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 Tooth extraction and possible implant restoration 
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3430
Location: Vermont
Post Re: Tooth extraction and possible implant restoration
Tonya - I've had dental nightmares my whole life - both real ones and the ones at night when I'm sleeping! LOL It really isn't bad, but then I was out of it from the valium. It was not painful at all from what I remember, even after the valium and novacaine wore off. My husband has had one or two and it really isn't a big deal, so don't get all worked up over it. Take a deep breath and relax. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Thu Aug 04, 2011 9:55 pm
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Joined: Wed Mar 02, 2011 1:04 pm
Posts: 251
Post Re: Tooth extraction and possible implant restoration
Thanks Lynn....I really appreciate your empathy...since I am not in a lot of pain and the chance of infection is small the neuro could even nix the whole thing for now...but we'll have to wait until aug 25th to see....Thanks for you kindess!!! Thanks for understanding!!

Best Tonya

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First symptoms in 2000 at 35 yrs old. LBD early onset dx 2-17-2011 at age 46.

' "I try not to worry about the future, but rather to "wonder"....and "wonder" is one step away from "awe" '......From a wise friend........


Thu Aug 04, 2011 11:04 pm
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Joined: Thu Jan 14, 2010 2:40 pm
Posts: 95
Location: California
Post Re: Tooth extraction and possible implant restoration
My husband recently broke a wisdom tooth while at a board and care home. (Apparently he bit down on a "pebble" in some soup). At the time we didn't realize the tooth was broken and perhaps it may just have been cracked. Now that it has broken, his regular dentist says it needs to come out, but I am afraid of a further decline. (The reason for the board and care began with constipation)... He is back home now and doing okay... But I am so afraid he will wind up in the hospital again over this procedure. I know not removing it might cause problems but am so fearful of the complications. Any suggestions? We are also going for yet another opinion as his diagnosis may not be LBD...
Thank you,
Roxanne

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My husband's first diagnosis in 2006 at age 64: Early Cortical Lewy Body Disease. He passed in Oct. 2013 at age 71. Autopsy indicated evidence for late-stage Alzheimer's only. NO Lewy Bodies were found in the hemisphere of his brain that was studied..?


Fri Aug 05, 2011 10:12 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Tooth extraction and possible implant restoration
Tonya,
Can you find out from the oral surgeon what meds are normally used for this procedure? Maybe it's "only" novacaine and, therefore, probably no need for much concern.
Robin


Sat Aug 27, 2011 12:30 am
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Joined: Wed Mar 02, 2011 1:04 pm
Posts: 251
Post Re: Tooth extraction and possible implant restoration
Thanks Robin - saw oral surgeon for consult on thursday -

My neuro gets input on this that she hasn't given yet, but the oral surgeon was saying versed, fetanyl and if necessary propafol (sp) - he is going to research LBD and consult with my neuro though before I schedule the appt so those meds could change too.....

I told him I was willing to be brave and go with novacaine only if neuro nixes those others....are there any anesthesias safe for LBDers? sorry if I have forgotten....mind not sharp right now....

In november before dx, I had 5 halcion, maxed out nitrous gas, (was awake for whole thing and never slept the whole day) for a root canal and no bad cognitive effects afterwards - wasn't on aricept or namenda then.....and IMO was not as deteriorated as I am now - even if the change is slight.....

I don't sedate well....i.e. sedating meds/versed etc., don't really work on me....so probably no need to risk it....the idea of being completely aware and alert of having my tooth extracted is stressing me out though.....

Thanks!

_________________
First symptoms in 2000 at 35 yrs old. LBD early onset dx 2-17-2011 at age 46.

' "I try not to worry about the future, but rather to "wonder"....and "wonder" is one step away from "awe" '......From a wise friend........


Sat Aug 27, 2011 8:31 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3430
Location: Vermont
Post Re: Tooth extraction and possible implant restoration
Tonya - I have no idea about anesthesia and LBD, but I took valium when I was having several of the stages done for 2 implants. I am very sensitive to meds, so I slept for about 8 - 10 hr. each time I took 1 small dose of valium. Don't know if you can take it or if it would help you, but just wanted to pass along my experience in case it might be useful to you. Good luck! Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Sat Aug 27, 2011 9:13 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Tooth extraction and possible implant restoration
Propofol was the med that Michael Jackson OD'd on, I think.

Sounds like novacaine might work best for you. Did the oral surgeon think it was do-able with novacaine?


Sat Aug 27, 2011 11:42 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Tooth extraction and possible implant restoration
And, this is the sum total of what's been provided by the LBDA on the subject of anesthesia and LBD:

viewtopic.php?f=4&t=130


Sat Aug 27, 2011 11:44 pm
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Joined: Wed Aug 24, 2011 12:05 pm
Posts: 7
Location: Washington State
Post Re: Tooth extraction and possible implant restoration
I've been reading this forum with great interest as I am trying to avoid the outcome of my father's last oral surgery. He has been diagnosed with LBD and that seems accurate to me. About 3 months ago he had a couple of teeth extracted and the next step is to get the the implants placed. I am very concerned about doing this based on his reaction to the procedure last time. The day of the procedure he seemed fine for the remainder of the day and evening. The next morning he was barely able to walk, extremely unsteady on his feet, incoherent, combative, etc. He remained that way for the entire day and was somewhat better the following day. I had to borrow a walker since he couldn't really stay balanced. I was almost at my wit's end, feeling like I just couldn't figure out how to take care of him. It was awful but over the next few days he improved. Did he ever get back to the state he had been in previously? I am not sure. I do know that he seems to be sliding in many ways downhill in the past couple of months.

So now the oral surgeon is ready to do the next procedure to add an implant.have the asked about the meds they used and they are the following: Versed (midazolam which falls into the benzodiapezine family), fentanyl and dexamethezone. I have a call into the oral surgeon's office to discuss alternatives. Meanwhile I have been looking for a definitive list of contraindicated drugs for people with LBD and am having a hard time finding this.

Dad keeps asking me about his teeth replacements and I have been putting it off because I am afraid of what could happen the next time.

Any advice? By the way, I guess I should introduce myself. I will do so in the forum for that purpose.
thanks, Beth

_________________
[color=#004000]Washington state. Daughter to an 84 year old man diagnosed with LBD in July 2011. I also have a mother, 83 years old, diagnosed with Alzheimer's disease June 2010. They both live with me now. We have a staff of caregivers to make it work.


Wed Oct 12, 2011 3:25 pm
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Joined: Sun Jun 24, 2007 5:35 pm
Posts: 344
Post Re: Tooth extraction and possible implant restoration
Beth, i have a list of meds to avoid with lbd that I compiled from lbda website and my husbands neuro. I am not saying it is complete, but it is a start. Send me a private message with your email address and I will send it to you if you like.

John is having two teeth extracted soon and I am worried, too.

So sorry about your dads reaction. Can he do without implants? We have opted not to do that since johns are in very back.

Pat

_________________
Pat Snyder, husband John, dx LBD 2007
Author of [i]Treasures in the Darkness: Extending Early Stage of LBD...[i][/i] [url]http://www.amazon.com/Treasures-Darkness-Extending-Alzheimers-Parkinsons/dp/1466428228/ref=sr_1_1?ie=UTF8&qid=1334092686&sr=8-1[/url]


Thu Oct 13, 2011 1:08 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Tooth extraction and possible implant restoration
"Meanwhile I have been looking for a definitive list of contraindicated drugs for people with LBD and am having a hard time finding this."


Beth,

The only list I know of produced by an MD is the Jay Van Gerpen list, which I posted here:
viewtopic.php?f=4&t=1589

The LBDA wallet card has a list of typical antipsychotics but I don't think it says "you must not use these meds." Rather, it says something like "if you absolutely have to, use these meds one time but try really hard to use something else."

Robin


Thu Oct 13, 2011 3:22 pm
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Joined: Sun Jun 24, 2007 5:35 pm
Posts: 344
Post Re: Tooth extraction and possible implant restoration
Beth, I was a little more awake tonight. Here is what John's neurologist gave me along with what I had already found on lbda website as Robin mentioned. So all of this is evidently physician sourced. Hope this helps you.

Medicines to Avoid with LBDAnticholinergic effects (most anticholinergic first)

1. Atropine (100% of maximal anticholinergic effect)
2. Scopolamine
3. Tolterodine
4. Hyoscyamine
5. Cholinergic Parkinsonism agents
1. Trihexyphenidyl
2. Benztropine
6. Diphenhydramine (Benadryl)
7. Amitriptyline (Elavil)
8. Digoxin
9. Nifedipine
10. Phenobarbital
11. Oxybutynin (20%)
12. Isosorbide dinitrate
13. Hydroxyzine
14. Warfarin
15. Dipyridamole
16. Codeine
17. Ranitidine (10%)
18. Dyazide
19. Furosemide (Lasix)
20. Nortriptyline

Medicines for Psychiatric Problems
Haloperidol (Haldol)
Chlorpromazine (Thorazine)
Risperidone(Risperdol)
Olanzapine
Aripiprazole
Fluphenazine (Prolixin)
Loxapine (Loxitane)
Mesoridazine (Serentil)
Molindone (Moban)
Perphenazine (Trilafon and Triavil)
Thioridazine (Mellaril)
Thiotixene (Navane)
Trifluioperazine (Stelazine)
Amoxapine (Asendin)

For Nausea, Vomiting, GI Problems
Metoclopramide (Reglan)
Promethazine (Phenergan)
Procholoperazine (Compazine)

_________________
Pat Snyder, husband John, dx LBD 2007
Author of [i]Treasures in the Darkness: Extending Early Stage of LBD...[i][/i] [url]http://www.amazon.com/Treasures-Darkness-Extending-Alzheimers-Parkinsons/dp/1466428228/ref=sr_1_1?ie=UTF8&qid=1334092686&sr=8-1[/url]


Sat Oct 15, 2011 11:08 pm
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Joined: Tue Mar 29, 2011 3:02 pm
Posts: 386
Location: East TN
Post Re: Tooth extraction and possible implant restoration
Glad to see amitryiptilene made your list…..

……I have no doubt this little devil….cost me about 10-20 years of productive life…..

_________________
Craig - Patient - Male - 56 years old - Lewy Bodies diagnosed on March 23, 2011 - cognitive disorder NOS dx 2007 - RBD REM dx 2007 issues for 20+ years - intention tremor 1974 - other issues many years


Sat Oct 15, 2011 11:28 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Tooth extraction and possible implant restoration
Pat,
Will your MD put his name to this list?
Robin


Sun Oct 16, 2011 12:22 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Tooth extraction and possible implant restoration
Pat,

Are the "Medicines for Psychiatric Problems" meds to be avoided?

Note that three listed under "Medicines for Psychiatric Problems" --

Risperidone(Risperdol)
Olanzapine (this is Zyprexa)
Aripiprazole (this is Abilify)

-- are taken by some with LBD who have no problem whatsoever.

It's a crap shoot. I assume this is why the LBDA has been very careful to never say "Never give these meds to someone with LBD."

Robin


Sun Oct 16, 2011 12:25 am
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