Answers to top FAQ’s
What Locations Do Your Dentists Travel To?
The dentists of Geriatric House Call Dentistry serve patients from coast to coast! We’re always expanding into new territories.
Do You Treat Dementia and Alzheimer's Patients?
Yes, I have advanced training in treating all forms of dementia, Alzheimer’s disease and Parkinsons diseases. In the case of the patient refusing to open, I have kind methods that always work. In the rare case that we cannot get the patient to comply, I work with an oral surgeon who is highly trained in geriatric sedation. Of course this is only used in the case of an emergency and as a last resort. And I always coordinate any surgical treatment with the primary care physician or nurse practitioner before starting.
Comprehensive Exam, Treatment Plan and Prophy
Before the initial visit I will send you a new patient form to be filled out including all medications, physician’s name and number…
It’s what you are used to seeing and filling out when you see any new doctor
Old xrays should be retrieved from the previous dentist(s), especially if the patient has dementia and may not cooperate for any new xrays.
After the new patient form is completed, an appointment can be made on the best possible day and best time possible, so that a family member can be present should they want to be. An aide/caregiver being present is fine, and I will teach him/her/they how to take better oral care of the patient. A report is sent to those you request it to go out to after every visit.
The initial visit includes an oral exam, an oral cancer exam, and a treatment plan (an outline of necessary treatment than can be done in the future outlining fees and alternative treatment of possible). It also includes placement of silver diamine (Arrest) if initial decay is present, and a generalized prophy (cleaning of the teeth). Oral products are given, an oral rinse may or may not be prescribed. Lastly, a lesson in oral care will be given to the caregiver. This is extremely important and my job to instruct.
Fabricate New Complete Dentures or Partial Dentures
I am completely confident that I can fabricate new complete dentures (no teeth present in the mouth) or partial dentures (few or many teeth present with missing teeth (spaces) in between.
Both types of dentures take 4 visits and the fee includes all adjustment appointments if necessary. New dentures may be necessary if the old dentures are loose or unfortunately misplaced/lost. Hospitals and Nursing Homes may be responsible for lost dentures. I am proud to say that my colleagues like to joke that I am the Denture Queen because no one fabricates more dentures than me. I guarantee that they fit. I can’t guarantee that every dementia patient can get used to a new object in their mouth, but I think the odds are great that most get used to them. And I place their name in the denture to make sure we know who they belong to.
Repair Old Dentures and Partial Dentures
NEVER try at home repair kits you find at the pharmacy or online. Once you touch them a lab will not agree to the repair. Hold on to the broken pieces and call me ASAP!!! I can definitely fix it. And NEVER use crazy or gorilla glue…or you will be throwing it out forced to get a new one. This is a great service and the turn around period can be a day or a few days at the most.
Reline Old Dentures
This is a great service if the dentures are loose or falling out during speaking or eating. The lining is soft and comfortable and alleviates the situation where the patient needs to get used to a new pair. This is a great treatment for the patient with dementia or Alzheimer’s disease. It’s almost like a new denture. I just can’t improve the aesthetics and a new denture(s( should be considered.
Fillings
I use a special material made specifically for the older patient. I do not use amalgam (silver fillings w mercury) and all my fillings match the original tooth. And yes I can repair a chipped tooth!
Extractions (Removal of Broken and/or Painful Teeth)
Yes, I can remove teeth in the home. I use extra small needles and anesthesia that only numbs the tooth I am removing. I pack the extraction site (hole) with a special material so that there is no bleeding and hopefully no pain. I am quick and thorough. It’s surprising but yes this can be done in the recliner or bed, and I bring my own powerful light source, so no worries.
Second Opinions
If you are worried that the proposed treatment your present dentist has given the homebound patient may not be what they can handle or absolutely need, I am happy to give you my opinion. Sometimes, no treatment is the best treatment, and I can help you decide. The most important factor we use to decide is to make sure there is no infection and whether pain is present. Patients deserve the best treatment that’s necessary for them. Sometimes I have to think outside the box.
Recement or Repair Crowns (Caps) and Bridges (2 Teeth on Either Side of a Missing Tooth)
I can recement a crown or bridge on a tooth stub as long as if there is a non decayed stub present. Often a crown breaks with the tooth attached and therefore cannot be recemented. If possible I will ask you to take a simple photo with your smart phone and I can tell you after sending it to me if recementation is possible or not. No reason to waste a visit to tell you the bad news. If this is the case, usually an extraction (pull the root tip) will be necessary.
Emergencies That Can’t be Handled at Home:
There are few cases where the patient cannot be handled due to behavior issues or extractions that are too complicated or risky to do in the home. Together with my oral surgeon (highly trained to treat this delicate and frail patients) we treat these patients in the office under light and safe sedation (light sleep). It’s done quickly and safely and there is no waiting in a crowded waiting room. This is sometimes the only way to be safe and I never take chances should there be a possibility of a complication.
Do you Take Medicaid, Medicare or Private Insurance?
I do not participate on any insurance plans, I am not a Medicaid provider and Medicare does not pay for dental services that are not performed in the emergency room. This may change in the future, so stay tuned. I definitely will fill out the necessary paperwork for reimbursement from your private insurance plan.
What to do if the Patient is on Blood Thinners like Coumadin, Plavix...
I will work with the primary care provider or nurse practitioner so that they can inform me whether treatment can be performed safely. Safety First is always my motto !
Dr. Alisa Kauffman teaches caregivers how to perform oral care on those who refuse or are unable to care for their own teeth. Alisa always tells her patients, “we only brush the teeth that we want to keep!”
