"You are never to old to take good care of your gums and teeth." Oral-facial
tissues "represent the very essence of our humanity. They allow us
to speak and smile; sigh and kiss; smell, taste, touch, chew and swallow; cry
out in pain; and convey a world of feelings and emotions through facial
expressions".*
Some areas
of your dental health will need to be monitored more often than at other stages
of life.
The aging process can often create subtle and/or dramatic changes in the
condition of teeth, mouth and gums:
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Plaque accumulates more as we get older and
it can become more difficult to remove tartar and calculus from our teeth,
this is why it becomes even more important to schedule professional
cleanings more than twice a year.
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| Teeth may also darken in color due to changes
in dentin that is under the tooth enamel. There
are new products and procedures that can restore your teeth to a more
attractive appearance.
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| Gum tissue around the teeth may begin to
recede which exposes tooth roots making them vulnerable to decay.
Fluoridated toothpastes and mouth rinses can help strengthen tooth enamel
and reduce decay especially on these exposed root surfaces.
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| Older fillings may weaken and/or crack
allowing bacteria to accumulate around the edges of these fillings to cause
cavities. Many people over 50 have decay on both their
teeth and root surfaces. Now you have a choice of what type of fillings
material you would like to use to replace these old fillings.
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Dry mouth, occurs
when there is not enough saliva to lubricate and moisten the mouth to wash away
the acids produced by plaque. This condition will cause tooth damage from decay. Drinking lots of water, avoiding sweets, tobacco, alcohol and
caffeine can help you deal with a dry mouth.
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Dental caries rate in older adults have increased 31 % in the last 10 years!
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Gingivitis is caused by bacteria found in
plaque that attack the gums making them red, swollen and bleed when you
brush. If
you have any of these symptoms see us
immediately. Gingivitis can lead to gum
disease if left uncared for. In fact three out of every four adults over the age of 35
have some sort of gum disease!
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In gum disease, if the infection becomes more
severe your gums will begin to recede and pull away from your teeth. The b will weaken and dissolve the bone that holds your
teeth in place leading to tooth loss, especially if you have osteoporosis. Treatment
for gum disease can reduce recession, bleeding and some treatments can even strengthen
the bones to hold your teeth in place.
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Surgeon
General's Report states: 23% of older adults aged 65-74 have severe periodontal
disease with men being more likely to have more severe disease!
| Poorly fitted dentures, illness, medications,
poor nutrition, and poor oral hygiene can increase the severity of gum
disease to create chewing problems and pain in your jaws. By
treating gum disease and replacing decayed teeth you can maintain chewing
and biting surfaces so you can chew and eat with comfort and ease.
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| Oral cancer occurs most often in people over
40. If you notice any red or white patches on your gums or tongue or
observe sores that fail to heal within two weeks please notify
us. This disease is often painless and difficult to diagnosis in its
early stages. It is especially important see us at least yearly if you wear
dentures so an oral exam of the gum tissue can be completed. Early signs of
adverse drug reactions, diabetes and/or oral cancer can be detected during a
regular dental exam.
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| Bruxism-brushing
to hard which causes wear and tooth damage. Excessive brushing could
particularly be a problem for the elderly. As people age, their
gums recede, exposing the tooth's root surface, hence the saying
that someone is ``long in the tooth''. The newly exposed teeth's
surface, called dentine, is softer than the tooth's normally exposed
enamel surface. Brushing too hard and for too long can cause wear
patterns on the teeth and injury the gums. Two minutes is a good
marker for correct brushing time, but he insisted that it was also
important to clean between the teeth by flossing. |
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If you
find it difficult to brush
and floss please inform us so we can make an
individualized oral hygiene plan for you. You may find a light weight electric
toothbrush and automatic flosser can help you
maintain good oral care. You may also want to try strapping the toothbrush
onto a larger object, such as a ball if you have arthritis to make the brush
more comfortable to handle. |
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Cavities at the gum line-try
Prevident 5000 Plus or
Gel-Kam or another fluoride toothpaste; fluoride varnish such as
Cavishield or duraphat.
Root Caries Prevention Advances
An article in a special supplement to the journal
Caries Research reviews the effects of dentifrices with high
fluoride contents on the management of root caries. Primary root
caries lesions which are a widespread and often serious
problem in older populations, can be difficult to restore. It is
generally accepted that fluoride ions promote remineralization of
tooth substances and reduce the rate of demineralization. The use of
a dentifrice with a high fluoride content may be considered to
reverse this condition since more fluoride is required for the
remineralization of roots than for enamel.
Woman Dentist Journal April, 2005; 3(4) Author(s) :
Margaret Scarlett Lynch E, Baysan A.
Reversal of primary root caries using a dentifrice with a high
fluoride content. Caries Res 2001; 35[Suppl 1]:60-64) ] |
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Early treatment of cavities and gum disease can reduce to need for
more extensive and expensive treatments later because early problems were left
untreated.
Remember there is a mouth-body connection. Your medical condition can have
an impact on how you receive dental care.
If you have high blood pressure
you will need to have your blood pressure monitored. If you have certain
types of heart conditions or joint replacements you may be required to be
premedicated before "work" is done.
How certain medical
conditions are now dealt with is very different than how they were handled five
or ten years ago.
The treatments
plans that are presented to you are based on your dental needs to restore
your teeth to optimum health to enable you to enjoy not only a beautiful smile
but also good health.
A good way to achieve and maintain good oral health is to see
us every six months for your recare appointments.
Remember a dentist can often diagnose certain medical problems before they
are identified by your doctor.
We are here to help you reach and achieve
your goal of optimum oral health at every age.
Untreated
oral diseases and conditions can have a
significant impact on quality of life.
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Updates
AARP has a message board on
Dental Decay :
http://community.aarp.org/n/pfx/forum.aspx?msg=7260.1&nav=messages&webtag=rp-health&redirCnt=1Medication
Compliance in the Older Adult Patient
AARP Focuses on Access to Dental Care
The September 2006 AARP Bulletin cover story 'Nothing to
Smile About' focuses on access to dental care – or the
lack of it. Dental disease has been called a silent
epidemic – especially among older people and children
who lack insurance or the ability to pay for care.
| An estimated 108 million have no
dental insurance – more than twice those without
health insurance. |
| About three-quarters of people 65
and older are not in dental plans. |
| In the 1950’s less than half of
adults 65 and older kept their teeth, compared with
70% today. |
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Self-report
questionnaires were distributed randomly to older adults, with the
median age range of 76 to 84,
Of the 115 surveys distributed.Among the respondents, 93% reported taking
prescription medication,
63% reported taking over-the-counter drugs, and 23% reported taking
herbal medications. Twenty-nine percent took four to six medications
daily, and 21 % took more than seven medications daily. Nearly one
quarter of the respondents surveyed reported that they had missed a
dose, while 15% stated that they had stopped taking medication before
their prescription was completed. Similarly, 14% responded that they had
forgotten to fill or refill a prescription, while 13% stated they had
taken less medication than prescribed. Of significance to oral health
practitioners, 35% of respondents indicated that their dentists did
not ask them when they last took their medications. (at our office we
update your medication list at EACH visit
Medication Compliance in the Older Adult Patient
Author(s): Adele Spencer RDH, MS ; Maureen Tsokris RDH, MS Source:
Journal of Dental Hygiene 2006;80(1):31
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Online Information
Relevant to Treating Older Patients
The dental management and how certain
medical conditions and therapies can affect oral health:
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Does Tooth Loss
Affect Dietary Intake?
Since the primary function of teeth is mastication,
tooth loss can reduce chewing ability that leads to detrimental changes
in food selection. This, in turn, may increase the risk of
particular systemic diseases since diet and certain health states, such
as cardiovascular health, are linked. For example, an increase in
dietary cholesterol and saturated fat, and a decrease in fiber have been
shown to elevate the risk of heart disease. Since a large portion of
the population has missing teeth, the effect on health risks due to
tooth loss may have a significant impact.
In what is, no doubt, one of the largest studies investigating a
relationship between tooth loss and diet, data were collected on dental
status, and food and nutrient intake from over 49,000 male
professionals. After adjusting for age, smoking, exercise and
profession, it was found that intake of vegetables, dietary fiber ,
crude fiber, and carotene was significantly lower, while intake
of total calories,cholesterol and fat was significantly
higher in edentulous participants compared to participants
with 25 teeth or more.
In a follow-up study with the same cohort of professional men,
longitudinal analyses between tooth loss and consumption of specific
foods and nutrients were performed. It was found that over an eight-year
period, participants without any tooth loss had greater reductions in
daily intake of saturated fat, cholesterol and vitamin B12, and greater
increases in daily intake of fiber, carotene andfruits compared to
participants with tooth loss. In addition,subjects who lost five or
more teeth were significantly more likely to stop eating apples, pears
and carrots compared tosubjects who lost four teeth or less. These
studies provide the best evidence to date for an association between
tooth loss and a change in food intake, and suggest that it is
advisable to incorporate dietary evaluation and nutrition
recommendations into dental visits for patients with tooth loss to avoid
the health risks of a poor diet.
References
1. Hung HC, Willett W, Ascherio A, Rosner BA, Rimm E, Joshipura KJ.
Tooth loss and dietary intake. JADA 2003;134(9):1185-1192.
2. Joshipura KJ, Willett WC, Douglass CW. The impact of
edentulousness on food and nutrient intake. JADA 1996;127(4):459-467.
3. Willett WC. Diet and health: What should we eat? Science 1994;264
(5158):532-537.
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Dental caries experience in older people over time.
The only caries risk factor common to all four
studies was the wearing of a partial denture (for root surface caries
only). Conclusions Older people are a caries-active group, experiencing
new disease at a rate which is at least as great as that of adolescents.
Dentate older people should be the target of intensive monitoring and
preventive efforts at both the clinical practice and public health
levels. There is no easily identifiable 'magic bullet' for preventing
caries in that age group, but the use of evidence-based preventive
interventions (such as fluoride) should suffice.
Dental caries experience in older people over time:
what can the large cohort studies tell us? W. M. Thomson British Dental
Journal (2004); 196, 89–92
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Oral Cavity Changes
The majority of the elderly suffer bone loss and disease in
the tissues around the teeth, as they grow older. As a result:
| 50 percent of the population over 60 have lost all of their
teeth
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| about 65 percent have lost all teeth in at least one
arch.
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Older people hence tend to choose foods that are easy to chew,
leading to reduced consumption of fresh fruits and vegetables high in dietary
fiber. Some elderly people may wear ill fitting dentures
making chewing difficult.
Compliments
Webdietitian
Food Guide Over 70
Nutrition & Aging
Nutrition Resources
Only 15% of the elderly have
any type of dental coverage!
*JADA, Vol. 131, December 2000.
February 06, 2008
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