Extraction for Elderly Patients who may have Dementia

Teeth can safely be extracted in the comfort of the patient’s home. We do not attempt to remove a tooth if we are unsure that it may be too difficult or risky to do in the home. In this rare situation, we always consult with my oral surgeon for help. We are fully insured to work with an excellent oral surgeon who can X-ray the difficult patient after they mildly sedate the patient. One of us will extract the tooth or teeth and we have an excellent support team around us. Of course, this is always coordinated with your primary physician or nurse practitioner.
Do not be surprised if we say “let’s do it in the bed…Or a chair!” Our Dentists bring our own light source and equipment. Our Dentists can extract almost any tooth – even on dementia patients!
Old Xrays are almost always necessary so try to retrieve them at all costs(and there should be no real cost after you explain the situation).
As always, we operate 100% within the comfort of the patient’s home throughout the entire process.

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Extractions Frequently Asked Questions

Question 1 – My mom’s crown fell out, can you come to the house and recement it?

Before coming to the appointment we ask to see the picture of the crown to make sure that just the crown came off. There’s always a chance that a part of the tooth came off because of decay or a fracture. From there, we can determine if it’s just a recement or if it’s a tooth that needs to come out.

If we know that we can’t recement it and it needs to be extracted, we let them know on the phone before they decide for us to come over.

Question 2 – How do we deal with a dementia patient?

We want to find out if the patient is on medication for dementia and who the caregivers are. We communicate about treatment to the caregiver and we need to know who’s gonna be there with the patient. It is vital that we communicate with the loved one to help diagnose and treatment plan for this patient.

When it comes to the extraction, we isolate just the one particular tooth. The patient may be unaware that they are numb and could bite their lower lip. We just try to focus on the one particular tooth to be extracted so that there is less trauma involved.

We also place medicine on the area that coagulates the blood. We will never leave a patient bleeding, we make sure the patient is comfortable before we leave the home.

Question 3 – Are we able to treat patients in a bed, chair, or anywhere?

We can do it anywhere! If you gave us a swing and told us to hang upside down we could do that too! We just want the patient to be comfortable to help us get the job done in the most comfortable setting possible.

Question 4 – What do we do about poor lighting in a patient’s home?

We always ask, where is the patient going to be when we go to see them? Can we open blinds? Is there a bedside table light? Or can we place one there? We also use flashlights or whatever it is we have in the moment. We want the caregivers to be engaged and see what we’re doing so we often ask them to help with a flashlight so they can see what we can see.

We also sometimes have a pair of glasses with a loop and a flashlight because there are some situations where it feels like you’re in a cave. It’s a life-changer!

Question 5 – What to do about a patient on blood thinners?

First of all, we have to have a written medical clearance from their doctor and that we are all on the same page. We can schedule as far in-between the dosage as possible and we will not leave until the patient is comfortable. We also use a special foam to help stop the bleeding and it keeps the area clean.

Question 6 – What if the extraction is too complicated?

If there is a situation where it may be too complicated or too involved, we let the patient know that we are unable to do this. We won’t charge for this visit and we suggest they see a specialist.

Question 7 – What sets us apart from other dentists?

Aside from the fact that we love what we do? It’s how important infection control is when it comes to extractions and we stand by our high standards in keeping everything clean and sanitized! We come in with our sterilized bags of instruments.

If you have a housecall dentist come to your home, always ask the dentists if they sterilize their instruments and how they sterilize their instruments.

We show our patients what a sterilized bag looks like vs a non-sterilized bag so that they understand that our instruments are sterilized. We also bring our own sterilizing wipes.

We also let our patients and caregivers know that we are COVID vaccinated.

Question 8 – How do we get a dementia patient to cooperate?

We make them feel comfortable by letting them know that we’re here to help. We approach them slowly and sweetly so that they feel comfortable.

We also talk to them face to face and stay eye-level with them. There is no reason that we should be strangers and come up behind them in order to work on them.

Question 9 – How do we know when we need to extract a tooth on a dementia patient?

We know when dementia patients are in pain and sometimes we have to talk the caregiver into extracting the tooth. We can tell when we push down and we can see the look on their face and that they are in pain, but they cannot always communicate that.

Not extracting a tooth that needs to be taken out can really have a negative effect on the patients health by preventing them from being able to eat and enjoying a better quality of life.

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