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"I am caring for my mother Betty, who is 97 years old, living in independent living with age-related decline, alzheimer's / dementia, anxiety, depression, incontinence, mobility problems, osteoporosis, sleep disorder, and urinary tract infection."

How do you know she needs a cavity filled? Did she go to the dentist? Did it fall out? Is she in pain?

If she's in pain, I think this is the guiding symptom that decides next steps. Does she willingly take medication?

More info would be helpful for most appropriate suggestions for you.
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Reply to Geaton777
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I'm a firm believer in not doing anymore than has to absolutely be done when dealing with someone near the end of their life and with many health issues like your mom.
Are these teeth bothering her? If not let her be. And if they're bothering her perhaps some Tylenol or Orgel can be used.
With your mom having dementia she will more than likely not understand what is being done, even though I'm sure the dentist could sedate her, but it could be quite traumatic for her.
I think you must now weigh the pros verses the cons, and do what is in the best interest of your mom.
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Reply to funkygrandma59
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I'd talk to your dental hygienist and see what they say.

I talked with my dental hygienist and she was very helpful to me in some situations with Mom.
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Reply to brandee
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So you are still taking Mom to the dentist, as it is likely he/she is the one who told you these cavities need to be filled?
I think, given what you told us of your mom's overall health in your profile, I would not take mom to the dentist unless she is in pain. IF she is in pain, a shot of novocaine and a filling should be minor compared to tooth pain.

All in all this is something to discuss with the expert! That's your dentist.
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Reply to AlvaDeer
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My mother is 99, there is no way I would have any cavities filled, why?

No, she won't have the best set of teeth in the graveyard but that is ok with her and me both.

I do not believe in doing anything further with her unless she is in pain, which she is not, so I would not have any dental work done on her,
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Reply to MeDolly
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Katherine1953 18 hours ago
Agreed. If a person is elderly with no dementia, it is a different story. But dementia patients should not be put through anything that will be painful or unnecessary. My LO was diagnosed 12 years ago. He had some dark lesions on his face that his doctor tried to treat in the office but when he flinched, the doctor decided to leave them alone. He said “ we are not going to torture him “. His doctor also said he will not ever have another colonoscopy.
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If the cavities are painful and must be filled or pulled, sedation dentistry is a good option.
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Reply to lealonnie1
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Unless those cavities are causing pain, I would not worry about them. I would not put someone suffering from a Dementia thru this.
My cousin was called about his Mom, who suffered from ALZ and was at least in her mid 80s, about needed some caps. He said no.
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Reply to JoAnn29
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"geriatric dentistry" is a thing--maybe see if available in your area?
I 100% agree with other replies about dealing only with teeth that cause pain.
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Reply to AndSoItGoes
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If she is not in pain.
If her chewing/eating is not being effected.
I would not worry about having dental work done.
If she let's you there are products for temporary fillings that you can try.
Help her with dental hygiene as best you can. Brushing teeth (non fluoride toothpaste) you can even brush with mouthwash. When you brush her teeth make sure you run a brush or swab high along the gums both top and bottom to clear any "pocketed" food.
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Reply to Grandma1954
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onlyavisitor 22 hours ago
Why do you say toothpaste should not have fluoride? I am 76 and my dentist recommended Sensodyne for me. It has more fluoride than Crest or Colgate.
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Be careful. The dentist may want to make some money. As long as she is not in pain, let it go. I myself am 83, and I have one molar that has a huge cavity. The dentist recommended I either have it extracted or have a crown put on it. It is not causing any pain or discomfort, so I think I will just let it go.
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Reply to kahill1918
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Elderly here can get home visits
they woukd be linked to dealing with elderly or sick people. Might be worth checking with local health authorities to see what’s available
hopefully those people would be better trained and not try to do extra in necessary work
if no joy check in a local care home and ask them what they do fir elderly patients teeth issues
it’s best something is sorted before it goes into a deeper oriblem
tooth pain is excruciating
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Reply to Jenny10
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In reply to Jenny10 - where do you live that has in home dental care? I'm in Arizona and have been trying to find that service as I am bedridden at age 77. Some of my top teeth have broken off and I'd love to get a top denture but have a hard time going anywhere due to the pain I have when sitting up, so as long as I'm not in pain I probably won't go have it done but if I could get a dentist to come to my home I'd have some work done. So I agree with most comments here that as long as there's no pain there's no need to make her go to a dentist.
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Reply to ButterflyPoet
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Katherine1953 18 hours ago
I am a retired dental hygienist. You can contact the local dental association for a referral or just google mobile dental hygienist. The hygienist should know a mobile dentist to refer you to.
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Research geriatric dentists for homebound geriatric patients. Gums are easy access for infection into the blood stream.
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Reply to Pap1947
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My 99 yo mother is in the process of getting a denture and a partial. We hesitated for obvious reasons, but went ahead because we think it will improve her self image. Even if she only lives a few more years, it will be a good investment for her. She can eat pretty well now, hopefully the new teeth will help.
That said, fillings are another challenge because of the anesthesia.
hopefully her dentist is caring and gentle and realistic. If there is no infection present, is the decay really a concern?
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Reply to Tracies
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Katherine1953 18 hours ago
My boss used to avoid making new dentures for a person who was quite elderly or having health problems. Many denture wearers get used to the old dentures, like comfortable old shoes, and never feel comfortable wearing a new one. Each case should be evaluated honestly to determine whether or not to proceed.
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If you are conflicted about caring for Mom's teeth, read the recommendations of Dr. Richard Isaacson...a world-reknowned neurologist leading the way in dementia care and prevention. His studies show that persons with good oral hygiene and healthy teeth score significantly higher on cognitive tests. Cavities that are ignored ultimately will reach the nerve and when that happens the pain is frequently intense and once that infection/abscess occurs the only options are a root canal or an extraction, both of which are much more traumatic than a simple filling. The dentist I work with, who sees many older and cognitively challenged adults, emphasizes frequent cleaning appointments (every 3 or 4 months) because good oral hygiene is hard to accomplish at a later age when vision and dexterity begin to be compromised, or because motivation has diminished. And he reminds family members that pain is under-diagnosed in people with dementia because they cannot always articulate what they are feeling...they may just exhibit anxiety, anger, or an inability to sleep. A compassionate dentist who will take the time to work with your mother might put temporary filling in a tooth rather than drilling it out in the usual way, and should look for the simplest fix to be sure that she is never in position to suffer unnecessarily. And a reminder that the bacteria in gum tissue that is not kept very clean, enters the other body parts easily and can wreak havoc in other areas, including the heart and brain. Ask your cardiologist!
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Reply to Shptstacey
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Katherine1953 18 hours ago
Also, some dentists have a laser available to remove decay that is painless and eliminates the use of a traditional drill. I am retired, but my most recent boss has that.
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I am a retired dental hygienist. Age alone isn’t a determinant for dental care. The health of the 97 year old patient needs to be considered. If she has stable health and her doctor has no concerns for her being seen by a dentist, and can walk or have a family member accompany her to an appointment to assist her in anything she needs help with, a good dentist should do a thorough examination of her mouth to not only look for cavities, but also examine all of her soft tissue to make sure she has no infections or lesions which might be uncomfortable or painful or a risk to her health. The dentist should have experience with aging patients. Just communicate with her medical doctor first and then with the dental office. Be aware that many seniors do not have dental insurance to pay for their care because Medicare does not cover dental care.
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Reply to Katherine1953
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susieangus: Pose your question to her DDS.
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Reply to Llamalover47
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My mother had to have teeth pulled at the age of 101 and moderate dementia. We ended up doing the procedure at a hospital so that they could use general anesthesia. This is because they were not sure what would happen if they used the "normal" anesthesia if they did the procedure in a dentist's office.

Not all hospitals have the facilities to do dentistry with general anesthesia and not all oral surgeons have hospital privileges.

The good news: The procedure was covered by Medicare instead of dental insurance.
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Reply to ChoppedLiver
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Great topic- To dentist or not to dentist in the very elderly
I also have decided not to bring my dentist phobic mom in. She has a very small jaw and jaw that doesn’t open very wide all her life (97 now). Back then her dentist had no child sized tools so it was torture for her. A few years ago she got addicted to her ‘chocolate filled mints’ that are filled hard candy. Before i could intervene she had chipped most of her front smile teeth. She doesn’t complain of pain or have trouble w food but won’t smile anymore. Can a dentist or who? create a cover that looks like teeth to wear on top when she visits or gets out?
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Reply to Bellerose63
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