Implants and Dementia
Question
Dear Dr. Crapo: Over my lifetime I’ve had a good deal of work on my teeth. I’ve lost a number of teeth to one thing or another but nothing disfiguring. About three weeks ago I visited the dentist and he discovered a lot of decay. I had a lot of x-rays and molds were made of my teeth. I went back and discovered that my condition was worse than I thought. After a good discussion, the dentist suggested I bring my husband back to go over the options. On the second consultation, my husband told the dentist that I had been diagnosed with a form of dementia, which is true. There are times that I am very lucid but other times when I’m quite forgetful. At this appointment, the dentist suggested a couple of treatment plans. One had me root canaling and crowning most of the teeth, in fact all the teeth that could be saved. He said this could be done and then implants put in where the non-salvageable ones were right now. He said dentures were an option but my palate wasn’t a good shape for having them and the lower denture is never a good idea – my husband has upper and lowers and never wears the lower one at home. He said I could also have my teeth out and get implants that hold in the dentures. He thought in the long run, that might be best. It’s hard to think of losing my teeth so I’m just working this out in my mind. What would you do?
Answer:
When decay is rampant, teeth can still be saved if they are treated appropriately (yes root canals and crowns may be the answer). This plan requires a high level of home care i.e. excellent flossing and brushing. In some cases, very specialized home care products are mandatory to get everything clean throughout the day, every day. Dentures are difficult to habituate oneself to in senior years. When you couple that with poor anatomy in the mouth, you may feel crippled in your ability to chew your food and easily carry on a conversation because the dentures will move around and make function uncertain. Lastly, it seems to me that rampant decay, coupled with times of forgetfulness, mandate a solution where decay is not a problem and caring for dentures that may be misplaced regularly or lost, is not possible. I’m saying that teeth fixed to implants in your mouth, giving you good function, is the best solution. Yes, you will still have to see the hygienist often but your chewing ability, your speaking ability and quality of life, will ultimately be better.
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Based on actual patient cases