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Why Is Oral Care Important In The Elderly?

Good oral care for older adults.

Oral care is crucial in the elderly for several reasons:

  1. Prevention of Common Oral Diseases: Older adults are at a higher risk for various oral health problems, such as tooth decay, gum disease, and oral cancer. Regular oral care can help prevent these issues, which can lead to toothaches, tooth loss, and more serious health complications.
  2. Systemic Health Connections: There is a strong connection between oral health and systemic health. For example, periodontal disease has been linked to diabetes, cardiovascular diseases, and other systemic conditions. Good oral hygiene can help manage these systemic diseases and reduce their impact.
  3. Quality of Life: A healthy mouth allows the elderly to eat properly, enjoy food, and maintain good nutrition, which is essential for overall health. Tooth loss and other dental problems can lead to difficulties in chewing and swallowing, affecting the individual’s ability to consume a balanced diet.
  4. Medication Side Effects: Many older adults take medications that can cause dry mouth, which increases the risk of cavities due to reduced saliva flow. Proper oral care can help mitigate these side effects.
  5. Detection of Oral Cancer: The risk of oral cancer increases with age. Regular dental checkups and being vigilant about changes in the mouth can lead to early detection and treatment.
  6. Impact on Social and Mental Health: Poor oral health can affect an elderly person’s self-esteem, social interactions, and mental health. Maintaining good oral hygiene can help prevent these psychosocial issue.
  7. Challenges with Dementia and Cognitive Impairment: Elderly individuals with cognitive impairments may struggle with maintaining oral hygiene. Assistance and regular dental care are important to prevent oral health problems in these individuals.

As a dental hygienist, I am always extra watchful of the oral health issues of the senior patients in our dental practice.

The elderly often have problems with dry mouth conditions (called xerostomia), which can lead to a high rate of dental caries (cavities).

Part of the reason for this is a decrease in manual dexterity, which means they aren’t able to effectively remove plaque and food debris.

In addition, many seniors have bridges or other dental restorations that can be difficult to keep clean.

And, due to cognitive impairments, some don’t remember to brush and floss.

How Poor Oral Care Can Contribute To Poor Health In The Older Person

  • Periodontal (gum) disease affects your general health. In fact, gum disease carries a higher risk of adverse medical conditions, such as stroke and heart disease, says the American Academy of Periodontology.
  • The American Academy of Periodontology also reports that recently, scientists “uncovered a potential link between P. gingivalis, the bacteria associated with periodontal disease (commonly known as gum disease) and Alzheimer’s.
  • We’ve known for decades that cardiovascular disease can be worse in people who have poor oral health. Over my thirty-plus years in dentistry, I have seen many patients who came in to the office because their cardiologist “made me”. In fact, the American Dental Association (ADA) reports that, “Several studies link chronic inflammation from periodontitis with the development of cardiovascular problems. Some evidence suggests that oral bacteria may be linked to heart disease, arterial blockages and stroke.”
  • Unfortunately, some older people have a poor diet. Nutritional deficiencies can result in missing teeth. “There is a strong link between tooth loss and malnutrition,” says AARP. “Among older patients who received treatment at the Rutgers School of Dental Medicine clinic, more than 25 percent showed signs of malnutrition or were at risk for malnutrition.
  • “Some studies suggest that periodontitis can make it more difficult for people with diabetes to control their blood sugar,” says the American Dental Association (ADA).
  • The Mayo Clinic reports that, “Certain bacteria in your mouth can be pulled into your lungs, causing pneumonia and other respiratory diseases.” This is often seen in seniors who are in nursing homes or who have caregivers who aren’t aware of the need for good oral hygiene.

Healthy Teeth Tips

Good oral health starts with removing plaque and biofilm from your teeth at least twice per day.

Electric toothbrushes help immensely if you have dexterity concerns.

Be sure to get one with a timer (most of us brush for about 35 seconds, but you should be brushing for two full minutes!).

It’s most effective if you divide your mouth into quarters, and use the toothbrush in just one section at a time.

Place the toothbrush partly on your teeth and partly on the gums and “walk it” slowly back and forth until the toothbrush timer signals that you have spent thirty seconds on that section.

Then move on to the next section.

After you’re done, run your tongue along your teeth. If you feel “fuzzy spots”, it means plaque or food is still stuck to your teeth.

You’ve missed cleaning that area and should brush it again.

A water flosser is great for seniors who hate to floss, have dexterity issues, or have bridges and implants to work around.

The one drawback is that they can be super messy until you get the hang of it (keep a towel handy).

Also be sure to remove and clean partials and dentures at least once a day.

And, don’t sleep in them! Your gums and oral tissues need to breathe and sleeping in these appliances is sort of like sleeping with your shoes on.

II also recommend that elderly patients get dental care twice a year – even if you have no teeth.

During regular visits, dental professionals check for signs of oral cancer and other oral health problems in addition to examining the gum tissue under your dentures and ensuring a good fit for your dental appliances.

Fluoride For Elderly

I always recommend using a fluoridated toothpaste, especially if the elder has a dry mouth (xerostomia).

Fluoride helps to reduce the risk of cavities and tooth root decay, which can be a big issue in people with xerostomia because their saliva flow has decreased.

Since saliva naturally “rinses” the teeth and helps to lessen decay-causing bacteria in the mouth, if saliva flow is reduced or impaired, the harmful bacteria gain a foothold and attack soft tooth roots and tooth surfaces.

I have seen senior patients lose so many teeth to decay in a short period of time that they have to go into dentures (which can have their own issues).

How Does Xylitol Help Dry Mouth?

Additionally, if the senior has a dry mouth and sucks on candy or chews gum to help moisten it, the candy or gum should only be sugar free.

Again, that impaired saliva flow is not rinsing off the sugars, so the acids from the candy sit on the teeth and can easily cause rampant decay.

Look for products that contain xylitol, which is a natural sweetener that helps to prevent cavities.

Xylitol tastes sweet but, unlike sugar, it is not converted in the mouth to acids that cause tooth decay. It reduces levels of decay-causing bacteria in saliva and also acts against some bacteria that cause ear infections.

*Note: WebMD also cautions that, “Dog owners should know that xylitol can be toxic to dogs, even when the relatively small amounts from candies are eaten. If your dog eats a product that contains xylitol, it is important to take the dog to a veterinarian immediately.

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