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Nitrous used to always work on my mom, but now it doesn't seem to work. It has become more difficult keeping her calm at the dentist and she has several upcoming appointments for crowns and cavities.

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How important is this dental work? Does she have pain or discomfort?
At some point dental visits are the last thing you should worry about. Especially with any kind of dementia. It's just too hard for the patient to be able to be calm and cooperative for this.

Is there an oral medication your mom uses to help keep her calm? I would use that and skip the nitrous gas, see if she is able to cooperate with just a novacaine injection. She may not be able to do it. If it's a good dentist, and one that knows her, they should be able to make recommendations to accommodate her needs.
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Reply to CaringWifeAZ
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My mom finally just said no more dentists period. Unless she gets a fatal infection we will not be doing any more dentist visits. It's far too much stress on them.
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Reply to JustAnon
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Sorry,I may tend to the cavities but I would not put a person suffering from Dementia thru getting crowns. Why are they needed?
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Reply to JoAnn29
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From Google:

Nitrous oxide
Is generally considered safe and effective for reducing anxiety in dementia patients during dental procedures, but it may fail or cause paradoxical reactions due to age-related brain changes or cognitive impairment. It can cause confusion or agitation in some patients, though it does not typically cause long-term cognitive decline. 

National Institutes of Health (.gov)
 
Potential Reasons for Reduced Effectiveness
Behavioral Resistance: Dementia patients may not understand the mask placement, leading to combativeness, or the sedation level may be insufficient to overcome severe anxiety.
Paradoxical Reaction: Rather than calming, it can sometimes increase agitation or confusion in advanced dementia patients.
Neurological Changes: Age-related brain changes can affect how the brain responds to sedatives.
Metabolic Factors: Vitamin B12 deficiency, which is more common in the elderly, can decrease the effectiveness of nitrous oxide and increase risks. 
National Institutes of Health (.gov)

Considerations for Dementia Patients
Safety: Studies indicate that nitrous oxide does not necessarily increase the risk of dementia progression, though it is not recommended for those with severe vitamin B12 deficiency.
Alternatives: If it is ineffective, dentists might recommend oral sedation or, in severe cases, intravenous (IV) sedation for procedures like extractions.
Dental Care Approach: A "tell-show-do" approach or simply adapting to the patient's anxiety level is often necessary, sometimes preferring to leave cracked teeth alone rather than attempting complex procedures, say AgingCare.com users. 

I myself only took my mother to the dentist for extractions, and while in Memory Care, used the mobile dentist who worked on her in her suite with Novocaine. Nitrous is a diversion only and does not keep pain away. Dental procedures are very stressful for dementia patients and should be kept to a minimum imo. The thought of implants, to me, is sheer insanity.
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Reply to lealonnie1
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I am starting to wonder about dental care in dementia patients. My neighbor who has dementia is being dragged to the dentist for numerous visits of several hours while receiving dental implants. He is very agitated every time he has to go. Is there a point where dental care is too much stress for the patient? I know implants and other dental work are big money makers for the dentists. Are there simpler treatments, such as extractions which would be more comfort care? Just seems I am hearing more and more of complex procedures which seem to be too much for a dementia patient to handle. I am a medical professional who believes in conservative treatment, but am not a dentist.
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Reply to Sandra2424
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