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Why Is Oral Care Important In The Elderly?

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Oral care is extremely important, particularly for the elderly. Aside from making day to day life more miserable, tooth loss, oral infections and cavities can severely and adversely impact physical health, especially in frail older adults.

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.


Sometimes seniors just accept dental problems as something that happens in old age, but it doesn’t have to be that way. We know that poor oral hygiene can worsen heart conditions and diabetes, along with increasing the risk of stroke and Alzheimer’s.

Using an electric toothbrush and flossing daily will go a long way toward keeping your mouth and body healthy.

Frequently Asked Questions

What are the most common oral health conditions that affect the aging population?

According to the Centers for Disease Control and Prevention (CDC), the most common oral health condition that affects the elderly population is untreated tooth decay. They state that “Nearly all adults (96%) aged 65 years or older have had a cavity; 1 in 5 have untreated tooth decay.”

Can teeth last a lifetime?

Absolutely! I had a lovely lady patient who still had all her own teeth at age 103. We used to think that people lost teeth simply due to aging, but now we know that you can keep your teeth (or most of them) all your life through proper oral home care. This includes flossing daily and thoroughly brushing twice per day with a fluoridated toothpaste, along with managing a dry mouth and visiting your dentist twice a year.

Oral Hygiene For Seniors With No Teeth

How To Help Elderly Brush Their Teeth

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