Q: Agnes is a patient of many years who has a chief symptom of lost partial dentures. She is 85 years old, and I have noticed that she has become confused recently and at times disoriented. She asked that I replace her partials with permanent bridges so that she would not lose them. Her oral hygiene is marginal at best and the supporting teeth are questionable as bridge abutments. I feel uncomfortable proposing such extensive and potentially expensive treatment to her if she is becoming mentally unsound.