can discuss issues but has confusion. She can handle clindamycin when she has her teeth cleaned. I can't make a decision right now because my husband is having his prostrate removed next week so my care plate is presently full. I appreciate your reply.
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