When we think of developing good oral hygiene habits, we usually think of children. And it is true, that the best time of life to create good habits like these is when you are very young. Dental health, however, is important throughout life, and may be even more significant for older adults.
Teeth are in greater jeopardy as they age. Statistics from the Center for Disease Control (CDC) for 2014 show that 2.3% of adults 18-44 years old were missing all of their natural teeth. For the age group 65-74 years old, this rate jumps to 16.4%. For the population of American adults over 75, the rate of total tooth loss is 26.8%. Older adults may experience dental decay at a higher rate than children because gum recession exposes a larger part of the tooth to contaminants.
Exposure to contaminants threatens tooth decay, but poor oral health is reflected in various other health conditions, and old age is the most vulnerable time for a breakdown of healthy body systems. The decay and loss of natural teeth is not inevitable in old age, though. Through proper oral hygiene, the elderly can continue to maintain good dental health and thereby have a positive effect on the rest of their bodies.
Importance of Dental Care for Elderly
There is a connection between oral hygiene and health in the rest of your body. In fact, oral health is a general indicator of other health issues. The mouth is naturally full of bacteria. As long as that bacteria is kept in check by good oral hygiene habits and functioning saliva glands, there are no problems.
Problems do arise, however, when oral hygiene is poor or saliva production is impeded, such as in elderly patients. When the bacteria collect in the mouth and travel throughout the body, it can cause or accelerate infections in other areas. Four important problems that can develop as a result of poor oral hygiene are:
Respiratory Infections — Pneumonia is a serious concern for the elderly, who often have diminished lung capacity due to aging. When you have infected teeth or gum disease, you are constantly breathing in that bacteria. It can travel to your lungs and cause infections as well. A build up of bad bacteria in the mouth for any reason is dangerous to your lungs.
Diabetic Complications — Diabetes is common among senior citizens, most of whom manage to control their symptoms with diet and exercise or medication. Diabetics are more prone to periodontal disease, due to a reduction in blood circulation. Blood sugar levels are also harder to control when gum disease is present. A combination of diabetes and periodontal disease can result in a prolonged period of uncontrolled blood sugar levels, which may cause more serious diabetes complications.
Cardiovascular Disease — Excessive bacteria build up in the mouth can easily get into the blood stream through gum tissue or abrasions in the mouth from poorly fit dentures. The more bacteria that get into the blood stream, the more likely it will travel to the heart and induce an infection. Bacteria can also cause hardening in the arteries around the heart, increasing the risk of a blood flow blockage, resulting in stroke or heart attack.
Dementia — When excessive bacteria travels around the body, it can possibly get into the brain through the bloodstream or even nerve channels in the head. If bacteria get into your brain, it can kill brain cells and later your thought patterns. Those sorts of changes in brain chemistry, especially in the elderly, can lead to dementia or Alzheimer’s.
The elderly are more susceptible to infection because their immune systems are not as strong as they once were. Bacteria build up in the mouth is a concern, especially given the location of the mouth in the head, with easy access to vital systems. As a result of age, senior citizens are more likely to have oral conditions that promote bacteria development.
As we age our health conditions change, including oral health. The increased use of medications, changes in body chemistry and other life changes affect the teeth and gums and can result in conditions not generally seen in younger patients.
Senior citizens are more likely to have dentures than younger patients. They also tend to take more medications and are prone to systemic health issues that affect their oral health. Common dental conditions that present in elderly patients include:
- Root Decay — The roots of the teeth are generally concealed by gum tissue. They do not have a protective coat of enamel like the crown of the teeth, so when the roots are exposed, they tend to decay rapidly. Root decay becomes a concern when gum tissue recedes.
- Dry Mouth — A number of medications can cause reduced saliva production. Certain diseases can also result in a chronic dry mouth. Radiation treatment applied to the head, neck or throat, to fight cancer or other serious diseases, may also reduce the flow of saliva in the mouth.
- Diminished Sense of Taste — As people age, their senses become impaired, including their sense of taste. Other factors, such as dentures, diseases and medications, also reduce the ability to distinguish between subtle flavors.
- Tooth Loss — Tooth loss is a very common condition for senior citizens. It is primarily caused by gum disease. Losing teeth can affect your bite and actually alter your eating habits, keeping you from getting the nutrition you need to stay healthy.
- Darkened Teeth — A lifetime of foods and beverages can leave teeth stained and yellowed, or even brown. This discoloration also appears when the enamel layer wears thin, revealing the dentin underneath. Dentin itself can undergo changes later in life that makes it appeal darker.
- Thrush — An overgrowth of a fungus commonly found in the mouth, Thrush is the equivalent of a yeast infection. Candida albicans can be triggered by certain diseases or drugs, some of which reduce the count of good bacteria in the system which normally keeps it in check.
- Stomatitis — The tissue beneath a denture can become inflamed and painful. When dentures don’t fit properly, are not refitted periodically, (following weight gain or loss, for instance) this condition can occur. An over abundance of fungus, like Thrush, or generally poor dental hygiene can also contribute to this condition.
- Uneven Jawbone — Following tooth loss, the jawbone can become unstable. When missing teeth are not replaced, the remaining teeth have room to move around and will drift into the empty spaces. Ultimately, the bite is affected, causing pain and other health issues including malnutrition.
Dentistry for senior citizens is a different practice than pediatric dentistry, for example. Older adults have different concerns when it comes to oral hygiene, and they need a dentist who is experienced at looking for and treating these conditions. When caught early in elderly patients, these common dental conditions can be reversed or relieved with treatment. As the condition lingers and is allowed to develop further, it takes more invasive measures to address.
Good oral hygiene is important at any age. As we get older, it becomes especially important, since dental health is closely linked to some serious health concerns for the elderly. The mouth becomes an avenue for bacteria to enter the blood stream and even the nervous system. Seniors, who already have a less robust immune system, should take precautions to protect themselves against excessive and unwanted bacterial contamination.
A comprehensive oral hygiene routine will help ensure that bacteria don’t to build up in the mouth. For many people, continuing a regular routine is enough. For some, making additions to the oral hygiene regime as you age is a good idea. The most important part of maintaining dental health for the elderly is keep the teeth and gums clean and having a dentist monitor the situation on a regular basis.
A healthy oral hygiene regime for the elderly includes:
The habit of brushing and flossing your teeth that you have established over your lifetime will serve you particularly well in your later years. Brushing is the first defense against bacteria buildup, tooth decay and gum disease. Even if you have never had a cavity, this is not the time to relax your brushing and flossing routine.
Since senior citizens are more susceptible to gum disease and tooth decay, it is a good idea to increase your daily efforts to fight cavities. Most dentists recommend brushing with fluoride toothpaste at least twice a day, and even between meals if necessary. Also, cleaning between teeth with dental floss or some other product designed for that purpose should be added to your daily routine.
Dentures need cleaned every day, just like natural teeth. Unlike natural teeth, however, dentures cannot be cleaned with toothpaste. It is too abrasive, and may do more damage than good. Instead, be sure to use a product specifically designed for cleaning dentures. Soaking them overnight in water is not enough to remove the bacteria that accumulates up during the day.
Dentures also need to be taken out each day to help maintain healthy gums. The tissue on the inside of the mouth needs at least a four hour break from the dentures each day. It makes sense to do this at night and clean your dentures at the same time.
Dental care is much more accessible now than it used to be. Some people may not have grown up visiting the dentist regularly, but as a senior citizen it is important. An annual dental check up can support your at-home cleaning efforts and also recognize signs of gum disease and tooth decay while it can still be treated.
Treat your dentist as part of your regular medical team. Be sure to update him on the medications you’re taking, or any health issues you have experienced since your last check up. He can give you tips on improving your oral hygiene routine. Remember that what goes on in your mouth can affect your whole body, so talk with your dentist about changes in diet, lifestyle and health since your last visit.
It is important to be aware of a dry mouth condition and take steps to improve it. Dry mouth can accelerate tooth decay and cause dentures to fit poorly and irritate the skin underneath them. By adding a moisturizing mouthwash to your daily oral hygiene regime, you could improve or even eliminate dry mouth. There are also sprays and gums available that encourage saliva production. Artificial saliva products are available at the pharmacy, but it is a good idea to consult your dentist about what product is right for you.
Diet and Lifestyle
Everything you put in your mouth has a potential to affect your oral hygiene. Maintaining a healthy diet, including fresh fruits and vegetables, will help keep your teeth and gums in good shape. Chewing is good exercise for your mouth.
Chewing tobacco or smoking cigarettes is not healthy for your mouth. You may have used tobacco products for years without any obvious consequences, but when you reach your twilight years your health risk from these increases. Ask your dentist about tobacco cessation products that could improve your oral health.
Fluoride continues to be an important part of a healthy diet, even for the elderly. Drinking plenty of water helps to remain hydrated and flushes out toxins. Scientists have proved that drinking fluoridated helps maintain healthy teeth, and is an important part of good oral hygiene.
Just like every other system of the body, it is important to maintain good oral health as we age. A robust hygiene routine will help insure good oral health by preventing decay and disease and by treating any adverse conditions before they become serious and affect other parts of the body. The mouth is the gateway to the body, so it makes sense to take care of it.
Making Dental Health a Priority
There was a time when dentistry was a luxury for those who could afford it. It was considered cosmetic, not essential and not covered by insurance. Many people who visited the dentist were concerned about how their teeth looked, and it was an accepted fact that senior citizens would lose their teeth.
Now, we recognize that dental health is an integral part of an overall healthy lifestyle. Teeth that look good are nice, but the health of your gums and the other tissue in your mouth is perhaps even more important. What goes on in your mouth effects the rest of your body and can change your health status is serious ways.
As we age, change is inevitable, but it doesn’t have to be all bad. Losing your teeth in your old age is no longer a forgone conclusion. By adjusting your regular oral hygiene routine for the conditions common to senior citizens, you can maintain good dental health, and that will be reflected in your overall health. Make dental health a priority to maintain a good quality of life throughout your twilight years.