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                                                        DR. DAN PETERSON

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Your dental health affects your physical well-being!

Home Care Suggestions Dental Needs Update

Oral diseases experienced by the older adult are either preventable or treatable.

     However many older persons do not avail themselves of the much needed treatment. Most persons currently older than 60 years were not introduced to the concept of preventive dentistry at a young age and thus are not use to the idea.

Dental caries (cavities) has increased in the older population 31% in the last 10 years!*

     For adults with their own teeth, effective plaque removal is the basic and essential oral home care procedure. Removal of plaque not only prevents cavities and gum disease but also enhances the overall sense of well-being by ensuring your mouth feels and tastes good.

     1.  Brushing for most older adults needs to be done in a circular manner using a soft toothbrush with light pressure. The best approach to tooth brushing is one specifically designed for your abilities and tooth status provided to you by your dentist.

     2.  Electric toothbrushes may be preferable to manual toothbrushes for many older adults, particularly those with arthritis or limited movement in their hands and arms. Electric toothbrushes usually have enlarged handles and require little or no arm or wrist movement to use.  These are very useful considering this population group has a high prevalence of coronal and root cavities.**

     3.  Toothpastes are also recommended since they contain ingredients that help remove stains, inhibit calculus formation (tartar-control formulas) and provide topical fluoride.

     4.  Since most older adults did not have the benefits of fluorinated water when they were children they can still gain some benefits from fluoride intake as an adult.  Periodic applications of fluoride by your dentist can be supplemented by daily use of a fluoride-containing toothpaste. There is no evidence that fluoride use at recommended doses is dangerous.

    5. Dental floss needs to be used daily to remove plaque from between the teeth. Older adults with impaired manual dexterity may find the use of a automatic flosser to be helpful. 

    6.  Certain mouthwashes or rinses may be good for your oral health, whereas others may be damaging, and may even make existing diseased conditions worse, or may have no effect at all. It is important for you to ask your dentist which mouthrinse is best for you because "cosmetic rinses," which are used primarily for a mouth-freshening effect have major disadvantages. They contain alcohol (6-29%), which can dry and irritate the mouth. Their effects last for only a short time and may only succeed in hiding the real underlying cause of your bad breath, which then may not be attended to properly.

   7. Dentures need to be cleaned after each meal to remove food. Once a day, dentures should be brushed and cleaned thoroughly and allowed to soak overnight. When dentures are out of the mouth they should be stored in a water-filled container. They should always be rinsed thoroughly before placing them into your mouth.

  8.  To help ensure a healthy mouth, it is recommended that the older person see a dentist every six months. At each visit, you should receive a comprehensive intra and extra oral examination, and a thorough questioning regarding changes in oral conditions and habits. X-rays should be taken periodically.

  9.  When redness, irritation, bleeding, soreness, sensitivity to temperature changes and/or chewing is present to such a degree that it interferes with daily routine or persists for more than 2 weeks, the problem should be investigated by a dentist. Often the situation is easily treated.

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Dental Needs Update  

Relationship between dental health and 10-year mortality in a elderly. The aim of the study was to assess the possible role of dental health as a predictor of mortality. The results showed that the more teeth or filled teeth a subject had, the smaller was their risk for death. The effect of missing teeth was significant after adjusting for the general health variables. Results support the hypothesis that poor dental health is linked to increased mortality among elderly people.
European Journal Of Oral Sciences Volume 111 Issue 4 Page 291 - August 2003

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Cleaning teeth may help prevent pneumonia in nursing homes

    Regular cleanings of teeth and gums may help prevent pneumonia in nursing home residents.

    The results are based on comparing pneumonia rates between residents
of 11 nursing homes who received regular teeth cleanings and those who received no additional oral care.

     This study found that residents whose teeth were regularly cleaned had fewer cases of pneumonia and were less likely to die from the infection. Pneumonia is caused by germs that build up in the lungs and block the flow of oxygen to the body. If the mouth is not clean, there are more germs in the mouth and throat, increasing the chances of sparking an infection.

     After following the patients for 2 years, the investigators found that residents whose teeth were not given additional dental care were
almost twice as likely to get pneumonia
. In addition, these residents
were twice as likely to die from the infection
, relative to those whose teeth were cleaned regularly.

     Facilities could have a staff member exclusively charged with brushing residents' teeth.  It is very compelling to have evidence that a common-sense, cheap, anyone-can-do-it intervention — that is supposed to be done anyway —could be saving multiple billions of dollars, if it were just done.  The benefits of oral care go beyond simple economics, it is important for:
bulletcost savings
bulletimproved odor
bullettaste perception
bulletfood enjoyment
bulletsocial interaction 
bulletimproved quality of life
bulletdisease prevention

SOURCE: Journal of the American Geriatrics Society 2002;50:430-433.

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  However, it is always to the older person's advantage to investigate a dental problem BEFORE it becomes commonplace, and ignored.

 Remember, oral cancer is painless in its early stages AND is most `treatable' in its early stages. The older adult is in the most likely age for the presence of a lesion. The presence or absence of teeth is not related to the possibility of developing a cancerous lesion.

Surgeon General's Report states: Oral and pharyngeal cancers are diagnosed in nearly 30,000 Americans annually, primarily the elderly; 8,000 die from these disease each year.

*May 2000 Dental Products Report.
**Dental Caries Prevalence and Dental Care Utilization Among the Very Old.  Warren, Cowen, Watkins, Hand J.A.D.A. Vol 131 Nov. 2000.

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PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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