Aging and oral health
North Americans are generally leading longer and healthier lives. Today’s seniors are also enjoying good oral health, keeping their natural teeth longer than previous generations.
The maintenance of good oral health is stressed throughout one’s life. It remains a very important cornerstone to good overall health and quality of life. Neglect of teeth and gums leads to infections in the mouth. There is a growing body of medical evidence that shows that the inflammation that results due to the infection in the mouth may be closely linked to other diseases such as diabetes and heart disease, and in severe cases can even lead to respiratory infection like pneumonia. But, by simply keeping up with regular brushing and flossing as part of your daily regimen, you can maintain good oral health. Your regular dental visits are a further assurance to help screen for other serious diseases including oral cancer.
Follow the same simple rules that have supported you throughout your life including:
- Maintain a daily regimen of brushing and flossing
- Avoid alcohol or drink only moderately
- Avoid tobacco
- Eat a healthy and balanced diet that incorporates fruits, vegetables and fibre-rich foods.
- Limit sugar-intake
- Visit the dentist regularly. Please do ask us any questions that you may have with respect to your oral health and update us on any changes to medications that you may be taking. If you are caring for an elderly parent, ask about ways for you to support their oral health care.
With increased age, seniors can be faced with several major overall problems related to their oral health:
- Age changes; general changes in their body physiology
- Dealing with the effects of disease and drug therapy; seniors may become more susceptible to oral diseases such as decay, gum disease and oral cancer. Additionally, increased use of medications, physical and cognitive deterioration and changes in diet may begin to impact oral health.
- Due to an incapacity to be mobile, seniors may not be able to always receive proper and timely dental care.
Here are a few other influencing factors to consider and discuss with your dentists.
Cavities and decay – Due to the lack of fluoride when many of today’s seniors grew up, they had a higher tendency to develop decay at a younger age, and consequently had more fillings than many of today’s younger population. Today, many of these fillings, if not looked after with proper oral hygiene at home, can develop re-decay around their margins. Another factor that leads to an increased incidence of decay in seniors is gum recession. Over time, if one is not careful in maintaining good oral hygiene, our gums can significantly recede. As the gums recede, the roots are more exposed and therefore susceptible to decay-causing acids.
Gum disease – Gum disease (gingivitis and periodontitis) is essentially caused by the bacteria found in plaque. The research evidence suggests that older patients develop plaque more quickly, but that the majority can prevent and maintain their gums and their health by focusing on good home care and regular preventive care at the dentist’s office.
Oral cancer – The incidence of oral cancer is higher among seniors. Regular dental visits can help to spot early signs of oral cancer and pre-cancerous conditions.
Dry mouth (xerostomia) – Older adults are susceptible to dry mouth, an appropriate environment for bacterial growth. The dryness of the oral cavity can result from a number of factors. Medications can influence the secretion of saliva from the salivary glands. The lack of normal saliva production leads to a very dry environment in the mouth. This dry environment results in an imbalance in the normal bacteria in the mouth and can lead to an overgrowth of microorganisms that result in increased dental decay and soft tissue infections of the mouth. Without saliva, your body losses one of its natural defences to cleanse the mouth of harmful cavity-causing bacteria.
To help combat a dry mouth, avoid caffeine and tobacco. Make sure you drink plenty of water and avoid refined sugar.
Medications – Many Seniors have been prescribed medications that contain sugar and can cause dry mouth, both factors that can influence oral disease. Common causes of dry mouth include certain prescription medications (eg. Antidepressants, antihistamines, pain medications, etc.), anxiety states, certain cancer therapies that might involve irradiation of the head and neck, chemotherapy, states of anxiety, Sjogren Syndrome, HIV/AIDS, diabetes, Parkinson’s disease, and certain foods and tobacco. 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 – Unfortunately, many seniors may begin to experience mouth or teeth problems that make them less likely to consume a healthy diet which further leads to a negative impact 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. All the more reason if possible for our aging population to try and keep their natural teeth longer in life. By virtue of being able to use their teeth, seniors make better nutrition choices, allowing them to continue to enjoy a wide variety of foods that further support ongoing oral health.
Health conditions – While diseases of the mouth and surrounding areas are a serious health risk, their relationship to overall general health is often not considered important or is simply overlooked.
Gum disease that is left untreated can lead to an increased risk of diseases of the respiratory system. This is primarily caused when the toxic bacteria that are contained in plaque make their way from the mouth to the lungs. The result is either respiratory infections or worsening of already existing cardiovascular conditions.
Seniors that are living with diabetes are a more susceptible population group to the effects of periodontal disease (i.e. gum disease that has advanced to the point of causing loss of bone and tissue attachments around existing teeth). Diabetics with uncontrolled gum disease are therefore more susceptible to tooth loss.
Seniors that may have compromised immune systems due to existing chronic ailments or medications are more susceptible to getting fungal and viral infections of the mouth.
Sensitive Teeth – A great number of people complain of tooth sensitivity, but more so amongst the senior population. The sensitivity is usually the result of a lifetime of wear and tear of the teeth and gums caused by factors such as brushing too aggressively, lack of oral hygiene leading to receded gums and overall gum disease, broken and fractured teeth, bruxism (grinding of teeth), acidic foods and complications resulting from certain dental treatments. The triggers for tooth sensitivity can be anything from thermal stimulation (hot or cold foods or drinks), sugary or acidic foods, or even just breathing in cold air.
Dentures – Many seniors who have lost some or all of their teeth are wearing removable dentures to replace those missing teeth. The proper care and maintenance of these partial or complete dentures is paramount to maintaining the health of the mouth. Poorly fitting dentures, and those that are not removed regularly to allow oral tissues and existing teeth to be adequately cleaned, can lead to further dental and oral tissue problems. Seniors that wear dentures are advised to continue regular dental visits to ensure the proper fit and function of their dental prosthesis.
Tips for seniors and caregivers
Regular dental visits are a perfect time to speak to the dentist about concerns that you may have with regard to your oral health (or that of someone under your care) and will help to spot trouble early. It is also a time to update the dentist as to any medical issues or medications that you may be taking that could adversely affect your oral health.
Some additional tips for seniors and caregivers:
Brushing and flossing
Review the tips for proper brushing and flossing as instructed by your dentist or dental hygienist.
Always choose a soft toothbrush, run the bristles under warm water so as to further soften the brush against gum tissue, and remember to replace worn brushes every 3 to 6 months.
If you suffer from any condition that makes holding the toothbrush a challenge (e.g. arthritis or any other health conditions), speak to your dentist or dental hygienist about options
Denture Care
When cleaning or caring for your denture, in order to avoid accidental breakage should they fall, make sure to have a folded towel or a sink full of water over which you handle your denture.
Avoid letting your dentures dry out. When not worn, do not simply leave them out exposed to the drying effects of air. Remember to soak them in a glass with water or a denture-cleaning solution.
Never place your dentures in hot water, as that will cause the denture material to warp.
Brush, clean and rinse your dentures daily.
Message to Caregivers
If you are caring for a senior who is faced with physical or cognitive deterioration, please take note of their oral health by simply observation inside their mouth for any problems. Their oral health does impact the quality of their lives and their overall systemic health. Maintain their regular dental visits in order that any problematic symptoms or troubling signs can be dealt with early. If possible, attend the dental visit with the elder in your care in order to provide as much relevant medical information as possible.