Good dental health is vital
for everyone because a healthy mouth is important for speaking, chewing, and
overall health. This is why it is essential that all older adults receive
good dental health care on a daily basis. It is important for the
caretakers of older family members or older patients to learn what techniques
will provide them with the best dental care.
Remember many older
adults or patients are sensitive to having their mouth and/or head touched.
Always be sure to move slowly and
explain exactly what you are going to do in order to not caught them off
guard or startle them.
While you brush and floss their teeth talk in
a soft, soothing, and friendly voice to put them at ease.
They will struggle and fuss less if you
approach them in an gentle and caring manner.
Here are some dental health
Use a soft bristle toothbrush
Brush their teeth with a gentle
circular massaging motion on the outside and inside surfaces of their
Be sure to brush the biting surfaces of their
Do not brush their tongue, it can cause
irritation. Scrape their tongue with a
tongue scrapper to remove bacteria and debris.
Replace their toothbrush about every three
You can try to give them some independence by
strapping their toothbrush to their hand by using a wide elastic band that attaches
their toothbrush to their hand.
You can enlarge the brush handle by
"taping" it to a sponge, bike handle grip or rubber ball. Or
try using "good old" duck tape wrapped around the handle to
increase the size of the handle to make it easier for them to grip.
You can lengthen the handle of the toothbrush
by taping tongue depressors, Popsicle sticks or a ruler to the handle.
toothbrush is another option that we recommend to many patients.
Don't let them share toothbrushes with anyone
If they are not use to flossing try the automatic
flosser. Their gums may bleed and be sore for about a week but
that will stop with regular flossing.
If they are use to using tread type floss you
need to use the following flossing technique:
How to floss, but don't forget to floss behind the last teeth in their
mouth, on each side ,because it removes bacteria and food around and under
the gumline where a toothbrush can not reach.
While you are flossing their teeth try
visiting with them or turn on the radio or TV. for a distraction.
Each morning BEFORE dentures are placed in
the mouth, it is important that the gums and roof of the mouth be gently
brushed with toothpaste to remove plaque and stimulate the gums.
The tongue should be scrapped for fresher
The dentures are to be cleaned daily to
remove plaque, food and to prevent staining. To learn how to clean
dentures see: Denture Care.
Any denture that is broken, chipped or
cracked should NOT be repaired by you but taken to their dentist to be professionally
If their denture is loose or ill-fitting they
should be taken to the dentist immediately, because poorly fitting dentures
can make painful sores in their mouths
If you notice any of the
following condition/s PLEASE contact their dentist or doctor:
Change in how their teeth fit together
Red, swollen or tender gums
Pus at the gumline of a tooth
Change in the fit of their dentures or
Very bad breath
Loss of taste and weight loss
Loose or chipped teeth
(Information provided by CDA)
communication techniques for people with
Rescuing - a second caregiver tells 1st carer
to leave so that she can
"help" her friend the resident.
Distraction - busy boards with familiar
Bridging - residents holds toothbrush while
RDH uses prop to break the peri-oral muscles spasms.
Hand-over-hand – carer’s hand placed over
resident’s hand to guide
Chaining - carer starts the activity,
resident completes it.
Dental problems can boost pneumonia risk in
Better dental care among the
elderly — especially in nursing homes — could reduce cases
of a particular type of pneumonia, according to
researchers from the University of Michigan and Veterans
Administration. Aspiration pneumonia is an infection that
occurs after bits of food or stomach contents are inhaled into
the lungs. Investigators found patients were at higher risk
for this type of pneumonia if they had dental plaque or
certain types of mouth bacteria. Overall, patients who had
a stroke, chronic obstructive pulmonary disease or
needed help eating were at risk for the ailment. "We
know, as a result of previous studies, that it's just an area
that tends to be overlooked in nursing homes It's often left
to the residents to clean their mouth, and they just ignore
it.People with dementia or other conditions that impair
their mental status, or those who can't easily move their
hands, are especially likely to have dental problems. In
the meantime, nursing homes should assign and educate specific
staff members, preferably nurse's aides, to do some actual
tooth brushing for people who can't brush their own teeth.
Additionally, they should encourage the use of a mouthwash,
such as chlorhexidine, which can kill some harmful organisms
in the mouth. "
By Meg Bryant Washington (Reuters
Respiratory infections The
oral cavity has long been considered a potential reservoir for
respiratory pathogens. The mechanisms of infection could
aspiration into the lung of oral
pathogens capable of causing pneumonia
colonization of dental plaque by
respiratory pathogens followed by aspiration
facilitation by periodontal pathogens
of colonization of the upper airway by pulmonary pathogens.
Several anaerobic bacteria from the
periodontal pocket have been isolated from infected lungs. In
elderly patients living in chronic care facilities, the colonization of
dental plaque by pulmonary pathogens is frequent. Notably, the
overreaction of the inflammatory process that leads to destruction of
connective tissue is present in both periodontal disease and emphysema.
This overreaction may explain the association between periodontal
disease and chronic obstructive pulmonary disease, the fourth
leading cause of death in the United States. These findings underline
the necessity for improving oral hygiene among patients who are at
risk and those living in long-term institutions.
[Mojon P Oral Health and Respiratory Infection JCDA 2002;68(6):340-5]
Poor Dental Hygiene in Elderly May Increase Risk of
Type of Pneumonia
A study of patients aged 57 years to
98 years found an increased risk for aspiration pneumonia in
individuals with dental plaque or certain types of mouth bacteria.
Aspiration pneumonia is an infection that is caused by
bits of food or stomach contents being inhaled into the lungs. The
study reviewed records of 408 patients and found those who had a
stroke; had chronic obstructive pulmonary disease, including emphysema
and chronic bronchitis; or needed help eating, were at risk for the
infection. They suggested that nursing
homes encourage the use of mouthwash and that they assign and educate
specific staff members to perform tooth brushing for those patients
who cannot do it for themselves.
Another study found: "Nursing home residents
who received regular dental cleanings were not only less likely to
contract pneumonia, but also less likely to die from the infection if
they did develop one. Pneumonia is caused by germs that gather in
the lungs and block the flow of oxygen to the body. If air in the
mouth is already tainted with disease-causing bacteria, it is easier
for an infection to spread to the lungs". They found that
" those who didn't receive the professional cleanings were
twice as likely to develop pneumonia and twice as likely to die from
Special Care in Dentistry Journal, Vol.20, No 4
2000 pgs. 149-153.
***Colleen Davy, RDH, DHSCL, British Columbia, CAN. firstname.lastname@example.org
Cyber Notes, Jan 2001
~Journal of the American Geriatrics Society, Kenneth Shay,
DDS July 2002.
February 06, 2008
Older Adult Index