As we age our risk for oral disease increases, with advancements in medical technology we’re living longer than we ever have.Good oral health and preventing oral disease are especially critical because each day 10,000 baby boomers turn 65 and basic Medicare doesn’t include dental care, when many people need it most.We will review oral health concerns for older individuals as well as providing some tips for how to improve oral health for all ages.
Xerostomia is the feeling of dry mouth due to insufficient secretion of saliva. It is most common among the elderly as a result of adverse effects of drug therapy, head and neck radiation, or autoimmune diseases. Chronic xerostomia has a debilitating effect on the integrity of the hard and soft tissues of the mouth. It becomes a problem because with less saliva our mouths become more acidic. In an acidic environment decay progresses rapidly. There are multiple products on the market to moisten the mouth, Colgate Hydris, Biotene, Xylimelts etc. While these products certainly help ease the sensation of dry mouth, more is needed to help protect your teeth. We typically recommend increasing you fluoride exposure. Depending on other risk factors we may suggest a prescription fluoride toothpaste or custom fluoride trays. Adding additional fluoride helps to strengthen your enamel and make it more resistant to decay.
Older adults develop new cavities more often than young adults. As we age, it is common for gums to recede from our teeth. These exposed portions of our root surfaces are not covered with protective enamel, instead they are exposed dentin. Dentin is much softer than enamel so decay on root surfaces progresses much more quickly than decay on other surfaces of the tooth. The combination of root surface exposure and dry mouth can lead to large amounts of decay in very little time. Similarly to dry mouth we would also recommend fluoride for root exposure, but we would also discuss your homecare. Removing plaque at the gumline is not only important for preventing decay, but it will also slow the advancement of recession. Your hygienist will discuss the best homecare aids for you.
Many seniors experience health challenges that can create obstacles for maintaining good oral hygiene.Certain diseases such as Arthritis, Multiple Sclerosis and Parkinsons (and others) can all affect our ability to brush and floss well. If this is the case a brush with a larger handle or an electric toothbrush may be the best option for you. A flosser with a long handle may aid you in flossing hard to reach areas. If you’ve noticed you’re having trouble, ask your hygienist to provide you with the best options to brush and floss effectively.
As we age our risk for dementia increases. At a certain point, tooth brushing will fall on the caregiver. It’s important as a caregiver to know how best to care for a patient’s oral health when they can no longer understand or do it themselves. Here is a great guide from Tooth Wisdom about the step-by-step process of caring for another’s teeth. As a caregiver, never hesitate to call your patients dentist, we are happy to assist you!
We can’t fight aging but we can prepare ourselves to deal with the changes that come with it. If you have any questions about any of the problems or recommendations that we discussed, do not hesitate to ask questions at your next visit. If you have noticed any of these problems or limitations, please let us know so we can best assist you with your oral home care. If you are a caregiver, we would also like to help you care for our mutual patients oral health in the best way possible and are very willing to answer any questions about techniques or products!
Institute on Aging
American Dental Association