My 90 year old mothers teeth are rotting out of her head and refuses to go to the dentist. Any suggestions to get her to go?
Her diet is horrible; she basically eats sweets/baked goods all the time. In the last few months three of her front teeth have broken off. I suspect that they are full of cavities and that’s why they’re breaking off.
She is willing to go to all of her other doctor appointments without too much reluctance, she’s scheduled for cataract surgery in March, she has congestive heart failure that requires her to have a cardiologist visit every 6 months, etc. But she refuses to go to the dentist.
I called her dentist, it’s been going on 3 years since her last visit, they are adamant about getting her in, but she won’t budge.
Is it vanity/embarrassment, or is it a sign of early dementia? I’m looking to change her primary care physician, as she never seems to discover any of the real problems when my mother visits.
My biggest fear is that her gums may become infected.
Is there a way to force someone to go to the dentist?
Thanks for any suggestions.
35 Answers
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Does your mom brush her teeth? I think my mom would only go to the dentist if her teeth hurt her, which they don't. So I feel your pain.
You're between a rock and a hard place, though, aren't you: the dentist won't do a home visit, your mother won't set foot inside his premises. I imagine the dentist's view is that he can't treat your mother adequately at home; while hers perhaps is that she would be entering a world of pain, fear and possibly shame. Was she ever good about going?
The only thing I can think of is asking her doctors - ideally the cardiologist but whichever she trusts most will do - to read her the Riot Act and get heavy about the additional serious risk she's running because of her frail health. If she gets abscesses she's going to be in big, big trouble.
Can you scare her into agreeing just to a check up, hold any treatment for now? - And make sure the dentist understands that he must on no account hurt or frighten her. Good luck!
Sounds like you have a good plan to get the cardiologist involved.
If you are changing her primary doc, I urge you to consider a geriatrician.
Ruggles, tell the cataract man to take a hike. He's in it for the money if he ignored all those warning signs.
It is possible for cataracts to gather speed and worsen rapidly; but if there's a field of vision that's gone awry I agree with PS, I'd be wondering too. If she's leaving the letters off both end of the line, there is something very wrong going on and it could be brain, or it could still be eye - but this needs to be assessed by an ophthalmologist, not a surgeon, let alone a high street technician. There are all kinds of degeneration that could be causing it.
Have you noticed any behavioural or mood changes in your mother? Chronic CHF, I'm afraid, over time does tend to damage brain function. With my mother it was very subtle for a long time before she had a minor stroke in February, 17 years after the CHF first presented. Try keeping a record for a while, it might make small differences easier to spot; and maybe ask if an MRI would be a good idea (unless she's got a pacemaker?).
Anyway, let's hope she won't have to put up with toothache as well for much longer! Best of luck x
The other rip-off is denture fixatives. I got excited about an advertisement for them and asked mother's dentist. She told me very firmly that as my mother had invested in a very good plate, it fitted her properly, would not deform, and required no glue. With dentures, it seems to be one of those purchasing decisions where you really do get what you pay for.
She was experiencing an episode of atrial fibrillation during her visit; so he added digoxin to her drug cocktail, and then said she’s doing really well. Okay, whatever. He also insisted that she goes through with the cataract surgery, and that it shouldn’t be dangerous for her and will improve her QOL. I agree, QOL is very important at this stage of the game. He did think it was a good idea to switch her primary care physician to a geriatrician, and he gave me a name of one in the same town.
The next stop was the arthritis specialist. He suspects that she has inflammatory arthritis in her right hip. Oddly enough, my mother never mentioned any hip pain before, lots of complaints about her shoulder, hand, and knee, but never, ever, a mention of her hip having pain. A hip arthritis diagnosis would explain a lot about her condition, as she has a hard time standing from a seated position, and she walks very slowly. She also refuses to sleep laying down –which I thought was more related to her CHF, and the possibility that she can’t breath while lying down.
Is it possible that she just doesn’t understand her own body? She’s not particularly articulate, but she doesn’t seem to be able to communicate very well. Sometimes it feels like she’s playing a game, and doesn’t want anyone to really know how she feels.
I then brought her to get the x-rays of her joints. I normally stay by her side at all of her procedures, but I figured I couldn’t be in the x-ray room, so I stayed in the waiting room. The technician came out after a few minutes and asked me to help her get my mother on her side on the table, as she said she was refusing to move into this position. I went into the room and my mother was hysterical, screaming like a child that she was afraid she was going to fall off the table, and that she couldn’t stand the pain. She was totally rigid and wouldn’t bend any of her limbs. With the help of two other attendants, and by showing her how to hold onto the edge of the table, we were able to slowly turn my mother onto her side, although she continued to wail.
After the final x-ray was taken, we sat my mother up, and helped to get her to her feet; she quickly calmed down. By the time we got home, about 10 minutes later, she never mentioned what happened again.
I want to talk to her about it, but I don’t want her to have to relive what seemed like a truly terrifying experience for her. Her doctors don’t think she shows any sign of dementia, but her behavior in that room has me really puzzled.
The technician had probably done something dumb like manhandling your mother without realising that she was hurting her. I know these people are busy and have a long patient list to get through, but I still wish they'd take just a couple of seconds to think what they're doing. Frail little old ladies hurt all over and get frightened. Do they not learn? Your poor mother. We've had similar problems with a blood pressure cuff that had a fold of skin caught in it (and the **!@! idiot nurse couldn't understand why my mother yelled her head off when it inflated), a cardiac physiologist who actually left her bruised after an echocardiogram (I reported it); and the worst incident I've seen was when two ambulance drivers came to transfer my 95 year old great aunt from one hospital to another. It was the end of their shift, they were in a hurry, but when they moved to haul her up from her chair without warning I said "hey!" and put my hand on her shoulder. They looked a bit shame-faced and started again; but if I hadn't happened to be there? She was recovering from a fractured pelvis, they'd really have hurt her just by being in too much of a rush.
It sounds to me as if your mother had a bit of a panic attack in the x-ray room; and I think it's understandable. Leave it a couple of days and then bring it up gently: "goodness, that x-ray wasn't any fun, was it..?" - kind of thing.
Whatever you do, don't clap your hands and say "Well if you think that was bad just wait 'til we get to the dentist..!" - lol. Any luck with that?
A panic attack would explain my mother's behavior, as it was extremely OTT.
The x-ray technician said to her in an authoritative, but not sadistic, way, "I know this hurts, but you’ve got to do this so we can get a picture of your hip; that’s what you’re here for.”
The good thing is, the x-rays are done.
I speak to her rheumatologist on Tuesday about the x-rays and blood tests.
I guess I need to do a little work on detaching myself from the situation so I don’t slide down a rabbit hole.
Have a great weekend!
Having difficulty rising has more to do with the weak knee than the hip.
How ever bad the x-ray looks don't consider surgery unless it is very painful. Hip surgery is very hard on the body as there is a lot of blood loss, knees they can tourniquet. Does she have OA or RA? R/A is inflammatory O/A is plain old wear and tear. There are treatments for R/A other than surgery to reduce the inflammation.
You also say she is on multiple drugs and the cardiologist just added Digoxin. Did he also tell you to check her pulse before she takes a dose. The usual recommendation is to with hold the dose if the pulse is less than 60. if it's too low she may pass out.
Does her A Fib come and go ie is her pulse regular at times and at others fast and/or all over the place difficult to count.
As my infirmatys progress drugs are changed and discontinued and I get some side effects.
I made myself a chart with the list of drugs down one side and then I looked up the side effects for each and for each drug listed the side effect I could recognize across the top. When I had finished I was able to see which drugs had many side effects in common and understand better what was happening and question the need for the worst medications. You also need to note the interactions so you don't give the wrong things together. I know this is a lot if you don't have a medical background
Many drugs your mother is probably taking may contribute to her weakness/dizzynes so it really helps to be aware.
Now to the dentist. do you think he would be willing to call her and invite her in. He can tell he already knows how bad her teeth are and how painful they must be and wants to help. Dental infections are definitely a risk to all hearts healthy or not. Sedation or anesthesia will allow him to get the job done quickly with fewer visits. He may want her to be on an antibiotic for a few days before he starts.
As far as the x-ray experience is concerned I would be inclined not to mention it unless she does. If she needs more then is the time to tell her you will be in the room and make sure they don't hurt her again. There is no reason you can't be at her side and help position You just need to go out while the film is taken - a few seconds. As was suggested get another opinion about the cateracts, they can indeed progress very quickly but only go ahead if she really wants it and you really feel it will improve her quality of life.
Resist any further investigations unless you are sure you want to treat the condition that is uncovered. Remember old people are great money makers.
if a colonoscopy was recommended would you put your mother through that and proceed with bowel surgery and a possible colostomy. I wouldn't I would call Hospice ASAP. I know people want their parents to live for ever but do they want them to suffer forever too?
Of course what she said was true, but there are ways and ways of helping the patient get into the right position. I just wish they'd take a little extra time and a lot more trouble to go gently with elderly people.
Veronica, asking the dentist to make her feel like an important patient - "He was so worried about me he called specially!" - and reassure her about her visit is a BRILLIANT idea. Hope the dentist will play ball: he'd have new patients queuing round the block, well worth his trouble!
Veronica, I agree that at 90 years old, and in the advanced stages of CHF, opening up more cans of worms is probably just going to make her last years more miserable.
I like your suggestion about the dentist, will mention it to him when I call next week.
She actually wants to do the cataract surgery, and she got the referral for the appointment with the rheumatologist from her PCP on her own.
Over the years I’ve noticed she likes to cherry pick the things she wants to have done, she had this pre-cancerous growth on her forehead that she wouldn’t agree to have removed. I forced her to have it removed, which improved her appearance so much, and prevented another possible health issue.
It must have also made her feel a little bit more self-confident.