Senior Dental Care
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Senior Dental Care

Older adults are more susceptible to dental problems than younger adults. Years of use, loss of insurance coverage, physical limitations that keep them from sitting through dental appointments, and neglect of routine oral hygiene due to memory loss and dementia contribute to oral health issues.

Dental problems worsen over time and eventually affect overall health. This exacerbation makes vigilance even more important for seniors. The incidence of tooth problems is higher among lower income and minority populations. Awareness of the causes of tooth decay and preventive steps can help seniors preserve and keep their teeth as they age.

What are the Main Causes of Dental Problems in Older Adults?

Many causes of dental problems in childhood and young adulthood carry over into older adulthood. However, age-related biological changes accelerate tooth decay and create new problems. The following are the most common causes of dental issues for older adults:
•Poor Oral Hygiene: Dentists recommend brushing for two minutes, at least twice a day or after every meal. This removes plaque and bacteria, which can build up on teeth and cause decay. Patients should also floss daily to remove trapped food particles between teeth.
•Skipping Routine Dental Care: The American Dental Association recommends a dental exam and cleaning every six months. Professional cleaning removes plaque buildup that brushing can miss. Dental examinations reveal tooth weakness and gum disease in their earliest stages. Detection allows faster intervention, which prevents minor issues from progressing.
•Poor-fitting Bridges and Dentures: Bridges and dentures replace missing teeth, allowing wearers to eat and speak normally. When the devices are poorly fit to the wearer’s mouth or degenerative changes to the oral cavity shift their fit, individuals experience agitation that leads to pain, inflammation, and infection. This can alter bite patterns, harm the jawbone, and affect natural teeth.
•Poor Diet: Acidic foods, processed sugar, coffee, and carbonated beverages bond to teeth and break down the enamel. This makes them more vulnerable to decay and bacteria. Poor diets also compromise overall health, leading to medical conditions that can compromise gum tissue and restrict blood flow, harming the oral cavity.
•Tobacco Products: Cigarettes, cigars, and chewing tobacco stain teeth, weaken enamel, and harm the gums. Smokers are also less likely to follow routine dental care recommendations. Smoking and dipping are also significant risk factors for oral cancers.
•Diabetes: Aging adults are more likely to develop diabetes. The disease, and the medication used in its treatment, can cause dry mouth or increase the glucose in your saliva. This allows bacteria to grow in your mouth and causes gum disease, which accelerates dental problems.
Alzheimer’s, Dementia, and Degenerative Neurological Disorders: Age-related memory loss and cognitive decline affect a person’s ability to remember routines and follow up on issues. Individuals with Alzheimer’s may forget how to use a toothbrush or overlook a toothache and fail to schedule dental care. During the later stages of these conditions, individuals may be unable to tolerate extended dental procedures or have difficulty complying with instructions.

How Do Dental Problems Impact Daily Life and Quality of Life for Seniors?

Smiles are a major factor in everyone’s first impression. Eating, speaking, and socializing require constant use of the mouth. Tooth problems can cause emotional and physical pain, leading people to alter their behaviors to compensate.
•Poor Nutrition: Healthy diets require whole grains, lean proteins, vegetables, and fruits. Eating these foods requires strong and healthy teeth. Adults with dental problems have difficulty chewing, leading them to choose softer foods, which often lack fiber and adequate caloric content. This harms digestive and overall health. Additionally, many softer foods are higher in sugar, which exacerbates pre-existing tooth problems.
•Self-Esteem: Broken, missing, or discolored teeth alter one’s self-image, causing negative feelings and a loss of confidence. This can lead to anxiety and depression as the person dwells on their dental issue.
•Social Withdrawal: People with dental issues may avoid social interactions when they can over insecurity or embarrassment. Dental problems may alter speech, leading people to avoid conversing with even acquaintances and loved ones. This withdrawal can lead to feelings of isolation, which further extend negative emotions.
•Pain: Dental problems progress when left untreated. This leads to significant pain, which worsens with time. Dental pain affects happiness, elevates stress, diminishes focus, and compromises the overall quality of life. Pain is often one of the last symptoms of significant dental problems.

Caring for Teeth in Old Age

Seniors’ teeth are more vulnerable to decay due to age-related loss of enamel, age-related health changes, and the side effects of certain medications. Older adults need to maintain good oral hygiene. They must monitor for changes in the mouth or teeth. Early detection and intervention is the best way to prevent problems from progressing.

Older adults should brush twice per day using toothpaste that contains fluoride. They should consult their doctor with questions about selecting the right brand. A brush that comfortably fits in the mouth but reaches all areas of the teeth is best. Flossing once per day is necessary to remove bacteria and food particles trapped between the teeth.

Seniors with dry mouths should sip water or other sugar-free non-carbonated beverages to help protect their teeth and gums. Sugar-free gums or hard candy can also increase natural saliva production. A dentist may be able to recommend artificial saliva.

Quitting smoking and tobacco use, limiting coffee and tea intake, and avoiding alcohol help protect aging teeth and prevent exacerbation of the conditions that worsen dental problems.

Attending dental appointments for routine cleanings and exams is important for seniors. Guidelines suggest a follow-up every six months, but dentists may make other recommendations based on a patient’s oral health and needs. Proactive dental care can detect problems in their earliest stages, minimize the amount of treatment, and maximize the preservation of natural teeth. Patients should advise their dentist about their medical history and what medications they take at each visit.

If a senior uses dentures or an appliance, they must maintain the hygiene of their natural teeth and clean the dentures. Routine dental care is necessary to ensure the appliance fits properly and remains intact.

Providing Dental Care for a Senior Loved One

Caregivers should establish a routine and be aware of the seriousness of dental problems for older adults. Those responsible for an older adult’s care should familiarize themselves with the common problems and risk factors.

Seniors with memory challenges should be reminded to brush twice a day. Caregivers should prompt them to brush or prepare their brush and supervise. Individuals with advanced cognitive decline or issues with coordination may need instruction or for their caregiver to brush them. The caregiver should use a small-headed toothbrush with soft bristles and brush the senior’s teeth and gums in a gentle circular motion.

Caregivers should schedule appointments, arrange transport, and possibly attend dental visits with their seniors. They should advise the dentists about the older adult’s health history, changes in their mouth, and medications.

If a senior resides in a long-term care facility, their caregiver should confirm with staff that the senior’s care includes oral hygiene. Caregivers should check the senior’s mouth and teeth for changes to the gums, tongue, and teeth during visits.

FAQ

What happens to teeth as they age?

Teeth are composed of a pulpy core made of dentin surrounded by a hard crown covered in enamel. They are affixed to the gums by dense tissue called roots, which hold them in place. Teeth cannot repair themselves or regenerate over time like bones or soft tissue.

As a person ages, food and beverages wear down the enamel. Proper brushing and dental care preserve the enamel. However, as it weakens, bacteria can penetrate the crown and harm the dentin, leading to tooth decay. Over time, dentin breaks down like other soft tissue in the body. As it deteriorates, the dentin becomes thinner and causes dark spots to appear in the teeth.

As people age, gum disease may cause the soft tissue around the teeth to recede, exposing the roots. Unprotected roots are vulnerable to bacteria. Exposure allows significant decay that can lead to severe pain, infection, and tooth loss.

How often should seniors get dental exams?

Dentists recommend biannual dental visits at a minimum. Professional cleanings remove stubborn plaque and complement routine brushing. Examinations are critical because they can identify gum disease, tooth decay, and other oral health problems in their earliest stages. Dentists may recommend a more frequent schedule to patients with complex dental problems, comorbidities, or other issues.

Does gum disease cause dementia?

The mouth contains over 700 types of bacteria. Gum disease breaks down the soft tissue, providing bacteria the chance to enter the bloodstream and travel to the brain. Studies indicate a link between oral bacteria and brain inflammation, supporting the link between gum disease and neurodegenerative conditions, including Alzheimer’s and dementia. Incidences of dementia are much higher in older adults with diagnosed gum disease than in their peers.

Does tooth loss cause dementia?

One current study found that individuals with tooth loss have a 48% higher risk of cognitive decline and a 28% higher chance of developing dementia. Scientists are now investigating the link between poor oral health and neurological degenerative disorders, including Alzheimer’s and Parkinson’s. Researchers also propose that nutritional deficits related to tooth loss may contribute to memory and cognitive disorders.

Final Thoughts

Tooth problems are an insidious issue for many older adults. Oftentimes, seniors delay treatment because they are unaware of progressing issues or due to financial considerations. It’s critical for seniors to maintain consistent oral hygiene, follow up with a dentist for twice-yearly cleanings, and remain vigilant about changes in their mouth or teeth that require immediate attention.

Seniors and their caregivers must consider the impact their overall health, medications, and mobility have on their dental health. Proactive steps to ensure teeth are properly maintained, doctor’s recommendation are complied with, and problems are addressed early is critical to preserving natural teeth and improving overall wellness.

Sources

1. Tooth loss associated with cognitive impairment, dementia – Harvard Medical School

2. Large study links gum disease with dementia – National Institute on Aging

3. Dental Care (for dementia) – Family Caregiver Alliance

4. Dry Mouth and Older Adults: Information for Caregivers

5. Oral Health for Older Adults: Quick Tips – U.S Department of Health and Human Services

6. Oral health-related quality of life and loneliness among older adults – National Library of Medicine 

7. Oral Health among Elderly, Impact on Life Quality, Access of Elderly Patients to Oral Health Services and Methods to Improve Oral Health: A Narrative Review – National Library of Medicine 

8. Dental Care – Alzheimer’s Association 

9. Diabetes, Gum Disease, & Other Dental Problems – National Institute of Diabetes and Digestive and Kidney Diseases

10. Older Adult Oral Health – Centers for Disease Control and Prevention

11. Brushing Your Teeth – Mouthhealthy.org

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