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Is there anyway my husband’s tooth can be saved?

Hello, I am writing on behalf of my husband who is 63 years old and suffered a mild stroke 6 years ago due to Atrial Fibrillation. He made an almost full recovery from the stroke with the exception of a gagging problem. Unfortunately, for the first 4-5 years post stroke he had been receiving treatment from an NHS dentist who did not deal with Derek’s gagging problem very sympathetically and at one point attempted to put a rubber dam within Derek’s mouth nearly causing him to choke which has resulted in the gagging becoming steadily worse. The gagging occurs when anything touches his tongue. Shortly after this, Derek required a tooth extraction and we located a Private dentist and moved practices for this procedure tp be carried out. In October 2014 , Derek began experiencing severe pain in LR7 and was advised that he requires Root Canal treatment, however, this week his dentist has advised that they cannot perform this procedure under sedation., due to the fact that Derek is unable to have the dam within his mouth and he will not be able to ‘bite’ afterwards- therefore xrays are not possible during the procedure plus new regulations bought in since April 2015(?) The tooth is currently temporarily filled and the dentist has advised that Derek should just live with it for the time being as he is not in any pain at the moment. They added that the tooth may last 6 months or so and then the only possible solution will be extraction. Is there any possible way that the tooth could be saved or the treatment performed to save the tooth? Derek has already lost two other teeth since his stroke and it would be such a shame to loose another as it could make eating difficult on the lower right hand side (the tooth concerned is LR7). Derek is taking warfarin, a beta blocker and flecainide for his Atrial Fibrillation at present. Many thanks

This is a tricky one .
from the dentists point of view . Your husband cant tolerate rubber dam or X rays . Both of these are standard practice for that sort of treatment . The dam is placed to prevent any medications leaking out , or in that past to prevent an accident such as an instrument being inhaled or swallowed . The risk under Iv sedation would be much higher , and sometimes even with sedation you cant get X rays , or get rubber dam on ( I had one like this last week ) although in the end we had to dress the tooth pending extraction as it wasn’t feasible to fill it anyway .
So its unfortunately unrealistic to think that anyone might be able to do this , and what your dentist has done is the right thing to temporise for now . The problem is also worse the further back the tooth is
Also your husband has medical problems which may exclude having sedation in a practice and only in a hospital facility . or if a dentist has an anaesthetist in to give the sedation .
The new regulations I think he is is referring to may be to do with the conditions under which IV sedation is done , but Im not sure .
The tooth may well last a lot longer , there is no way of telling so you have time to come to a decision.
Unfortunately medical problems, medications and age can be a combination where teeth can start to decay and give problems
I dont have the answer, but hope this helps
Jenny

Answer provided by: Dr Jennifer Pinder Retired
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