The mentally Ill and the Dentist

Today, my daughter agreed to go to the dentist. First time in years. She has infections, cracked teeth, Ca I ties, and needs root canals. This does not surprise me since the mentally ill have issues with teeth because of medication, diabetes and poor hygiene. The dentist, at first, would not speak to me not bring her conservator. When I came in and indicated she had good dental coverage through Medi-cal, he said we will see.
It seemed like it was too much to bother with a medical mentally ill person. Too hard. No one cares about this population. I asked if he would give her an antibiotic, and he first said no, and I said if you know she has an infection and refuse, I’ll report you.

Here are my questions. My daughter says nothing is wrong with her she is fine. Sound familiar. The X-ray s show otherwise. I think she may have to be sedated, but know she won’t agree with it. So what do I do. Let her teeth rot. Get a conservatorship, run the risk of her leaving, she has done that. Any advise would be appreciated. I am quite depressed today :confounded:

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Hi @Cerium I’m so sorry, this is so frustrating. I suppose talking to her about loosing her teeth won’t work. Is she denying her pain? Did he give you a list of what needs to be done? Maybe she would be willing to have one thing done at a time? Perhaps the easiest thing where she wouldn’t need to be sedated? Maybe try to make it as nice of an experience as possible. Is there anything that she likes that she could get a as a reward for after each procedure?

Bless you, Diane for your kindness. It is virtually impossible to reason with her on many subjects. I think, on a deep level, she is in pain, or she would have not gone. Whenever I ask how she feels, it is fine. When her glucose is 225, and o say how do you feel, it is fine. So many times we are living in the dark as caretakers. I try to do the best i can. It was the dentist who refused to do anything, even a simple cleaning. I did not think he wanted to work on her since her teeth were so bad, she had mental illness, and he wouldn’t have made money. Thanks for listening.

Yes, mentally ill people have poor oral health for the reasons you mention and in our case a bit paranoid about what our dentist is really doing. :frowning: Yep I work for the dentist and son still does not trust him.

It sounds like you already have an adversarial relationship with your guy. You should be able to get a treatment plan which should identify which teeth need immediate treatment. And find a new dentist. A cracked tooth can be stable for years, but infection not.

Is there something your daughter really wants that you can trade for dental visits? We are not successful in getting son to see dentist unless he thinks he has mouth cancer. Then he goes in. In the meantime, buy a waterpik and a good mouth rinse and do whatever you can to get compliance with good home care. It won’t fix what is wrong, but may stop other things from starting. And maybe remind her EVERYONE needs to take care of their teeth or their teeth will fall out and that just is not pretty. Hope things work out for you.

My daughter recently went to the dentist and had her teeth cleaned. The dentist and hygienist were known to her from 5 plus years ago, and they were forewarned of her mental state now. It went well.

Tomorrow she is going back (I hope) to get a cavity filled. She looked worried when I said tomorrow was the day, we will see if she goes and how she cooperates or not.

It is very important to have a dentist that is on-board with treating a mentally ill patient. I have to pay out of pocket for this. Was $89 last time and will be $190 tomorrow. Ugh. But better than the tooth continuing to rot.

If my daughter won’t cooperate, I won’t be able to push it…

She must be struggling with a lot of inner turmoil if she is in need of a root canal, but refusing treatment.
That is a lot of pain to ignore / tolerate.

I would point out that dentists are a dime a dozen in most cities in the U.S. If you’re American, don’t settle for a dentist who doesn’t care or takes convincing to work. That’s not how our society works. Find someone who has compassion.

Is it possible for your daughter to choose a dentist that she feels like she can trust?
When my brother moved in with me, we sat down together and looked at the profiles and qualifications of every doctor in the area and in the insurance network. The one he chose is the same one he still sees today. They have a good rapport.
Maybe your daughter would be more comfortable with a dentist she chooses (assuming she even has the interest to choose one).

The last time I got Jeb to the dentist they wanted to do something called a “deep cleaning”. The gum lines for his front lower teeth have receded horribly. I believe it is from the years when he self medicated constantly with pot. You can’t see it unless he pulls down his lip.

He got half of the deep cleaning done and has refused to go back. The procedure must be more than he can handle.

I am so sorry Cerium, I have had to go the “let the teeth rot” route. Jeb does continue to take his immunosuppressive meds to keep his transplant, but he refuses to return to the dentist.

@hope, i hear you. This morning my daughter says she does not need to return to the dentist for a year. She went. She would have complied. This jerk just did not want to deal with medical and a person with schizophrenia. Now, she says she will not go for a year! I too may have to let it go. Just do not want anything horrible to happen due to the infection. At least. She is taking the antibiotics today. I feel so down today, of course, I blame myself for not doing s better job here, i am her sole caretaker, and should have known better. This too shall pass. Even strong people break. Thanks for listening.

@Cerium As we both know it is extremely difficult to get people with sz to do something they don’t want to do.Please don’t be so hard on yourself. At least you got her to the dentist! That is amazing in itself.

Early in my sons illness we tried to pair him with a partner so to speak who would help him do things like go to the bank, go to the batting cages, go for a walk - whatever he wanted to do, go shopping. They help people do the things that are hard for them to do. It’s called therapeutic mentoring and usually they have a degree in psych or counseling. Kinda like a buddy. I wonder if your daughter would be open to something like that. My son was not but I know some people are. Eventually, the person could talk to her about the dentist. Just a thought.

Its so frustrating when people won’t help us help our family members. When I have needed help I do tell them that Jeb is “special”, people do tend to help me more when I use “special” or “brain damaged”. Probably won’t do much to end stigma, another cross I will have to add on to the pile of crosses I am bearing.

Also @Cerium I’m sorry the dentist didn’t try to help or do the work. He is a doctor after all!

I’m so glad my son started going to the dentist last year. He will get some cleaning done, tho the last time, he had them stop early. He is pretty obsessive about brushing his teeth, so they are in pretty good shape.

The only thing I can suggest from my experience is to let your daughter know that whenever she is ready to go, you will do your best to get her in. Try “shopping around” right now to find someone who will work with her. Then occasionally bring up the topic that whenever she is ready to go, you will make it happen. Maybe ask her every so often, How do your teeth feel? Do you think you are ready to try the dentist again?

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Really great suggestions from everyone. I know you all get this.

I found a dentist who will do a deep cleaning without anything else. I made an appointment in 2 weeks. I can’t leave it up to my daughter or she will not go. She said she was not going back for a year. I said I found a place that will just do a cleaning and she said maybe. Baby steps. When you ask her how she is, the answer is always fine.

Those of you with children who go willingly to the dentist, you are truly blessed!

ThNks for your help.

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Hi, We have gone through this at times, in moments. I wound up telling the dentist’s office that my family member has a disability after one doctor was openly mean to them.

Sometimes my family member has jumped up out of the chair and I was sitting in the room, so I follow and bring them back.

It’s so incredibly hard and stressful not to know whether or not they will attend and/or complete medical appointments. My family member is in treatment and this is not currently an issue, but when it was, it took up so much time and effort. Also, lots and lots of bribes like meals out, music stuff, and even $20 cash once.

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My daughter and I made it to the dentist today, where she had a cavity fixed. I was told that she did “ok” and that whenever something odd was said, it was not countered or argued with. She won’t let me go with her into the treatment rooms as she has told me that she isn’t a child.

The dentist and assistant both know she has schz and are supportive. The oddest problems occurred in the waiting room which was full: strange comments by my daughter aimed at a few of the occupants of the waiting room, like “it takes a better mentality to think that way, you know?” (since she has special mental powers to read other’s thoughts). But I just sat next to her and looked at her with every comment (saying nothing) so they thought she was talking to me.

With people who would be prejudiced or afraid of schz, I tell them she is “special needs”. Usually, folks are not afraid of that idea.

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I’m all a out the bribes. That is how I got her to go to the psychiatrist. She now goes willingly, so maybe it just takes time. She still refuses to see a dr, but thankfully, she is connected with, or shall I say, I am connected with s great person at the diabetes clinic so services are available.

As far as a mentoring buddy, what a great idea! Sadly my girl wants to be around no one. I had to chuckle when I read @bereabdhere have to bolt out of the chair and run after them. Hoe often I was in that situation. I still wait for the shoe to drop, but Can say since I retired my daughter is so much better. I think she feels safer.

Today, I bought all kinds of tooth brushes and pastes flosses and mouth washes, spending 35$ Tonight is show night. Imagine how families without those with mental illness would react to reading about this stuff. Lol

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I too frequently describe my son as “having a disability”. Which is true, but much easier for people to deal with than saying “serious mental illness”.

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My son is 31 and has not gone to a dentist in 13-15 years. He’s agreed to go see one next month. I hope he doesn’t change his mind. Every year I’ve urged him to get his teeth cleaned and every year he’s refused. It’s very worrisome, but so what else is new with SMI?

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I just changed dentists today. The one I was seeing is skilled but mean. He thinks I eat a lot of sugar because of my weight. My primary doctor felt bad enough when I told her that she prescribed me phentermine to see if it countered the meds. I am on several that all cause weight gain. An hoping this new dentist is nice and understands mental illness means I don’t take care of myself when ill.

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It seems my daughter is more communicative since going to the dentist. She asked me to call the dentist tomorrow and tell her (it’s a woman dentist) that part of the filling that is too sharp. So my daughter will be going to the dentist again. This took 2.5 years to occur, but I am very happy that it is happening.

I hope everyone looking for one can find a good dentist and get a good result.

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