Your Oral Health

Geriatric Oral Health A healthy mouth is one of the greatest ways to keep yourself looking and feeling young, all throughout your life. Even as you grow older, you would surprised to know that how simple care can make you achieve a healthy mouth and a healthy life. This section deals with the oral care of senior citizens and talks of how the old belief that “as you age you ought to lose your teeth” is completely wrong, atleast not in today’s modern dental science. What is Geriatric Dentistry? Geriatric dentistry or gerodontics is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal aging and age-related diseases as part of an interdisciplinary team with other health care professionals. Why is your oral health important? Your mouth performs vital functions of chewing, speech and aesthetics thus forming a part of your appearance, expression and nutrition. The best way to maintain oral health is to maintain your natural teeth and to take care of your mouth. But this certainly doesn’t mean that if you have lost your teeth and do not have adequate oral health, that you have lost your right to good oral health. It is never too late to have good oral health! If you do not replace the missing teeth, then the overall oral health will suffer and so would the functions of expression, nutrition and appearance. Oral and general healths are related. Many oral diseases were considered normal initially and as an outcome of aging. It is important to know that no oral is normal at any age. Many scientific researches have proven that many oral diseases can worsen or risk many systemic diseases beyond doubt. It is thus the importance of good oral health needs no further explanation. Bleeding gums, visible root surfaces and loose teeth are not normal at any age. These are usually signs of an infection called periodontal (gum) disease. Increasing medical evidence suggests that an unhealthy mouth may worsen serious medical problems, like heart disease, stroke and diabetes. Simply said, we know that oral health is important for overall health and vice versa. Periodontal disease is caused by the bacteria in dental plaque, which if not removed through daily tooth brushing and flossing, results in red or swollen gums that bleed easily. If plaque remains on teeth too long, a hard deposit called tartar or calculus forms. This deposit is removed by your dental hygienist or dentist when your teeth are professionally cleaned. Left untreated, periodontal disease can destroy the gum tissues and bone around your teeth and eventually teeth can be lost. Periodontal infections can be serious and can affect not only the mouth, but potentially your overall health. Taking care of your teeth? Brushing, flossing and taking care of your oral hygiene are just as important as it was when you were younger. Taking care of your oral hygiene is one of the major ways to take care of your oral health. However it should be remembered that meticulous oral hygiene doesn’t obviate the need of regular dental visit. Brush your teeth twice a day with a fluoride toothpaste. Choose a toothbrush with soft bristles. Harder bristles can wear away your enamel and damage your teeth and gums. If you have limited ability to move your shoulders, arms and hands you might benefit from using an electric toothbrush. The handle is larger, which makes it easier to hold, and the powered brush does a lot of the fine movement needed to assist with cleaning your teeth. Clean between teeth daily with floss or another interdental cleaner. Floss holders are designed to make it easier to use floss between your teeth. Special interdental cleaners, such as picks, brushes or sticks may also work effectively for you. Talk to your dentist about what types of oral care products will be most effective for you. Oral hygiene products including fluoride and desensitizing toothpastes, toothbrushes, floss, interdental cleaners, oral irrigators, and mouth rinses. Replace your toothbrush every three or four months, or sooner if the bristles become frayed. A worn toothbrush will not do a good job of cleaning your teeth Taking care of your dentures Bacteria stick to your teeth and also to full or partial dentures. If you wear dentures, cleaning them on a daily basis is very important. Generally, dentists say to take your dentures out of your mouth for at least four hours every day. It’s best to remove your full or partial dentures at night. To stay healthy, the lining of your mouth needs to rejuvenate after prolonged contact with dentures. Your own dentist will provide you with instructions about how long your dentures may be worn each day. Denture cleaning products like denture cleansers and overnight soaking solutions, help keep dentures fresh and clean. Simple steps to good oral health The right choice for food and healthy living can make is one of the major ways to prevent oral problems as well as take care of your overall health. Here are one, two, three easy steps for healthy mouth. Drink plenty of water. As your age advances there is a possibility of decrease in the flow of saliva, due to which you may experience dryness of mouth. If the flow of saliva drops considerably then there problems like dental caries and periodontal diseases start showing up. Drinking ample water is one of the basic remedies for such problems. Drinking adequate amount of water is also important for your overall health. Healthy food: Healthy diet rich in natural fibres helps in maintaining the oral hygiene as well as providing nutrients like Vit. C, A, D, etc. necessary to maintain oral tissues is good health. Avoid beverages like coffee, tea, carbonated drinks, which may harm your teeth. If you are suffering from diabetes, then it is essential that you follow your dietician’s/physician’s on food meticulously. Quit Tobacco: There is no age barrier to quit. Research has now proved that quitting at any time has health benefits. Tobacco consumption increases problems with gum disease, tooth decay and tooth loss, affects healing after dental procedures and retention of dental implants. The benefits of quitting smoking are important for both general and oral health. Oral hygiene: Brushing: This is the basic oral hygiene step, which you have been following all your life….Just need to stick to the schedule of brushing twice daily. Use fluoridated tooth paste and contact your dentist to help you select the right brush. You may need to use a medium or a soft tooth brush, soft brush especially if you have undergone gum surgery. Replace your brush every three months, it is essential to prevent harm to your gums caused by the fraying of the bristles. Mouth washing: this is important to kill the harmful bacteria of the mouth and offer you protection against periodontal diseases and caries. Chlorhexidine mouth wash is recommended once daily, cause your teeth need some extra care… Flossing: brushing reaches only 70% of the area, the rest 30% is taken care by inter dental cleaning. If the space between your teeth is more then you may need interdental brush to reach effectively the inter - dental spaces. Ask your dentist for the right choice of floss and interdental brushes. Common oral problems As one grows older there will be prominent facial changes occurring gradually. Subtle alterations in lip curve, mucosal lining mouth, tongue, teeth, gums, and the bone that supports the teeth are some of the changes occurring in the mouth. Dry Mouth (Xerostomia) Reduced saliva flow that results in a dry mouth is a common problem among older adults. It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics. Some of the common problems associated with dry mouth include a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages. Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive cavities can form. Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses. Problems associated with xerostomia can be summarized as: Dental caries and periodontal diseases- due to reduced saliva protection Dryness and burning of mouth Alteration of taste Other infections like sore throat The total effect on the mouth is deteriorating, and unless taken care of can be deleterious. Lips The most common change in lips observed in the elderly patients is a type of lesion called angular cheilitis. The skin folds with fissures at the corners of the mouth. A fungal infection (candidiasis) it is caused due to lack of vitamin B. Treatment with Vitamin B would help resolve the condition Tongue Smooth and shiny tongue is a sign of Burning Mouth Syndrome caused due to deficiency of iron (anaemia) or other minerals. It results in loss of taste, or sensation. Proper nutrition and nutritional supplements would help in the slow resolving of the condition. Teeth With age most of the teeth turn yellowish. Signs of chipped teeth and tooth wear are also common in this age. Thinning at the tooth base is often the result of improper brushing, most of the times due to hard bristled toothbrushes. Dental caries in elderly Tooth decay is not just a child’s problem. Adults of all ages can have cavities, too. The causes for tooth decay are the same for everyone, regardless of age. Decay results when the bacteria in plaque feed on the carbohydrates (sugar) in our diet to produce acids that can cause cavities. Yet, the nature of the decay problems do change somewhat;as people grow older. Adults are more likely to have decay around older fillings, and because many adults grew up without the benefits of fluoride, they may have many more fillings. Decay of the tooth root is also common among older adults. Root caries (decay) occur when the gums recede, exposing the softer root surface, which decays more easily than tooth enamel. Tooth decay is also promoted by dry mouth. This condition—called xerostomia—occurs when the supply of saliva is greatly reduced. It can be caused by many types of medications (such as anti- histamines, anti-hypertensives, and anti-depressants) or radiation therapy to the head or neck. Saliva is needed to lubricate the mouth, wash foods away and neutralize the acids produced by plaque. Allowed to continue, dry mouth can lead to rampant tooth decay. If you think you have this problem, be sure to discuss it with your dentist or physician. They may recommend an artificial saliva and fluoride products to help prevent decay. Tooth loss: Today, older adults are keeping their natural teeth longer because of scientific developments and the preventive emphasis in dentistry. Good oral hygiene and regular dental care are important throughout your life, whatever your age. By practicing good oral hygiene at home and visiting your dentist regularly, you will prevent dental problems and save time and money as well. In the process, you can save your teeth and gums. By avoiding gum diseases and dental caries by maintaining a good oral hygiene, tooth loss can be avoided, thus in turn saving you the problems of tooth loss and also money. Gums Gums disease—periodontal disease—often progresses slowly, without pain, over a long period of time. This is one reason why it is common among older adults. The longer the disease goes undetected and uncontrolled, the more damage it causes to gums and other supporting tissues. Although periodontal disease is caused by plaque, other factors can increase the risk or severity of the condition. These include food left between the teeth, smoking, smokeless (spit) tobacco use, badly aligned teeth, ill- fitting bridges or partial dentures, poor diets and systemic diseases such as anemia. Although periodontal disease is common, it can be controlled or arrested. In its early stages, it can be reversed. Treatment of advanced cases may require surgery. Look for these warning signs and see your dentist if you notice any of them: bleeding gums when you brush; red, tender or swollen gums; gums that have pulled away from the teeth; pus between your teeth and gums when the gums are pressed; loose teeth or teeth that are moving apart; any change in your bite; any change in the fit of your partial dentures; constant bad breath or bad taste. Although periodontal disease is common, it can be controlled or arrested. In its early stages, it can be reversed. Treatment of advanced cases may require surgery. Look for these warning signs and see your dentist if you notice any of them: bleeding gums when you brush; red, tender or swollen gums; gums that have pulled away from the teeth; pus between your teeth and gums when the gums are pressed; loose teeth or teeth that are moving apart; any change in your bite; any change in the fit of your partial dentures; constant bad breath or bad taste. Note: Research has suggested a link between periodontal disease and other chronic diseases like coronary heart disease, stroke, aspiration pneumonia, and complications from diabetes. It is important to visit your dentist: The dental visit is as important at this age as it was when you were young. Even in case that you have lost all your teeth, yet regular visits are important for checking the health of the oral cavity. Dental visit is not only important for checking for diseases like teeth decay and periodontal diseases, but it is also important to check for diseases like oral cancer, bacterial/viral/fungal infections of the oral cavity. There are also possibilities that the medications that you are taking may have an impact on your oral health. It is thus extremely important to inform your dentist of any diseases condition that you are suffering from and the medications that you are on. Many a times medications may reduce the salivary flow and this may predispose you to more problems. Common conditions and medicines that may cause dry mouth are: High blood pressure medications, such as water pills Cholesterol lowering drugs Pain medications, sedatives and muscle relaxants Anxiety, depression and most other psychiatric medications Allergy and asthma medications Seizure medications Medications for Parkinson’s and Alzheimer’s diseas What do you need to get for the dental check up? An up-to-date list of your medications including vitamin supplements An up-to-date list of your medical conditions and allergies and related medical reports and records Information about your health care providers, including all of your doctors and their phone numbers and your previous dentist (if applicable). Information about your emergency contacts. Your dentures or partials, even if you don’t wear them. Thus the importance of regular dental visit cannot be underestimated. Effect of medication on dental treatment When your dentist asks for your medical history, be sure to provide complete, up-to-date information on your health. Inform your dentist if you have experienced recent hospitalization or surgery, or if you have recently been ill. Also tell the dentist the names, doses and frequency of any medications you are taking—whether prescription or over- the-counter products—and the name of your physician. Inform the dentist of any changes in your health or medications. This information will help the dentist to select the most safe and effective method of treatment for you. Dentistry for the elderly Dentists are experiencing a quiet revolution in their offices as the number of older patients increases steadily and their treatment centers more on natural teeth. The profession knows that this burgeoning population group is wearing fewer dentures and is keeping natural teeth longer. Also, we know that some patients in this group require special consideration because reduced mobility and dexterity may make daily oral hygiene difficult. In addition, medical conditions and impairment are factors that dentists take into account for certain patients. Sometimes, lack of awareness about available treatments and techniques leads older patients to make false assumptions about their dental health and tolerate conditions such as toothaches, bleeding gums and clicking dentures. Dentists are gaining practical information on how to effectively manage the treatment needs of older patients. Many dental societies have set up access programs to assist older adults, individuals with physical or mental disabilities or indigent persons to receive care. Dentists are increasingly sensitive to the special needs of and the importance of dental health in the older patient. Older adults are more health conscious as a group than ever before. Their oral health is an important part of their overall health and the dental profession is committed to providing the treatment and guidance older adults need to maintain it. Anxiety for dental treatment Anxiety over dental treatment is not unusual. People of any age can experience it. Older patients may be less able to cope with the stress due to certain physical conditions such as vision or hearing loss. Communication between you and your dentist is an important aspect of a comfortable dental visit. You should share your feelings with your dentist and the staff. Let them know that you are anxious so that they can adjust their treatment and their pace to meet your needs. Advances in pain and anxiety control, including many behavioral therapy techniques borrowed from psychology, have made dental visits relatively anxiety- and pain-free. Cosmetic surgery, what could be the benefits? Older adults can benefit from many of the options available today for improving the look of a smile. Your dentist can describe and discuss with you the range of treatments that would be right for you. Part of older adulthood is the acceptance of aging and the development of realistic expectations for appearance. In that context, dental treatment for older adults can be a healthy and adaptive way of maintaining dental health and emotional well-being. Our teeth and mouth play a critical role in psychological development and well-being throughout our lives. Modern dentistry has expanded esthetic options for people of all ages. Coupled with good oral hygiene and regular dental visits, cosmetic techniques can help improve the appearance of your smile. Affordability of dental treatment Even if you cannot pay for dental care, you don’t need to live without it. Thousands of dentists across the country assist the elderly on fixed incomes by offering their services at reduced fees through dental society-sponsored assistance programs. The availability of such aid varies from one community to another, so call your local dental society for information about where you can find the nearest assistance programs and low-cost dental care locations, such as public health and dental school clinics. Other sources of such information are local social service organizations. Remember, taking care of your teeth is a dual responsibility, that is shared by you and your dentist….Visit your dentist twice a year or as by recommended by your dentist….

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