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Wrestling With Difficult Issues

Question:
Dr. Crapo: My mother had a trauma to the head fifteen years ago. Since then her speech has deteriorated to a state that she only can make a grunting sounds when she needs to communicate and then point to make herself understood. She understands everything we say, so we feel grateful for that. The problem is her teeth. She only has two teeth remaining on top and the remaining nine or ten teeth on the lower are decayed off at the gums. She also now complains of pain in the lower teeth, especially on her right side where there is one tooth left standing. We have taken her to several dentists. She’s difficult because she’s in pain, so she needs sedation for any cleaning or inspection. She can’t chew her food, so we’re at a loss of how to help her. One of the dentists suggested the remaining teeth be removed and dentures put in. He did say that at her age – she’s eighty, getting used to dentures will be a challenge. I’m not sure what her tolerance for chewing with false teeth will be like, so we’re very unsure of what to do. She tolerates sedation well, though it’s a bit of a wrestle job to get the line in and going. As her family we want to help her but we just don’t know how to go about it.


Answer:

This is a real challenge! Cooperation is paramount to helping her. If it’s a “wrestle” to get the I.V. started, struggling with a patient is not the way to go, even if you’ve been successful. Oral sedation would be a way to start, so she’s not resistant to the efforts of those administering the I.V. sedation. If she does well with the sedation, the surgery can be accomplished but when lower teeth are decayed to the gumline, the teeth may have to be removed with more complex surgery. Post operatively there is more swelling so the lower denture is unlikely to fit at all.


People in their senior years adapt more slowly to dentures and if she can’t express herself, fitting a lower denture under a sedation may never produce quality results.


The best solution is to fix the lower teeth with implants – then there will be no concern with movement, sore spots so common with a new denture and the awkwardness of chewing. The most important part of the transition is ease at acclimating (getting used to) to the new teeth. Whereas the denture is nigh impossible – the fixed-to-implants-bridge is almost instantaneous. Once the gums have healed, normal eating (with the exception of hard, chewy or sticky foods for 4-6 weeks) is as easy and efficient as natural teeth.


If we can help, we’d like to. Call 250-800-3647 for a free consultation.


This article was originally featured in the Victoria Times Colonist on November 22, 2015.


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