Hi all, I need help figuring out what to do regarding my MIL's teeth. I've been through this before, and asked about it before. It's been years of deciding to wait, then trying something, and it not working, trying something else. And here I am again because it all went to heck.
Background: MIL (87) is very frail, very minimally gets around with a rollator. Lives in an Assisted Living facility. When we take her out to dentist/doctor appointments, we use a wheelchair. She just barely can get in and out of the car from the chair, it's getting super dicey. Can barely get from the wheelchair into a dental chair. She also has moderate dementia, she can handle going to the dentist and following instructions -- for now. That may change in time. Basically, we need to not have to take her in all the time.
The problem: she had a missing tooth on top front, and the tooth beside it broke. Dentist determine a crown for it was better, as there were concerns about her being able to clean a bridge. Before we got to this point, we were kind of like ok, do the bridge anyway, but they said it wasn't a good idea anymore.
So the crown kept falling out. We were in and out of there to have them put it back in. Asked about options again, this time they strongly recommending putting what they called "permanent temporary crowns" on two additional teeth to the right of the one with the crown. Said bonding them together would make it all stronger. So we did it.
The temp version of the three they put in held fine during the time we waited to get in for the "permenant temporary crowns." One day later, it all fell out. And then she lost it. My husband just called, he looked all over her tiny room, can't find it. There's a trashcan next to the recliner she sits in all day, he fears she may have knocked it in there. This is probably $800-$1,200 for those damn things. She is low income, slowly spending her way down to being so broke we have to move her to a medicaid bed in a nursing home. She is NOT on Medicaid yet. So, we need something we can pay for now and it will last, not something that may keep costing us because she loses it.
Now I don't know what to do, even if they make another and put it in, it will obviously be constantly falling out of her mouth. We just can't be taking her in all the time, it's too hard. AND she will probably lose them again. AND the dentist assistant told us, AFTER these were put in, she shouldn't use them to bite down on anything harder than a banana. Forever. I had carefully asked the tech and dentist before we did this about that, they said doing it this way with three bonded should solve that problem. AND the dentist and assistant new she lives in assisted living, and we'd told them no, people will not be cutting her food up into small pieces for her, they don't do that level of care. And she doesn't live with us to do it. And they let us put these crowns in, and after they again tell us we should just cut her food up tiny at every meal.
I don't know what to do. At all. Now, because of what they did, putting crowns on two additional teeth, with them off she has four teeth in the front that are messed up or missing.
We had decided before not to do anything removable, as it could easily be lost. The dentist agreed. What has happened here with her crowns that fell out prove that is exactly what could happen. Well, now maybe we do need to consider getting a removable partial denture (flipper). I don't know, I just feel rather sick and upset about it all.
Does anyone have any suggestions here?
The way I see it, you have 2 choices. Leave her w/o front teeth or have real crowns put on.
Also, find a new dentist.
Good luck. The aggravation never ends, I know. Been there done that.
It still was expensive and she will only wear the upper. I stuck with the “temp” dentures because getting her “permanent” dentures was going to be over $10k, which wasn’t clear to me when we paid for the temp ones, also over $10k. We should have shopped around. There are no good choices at some point and this is why the elderly often end up toothless. Please start by finding a dentist who understands her limitations.
Or should I get the second opinion first, while the teeth are out? The thing is, when I call the dentist who did all this, I suspect they'll want her back in as soon as possible.
I literally feel a little sick and dizzy contemplating this and what to do next, and feel like if I'd made a different decision, it would've been better. But I googled and asked questions and looked into it all, and there were no clear winning answers, so I went with what the supposed professional recommended. I'm assuming putting crowns on those two additional teeth messed them up in a way that they would've been better off left alone.
What's her life expectancy, do you have any idea? Could she live to 97? If ten more years are likely, she's going to need teeth that work as well as possible. I'm saddened by the care home residents I see every day when I visit my husband. Many must eat only pureed food, and the texture isn't appetizing, nor is the taste. Many will not eat, though they could and would if they could eat ordinary food in its ordinary state, like a piece of pizza that they could bite and chew. The cooks puree a pizza, and you can't convince the mostly toothless that it actually is pizza. So they don't eat, they lose weight, and they die toothless or partly so. If only they'd taken care of their teeth, but now it's too late and has affected their overall health.
That's all I can think of at the moment. I'm sorry for all that has happened!
First, a crown is considered a permanent dental "tooth cover" that covers a damaged natural tooth, and is supposed to last 15+ years before needing to be replaced. Crowns don't just "fall out" in one day after they are installed! They do a crown by grinding down the broken natural tooth (still anchored in the jaw) to make a new "cover" for the damaged tooth, that looks and performs like a real tooth. They design a "temp" crown (usually out of plastic) to glue on until her final, real crown (made out of porcelain, cubic zirconia, or dental GOLD) is made at a lab, and sent to the dentist.
When they do new crowns on the two teeth opposite a missing tooth (in the middle), they have the lab build the two crowns, and put a new false tooth in the center, which is called a Permanent Bridge. I've had one done at age 65, and it's lasted for 8 years with no issues. This temp dental "Bridge" fixture is just until the final one is made. A Permanent Bridge stays on forever, why it is called a "Permanent Bridge." Telling you they are concerned she can't "clean the bridge" is ridiculous! You brush it like the rest of your teeth! It doesn't come out, period.
Last, there is no such thing as "Permanent Temporary Crowns." When they are doing a crown, they are grinding off all the damaged natural tooth first, treat it with medicine and glue on a TEMPORARY crown, until the real (permanent) crown arrives from the lab. Then they remove the Temp crown, and put in the new permanent crown, WHICH IS SUPPOSED TO LAST AT LEAST 10-15 YEARS!
To do this wacky front teeth fix they did was ridiculous! If MIL eats any raw veggies (carrots), corn on the cob, hard or chewy candy, nuts, steaks, or anything chewy or crunchy, it could possibly crack the front crown, especially a Temporary crown, which they gave her so she could eat and not go home toothless. Any "temporary" crown is only to get by a week or so, until the real one is made!
Yes, you definitely should NOT have any "removeable" dental work done for her, since dementia patients tend to LOOSE their false teeth. They take them out, forget about them or roll up in a napkin, so there goes $3,000 in the trash.
I'm still confused as to what exactly this dentist did to her to have it "fall out" so easy, or she "can't eat anything harder than a banana?" It sounds like they gave her a piece of plastic junk to put in, and crossed their fingers!
At 87, I don't think I'd invest in more solutions! Find another dentist that knows what he's doing. I wouldn't pay the bill for the "teeth" thing they put in that fell right off either. Tell the dentist to take you to Small Claims if he wants to get paid. The Judge will laugh when he hears "Permanent Temporary Crowns" and you will win.
That dumbass dentist should be ashamed of himself. DON'T PAY HIM and get another dentist. Good luck!
Also, I wonder if they gave her a flipper while waiting for the permanent crowns? You can't bit with flippers really, they are really just cosmetic.
Good luck with this challenging project.
Hygenist will tell you to make a silly loop with the dental floss to clean the healed gum under the false tooth. Seriously? I got a Waterpik Sonic Fusion electric toothbrush that handles it easy. In fact, i have less issues with cavities after getting that thing. It's half sonic toothbrush and half water flosser, super easy to use.
You will love your Permanent Bridge! I got mine for $3,000 instead of a $4,000 single tooth implant. You forget it is even there.
I don't know much about dental work, I've had few dental problems of my own. I've asked like mad online over the course of a few years now about how to solve her dental problems, and at the dentist office. And we'll make a decision, and go with, but then more problems come up. And it sure seems like the dentist should be the one giving me solid advice. I'm concerned how incompetent and scammy dentists can be now, I've gotten shocked to learn how much of that goes on in dentistry. All I know now is I don't know what to do. I'm getting very distressed, depressed and hopeless over this. I mean, it's just one of many things that are incredibly difficult we're dealing with, but this one feels real bad and sickening, it's so important. I guess there's no way to get an answer online, I need someone with very good knowledge of dental issues and my MIL's type issues to go with me to the dentist to help when they throw a curveball of some sort, and I haven't got that and won't be getting that.
She cannot get an empty tooth socket crowned, a crown is a fitting over a bad tooth....one with a root to hold it firmly in the jaw.
At least nowadays, they don't charge for each implant tooth and titanium screw! They install 4 screws on the upper teeth, call it a "4 on Arch" (same for teeth below)
Figure that runs $18,000 per arch (of 15 teeth each) in California.
That's if you don't need a bone graft. Much less time in the chair.
So I know for sure not to go down the road of implants. What I don't know is if some are saying just don't fix this problem, and that you'd then need to yank the 3 teeth fragments, what the heck we would do if she can't really eat with four missing front teeth. I don't know what the heck to do here, but I do know implants are not a good idea. This is just a nightmare.
If we were discussing a molar, I'm sure you would just have it pulled but the front teeth are very key to her face looking normal. She can learn to bite differently on the side when needed if her other teeth are healthy. Many, many seniors have to stop eating things like whole apples and pivot to applesauce or fresh apples that have be pre-cut because of dental work. She won't be alone with that adaptation.
My mom was more concerned about her appearance than anything and I'm convinced that's the main reason she has complied with wearing her upper denture. She also said she would rather die than have her teeth pulled, but she is still here 4 years later.
I'm sorry you are at this point. There are no easy or good answers at some point, just least bad.
Also, they are looking into if the crowns can be remade without doing another cast, have called the place that made them yesterday and no word back. But they also have not said if there would be a charge for this (I asked, no answer), and I'm hoping that if it turns out that it's our best bet at this point, the fact that I'm getting a second opinion won't affect whether or not they give us the remade crowns for free or not. We did have to let them know about the second opinion, because we needed xrays and a treatment plan that were requested by the 2nd dentist.
Anyway, that's where we are.
I really feel for you; dental issues with someone who is elderly and frail can become incredibly stressful.
I wear dentures myself, and one thing I’ve learned is that sometimes the simplest solution is the best one, especially at your MIL’s age and with her mobility and dementia.
If crowns are repeatedly falling out, it may just mean the remaining teeth aren’t strong enough to support them anymore. In someone who is 87 and has difficulty getting to appointments, many dentists will often recommend simpler options that require fewer visits.
A small removable partial denture (sometimes called a flipper) might be the most practical option if appearance is important. It isn’t perfect and it could be lost, but it’s relatively inexpensive and easy to replace if that happens. It also avoids putting more stress on fragile teeth.
Another option some families choose is simply leaving things as they are unless there is pain or infection. Many people do just fine eating softer foods.
I wear dentures myself and I mostly eat softer foods. My blood tests consistently show good nutrition, so eating that way doesn’t necessarily mean someone can’t stay healthy.
At this point, it may help to ask the dentist what the lowest‑maintenance option would be for her situation, given her age, mobility, and dementia. Comfort and minimizing appointments may be more important than trying to restore everything perfectly.
I’m really sorry you’re dealing with this. It sounds like you’ve been trying very hard to do the right thing for her.