Ageing and Oral Health

Introduction

There are quite a good number of the elderly people in the world today who are leading a longer and healthier life. That too with all their natural teeth in place! Have you ever wondered the reasons behind this? Have you at any time inquired about their oral health? For better general health, it is imperative that oral health care and hygiene are given proper care. The elderly people of today are also enjoying good oral health, keeping their natural teeth longer than the previous generations.

Maintaining proper oral health care and hygiene, remember, is more important as you age, as it not only benefits your oral functions, but can also influence your overall health and quality of life. In fact, oral care is increasingly important during the mid forties and the years thereafter. There is a growing evidence that neglect of teeth and gums causes infections which may be closely linked to other diseases such as diabetes and heart disease, and can also contribute to pneumonia. The good news is that regular brushing and flossing supports good oral health, while visits to your dentist can help to screen for the serious diseases including the oral cancer.

Follow the same simple rules that have supported you throughout your life including:

Maintain a daily routine of brushing and flossing.
Avoid alcohol and tobacco.
Eat a healthy diet and limit consumption of sweets.
Pay regular visit to your dentist - speak to your dentist about any questions you may have on changes in your oral health and update the dentist on any medications you may be taking. Also, if you have an elderly parent, ask about the ways to support their oral health care.

There is growing evidence that neglect of teeth and gums cause infections which may be closely linked to other diseases such as diabetes and heart disease, and can contribute to pneumonia.

With increasing age, seniors may become more susceptible to oral diseases such as decay, gum diseases and oral cancer. Additionally, increased use of medications, physical and cognitive deterioration and changes in diet may begin to impact on oral health. Here are a few other influencing factors to consider and discuss with your dentists.

Cavities and Decay - The elderly people have a greater tendency to get decay around older fillings and have more fillings than younger people because many elders did not grow up with fluoride toothpaste. Roots of teeth also become prone to decay because they are exposed when gums recede. This is caused by exposure of the tooth root to decay-causing acids. The tooth roots become exposed as gum tissue recedes from the tooth.
Gum Disease - The elderly persons need to continue to focus on prevention of gum (periodontal) disease. Although the symptoms of periodontal disease often are subtle, there are warning signs. Gum diseases not treated in the initial stages later develop into a more serious form of disease called periodontitis which may have serious repercussions on general health.
Oral Cancer - The incidence of oral cancer is higher among senior citizens. Starting as early as the age of 40 you should speak to your dentist about oral cancer and get yourself examined for any cancerous lesions in the mouth. In the case of person addicted to tobacco use in its various forms, it should be done as the possibility of oral cancer cannot be ruled out. Regular dental visits can help to spot early signs of oral cancer and pre-cancerous conditions if you are a regular user of tobacco.
Dry Mouth (xerostomia) - Older adults are susceptible to dry mouth, an appropriate environment for bacterial growth. This is a condition of the mouth becoming dry for want of adequate secretion of saliva. The reason for this condition may be numerous. This encourages more problems with your teeth and gums, which then can lead to other problems such as periodontal (gum) disease. The signs of dry mouth include reduced saliva, bad breadth, loose dentures and increased plaque. To help combat a dry mouth, avoid caffeine and tobacco. Make sure you drink plenty of water and avoid refined sugar.
Medication - Over-the-counter, prescription drugs, vitamins and minerals, and herbal preparations are used frequently by many adults, particularly the senior citizens. Many medications contain sugar and can cause dry mouth, both factors that can influence oral disease. It's important to tell your dentist about any medications you are taking and other possible symptoms, such as abnormal bleeding, taste alterations and soft-tissue symptoms like swelling and discoloration.
Diet - With the benefit of keeping natural teeth longer in life, the elderly continue to enjoy a wide variety of foods and can further support their ongoing oral health by making better nutrition choices. Unfortunately, many seniors may begin to experience mouth or teeth problems that make them less likely to consume a healthy diet with negative impacts on oral health. Some of the reasons for this include a decrease in appetite, physical disabilities, dementia, such as Alzheimer's, or untreated tooth decay.
Health Conditions - While oral disease are a health risk, their relationship to overall health is often overlooked.
Untreated gum disease can increase the risk of respiratory disease. This happens when bacteria in plaque travels from the mouth to the lungs, causing infection or aggravation existing cardiovascular conditions.
People with diabetes are more susceptible to periodontitis - an infection of the tissue that hold the teeth in place. The infection can lead to loss of the bone that holds the tooth in its socket and many result in tooth loss.
People with weakened immune system are more likely to get fungal and viral infections in the mouth.
Tooth Sensitivity - Tooth sensitivity is a common complaint of the elderly persons. People with sensitive teeth may experience pain when consuming hot, cold, sweet or very acidic foods and drinks, or breathing in cold air. Sensitivity can be caused by things like brushing too hard, receding gums, gum disease, cracked teeth, teeth grinding, acid foods or routine dental work.
Dentures - If you wear dentures, ensure they fit properly, maintain a proper cleaning routine and continue to visit your dentist for all your oral health care needs. Removable dentures remain a common solution to replace missing teeth among the seniors. Proper denture care is important for both the health of your dentures and your mouth.

It is important to speak to your dentist about any concerns that you may have with your oral health or for that matter that of lover ones. Always ensure that your dentist is aware of any health issues you may be experiencing or medications you may be taking. Regular visits will help to spot problem signs early on.

Tips for the Elderly

Brushing and flossing

Review the tips for proper bushing and flossing.
Choose a soft toothbrush and remember to replace worn brushes every 3 to 6 months.
If you suffer from arthritis or any other health conditions make it difficult to hold your brush, speak to your dentist about options.

Dentures

Handle dentures with care. To avoid accidentally dropping them, stand over a folded towel or a full sink of water when handling dentures.
Brush and rinse your dentures daily.
Be careful not to let your dentures dry out. When not in use, dentures should be placed in a denture cleanser soaking solution or in water. Dentures should never be placed in hot water, as it can cause them to wrap.

Caregivers

Oral health is an important factor in our day-to-day lives. From eating to conversation , oral health impacts quality of life. Senior citizens facing challenges with physical and cognitive deterioration may require support with basic daily care. If you have an ageing parent, consider the following:

Speak to a dentist on ways that you can support the oral health care needs of an ageing parent or person in your care- including help with brushing natural and artificial teeth, looking inside the mouth for problems.
Regular dental visits will also aid in spotting trouble signs or sources of pain. Attend the dentist with the elderly in your care and ensure that you provide the dentist with as much information as possible on medical history and medications that the elderly may be used to.

Improving the Oral Health of The Elderly

The percentage of older adults who have lost all their natural teeth has somewhat declined since the 1990s.
This decline is the result of major improvements in the field of oral health, including: community water fluoridation; advanced dental technology; better awareness of oral hygiene; and more frequent use of dental services.
Gum (periodontal) diseases are associated with diabetes and possibly with cardiovascular disease and stroke. These and other oral health problems among older adults can lead to needless pain and suffering; difficulty in speaking, chewing, and swallowing; and loss of self-esteem.
Practices such as drinking fluoridated water, carefully brushing and flossing teeth, and getting regular professional oral health care have been shown to be instrumental in maintaining and improving oral health. These measures are the only ways by which older adults can avoid loosing their teeth or requiring extensive treatment to curb infection and restore tooth function. These, however, vary widely among older people of different socioeconomic backgrounds, and this variation offers strong evidence that many older adults have not benefited appreciably from improvements in preventing and controlling oral diseases.
The following guidelines can help all older adults improve their oral health and lower their risk for dental decay and tooth loss:
- Cultivate drinking of fluoridated water and use of fluoride toothpaste. Fluoride provide protection against dental decay at all ages.
- Practice good oral hygiene. Careful tooth brushing, twice a day - in the morning and before retiring to bed, and flossing to reduce dental plaque -- can help prevent periodontal disease.
- Ensure professional dental care. Professional care certainly helps to maintain the overall health of the teeth and mouth and helps to detect precancerous or cancerous lesions early in their development which can be treated, if detected early.
- Avoid tobacco. Smokes have a greater risk of developing periodontal disease than non-smokers. Spit tobacco containing sugar also increases the risk of dental decay.
- Limit alcohol. Drinking excessive amounts of alcohol is a risk factor for oral and throat cancers. Alcohol and tobacco used together are the primary risk factors for these cancers.
Throughout the life span, oral health is an integral part of general health and well-being. The oral health of the elderly, however, is very often neglected. Many older adults -- especially those with low incomes or physical or cognitive limitations -- are not able to maintain their oral health or make it to the dentist's clinic. Mediclaim does not cover routine dental services, and Mediclaim coverage is not available in respect of dental diseases.
Unmet oral health needs among the older adults will only be solved through the coordinated efforts of clinicians, public health professionals, the ageing services network like home for the aged, and families. In the past, there has been little collaboration among these groups. IDA has devised a programme called "Prathyasha" as a part of its social commitment to deliver free dentures to the poor and needy and several local and state branches are in the process of implementing it. Over 8000 dentures have been distributed so far and about 5000 dentures have been set as the target for the current year. The goal of IDA's oral health programme is to identify unmet dental needs among the older adults and promote partnerships and community strategies to address these needs.
Other promising approaches for improving the oral health of seniors include the following:
- State and local efforts to ensure that community drinking water has optimal fluoride content;
- Health communication campaigns to increase public awareness of the importance of oral health and the benefits of fluoride;
- Expanded partnerships between clinical and public health professionals and the ageing services network to increase the likelihood that older adults with limited resources and functional abilities receive dental services;
- Development of innovative and effective strategies to prevent and treat oral diseases too make them sustain their teeth for life.

Oral Care for the Elderly

The Focus

The advances in dental technology are providing the means for more people to keep a healthy set of teeth well into later life than ever before. Improved dental care for older adult persons or the elderly now means that pulling a tooth at the slightest sign of infection is thankfully a thing of the past. At present, dental care for the elderly focuses more on restoration than on prevention of oral disease and there are a few rules that should be followed religiously to ensure good dental health.

Need for Dental Hygiene

The mouth is an entry point for many bacteria. So, regular and correct hygiene habits are essential to health, more so when one ages in life. With advancement in age and susceptibility to diseases, there may be decrease in manual dexterity making it more difficult to practice these habits. Older adults may need to use electric toothbrushes and other special brushes to clean between the teeth. Some elderly people are even unable to brush or clean their teeth owing to certain ailments. People with arthritis, or other limitations to movement, may need modified toothbrushes with thicker handles. The correct methods of cleaning the teeth, suitable for the individual, are absolutely important to maintain oral health.

Dental Problems and the Elderly

More people than ever have healthy teeth well into their later life but the ageing process does bring about its own set of medical problems. Elderly people are more susceptible to oral disease and this can bring about further medical complications and complaints. Many people are unaware that oral disease is closely related to their overall health and if oral disease is discovered it may well be that there are also other underlying medical problems.

With age, our salivary glands may naturally produce less saliva leading to dryness of the mouth. More often, the cause may be the medicines we take (for high blood pressure and depression). Dryness of mouth can cause discomfort with dentures, bad breadth and tooth decay. These need to be attended to maintain oral health and hygiene.

Common Oral Problems for the Elderly

Among the more common dental complaints of the elderly is a condition called dry mouth that occurs due to a reduction in the amount of saliva produced. Dry mouth can happen for a number of reasons, the most common being the amount and the type of medication taken. Dry mouth can also occur as a result of cancer treatments using radiation.

Tooth Decay

Older adults may see an increase in tooth decay due to reduced saliva. Saliva helps to wash away the acids produced by bacteria in plaque - acids that attack the tooth structure and cause tooth decay.

Adults may also be prone to decay because of exposed root surfaces or worn-out chewing surfaces where the protective layer of hard enamel has been lost. Root decay occurs as the gums recede from the teeth. When the gums recede, the roots of the teeth are then more exposed to bacteria and become more susceptible to decay. Decay on these surfaces can spread rapidly.

Regular dental check ups by dentists could help carry out saliva tests to check on the quality of saliva and recommended ways to increase protection against tooth decay. Examples of such protection include regular fluoride applications, use of calcium creams at home and the use of fluoride containing filling materials rather than amalgams.

Gum Disease

Older adults with poor oral hygiene may suffer from gum disease without being aware of it. Gum disease caused by plaque is a major factor in tooth loss and can occur due to variety of reasons. Poorly fitted dentures, the use of tobacco, and unhealthy diet and food left between teeth will all enhance the risk of plaque. Diseases such as diabetes and cancer will also be common sources of gum disease. If gum disease is left untreated then it can cause other medical complaints such as heart and respiratory problems.

Uncontrolled gum disease has been associated with increased risk of heart disease and strokes. People with diabetes are more prone to infection and need to be especially aware of the possibility of having gum disease. Gum disease is a “silent” disease that often goes unrecognized until advanced symptoms like looseness of the teeth occur.

Research has shown, and experts agree, that there is an association between periodontal diseases and other chronic inflammatory conditions, such as diabetes, cardiovascular disease and Alzheimer’s disease. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions.

When an inflammatory condition is suspected or diagnosed, it is important to consult with both a general physician and a dental health professional, such as a periodontist. Sometime the only way to detect periodontal diseases is through a periodontal evaluation.

Regular checkups are necessary to make sure that gum disease is kept away with good hygiene habits. Good dental care for the elderly persons will take all of these problems into consideration and restorative measures by a dentist can be taken to ensure that the problems treated and minimized.

Darkened Teeth

After a lifetime of consuming food, tobacco, drinking coffee, tea and other stain inducing liquids, the elderly will find that darkened teeth may be a problem. Darkened teeth can also be caused by changes to dentin, which is the tissue that lies beneath the tooth enamel. Darkened teeth have become a scourge among those addicted to chewing betel leaf and arecanut. Stained teeth become a social setback for many elderly persons.

Denture Care

Dentures need to be changed every 3 to 5 years. This is because the gums and teeth that support dentures will change shape and position over time. Then the dentures will no longer fit well. Continuing to use worn-out dentures that do not fit well can cause a range of problems like ulcers or sores on the gums and looseness of the remaining teeth. Furthermore, chewing will not be so efficient. Even the appearance of the person can be affected. Regular checkups for older patients to make sure that their dentures are in good condition should be carried out and ensure that they are cleaning their dentures, as well as their natural teeth, well.

Attitude to Dental Care

Older adults may not have had the benefit or regular care during their youth so their dental health would be compromised. In addition, they may be distracted with other issues and think that dental care is “unnecessary”.

Now with increasing evidence of the connection between evidence of the connection between the health of our mouths and our general health the necessity for clean, healthy mouths become clear.

Our mouths affect our physical health and our psychological well-being-at any age. Good oral habits like brushing and flossing need to be maintained all through life, more so when one advances in age to avoid other complications.

Daily Dental Care for the Elderly

Daily dental care for the elderly should consist of a regular brushing and flossing routine. This should occur twice daily, once in the morning and then before going to bed at night. Persons wearing partial or full dentures should take particular care to have the dentures cleaned thoroughly to ensure that no food is left on the dentures that can contribute to gum disease. If you have a problem with mobility and find it hard to visit the dentist at his clinic then there are now mobile vans with dentists who will make visits, either in your home or to your nearest residential home. The mobile vans are a feature of the Oral Health Month celebrations. The ageing process does not mean that teeth should be neglected and regular dental care means many senior citizens can have a full set of healthy teeth for the duration of their lives. Dental health contributes to longer life!

Dental Examinations for the Elderly

Regular dental examinations for the elderly are vital in order to ensure that any oral diseases are caught in the early stages. When you visit your dentist for an examination, the dentist will take into consideration health complications that the elderly are susceptible to. If it has been a while since your last examination, the dentist will take into consideration health complications that the elderly are susceptible to. If it has been a while since your last examination then the dentist should conduct a thorough oral examination and he will also ask questions regarding your general oral health, particularly if there has been any recent bleeding to your gums or swellings in your mouth.

During the examination, the dentist will check your face, neck, lymph nodes and salivary glands. This is quite normal as the dentist will be looking for any swellings, lumps or discoloration to the skin. The dentist will then conduct a full oral examination of your mouth, gums and teeth, looking closely for any signs of gum disease or decaying or cracked teeth. If you wear dentures the dentist will also examine these for any signs of breakage or wear.

Ageing and Oral Health