Older Adult Special Dental Care Needs

OLDER ADULT'S SPECIAL NEEDS

Senior citizens, the fastest growing portion of the U.S. population, are keeping their teeth longer than prior generations and have special dental needs

As the population ages, the dental needs of the individual over 65 become increasingly specialized; each individual has different medical problems and take different prescriptions which can adversely interact with dental anesthesia. Dental patients, especially the elderly, need to keep their dentist informed of any changes or updates in their medical history to help prevent potentially harmful drug interactions or health conditions.

"Many medications cause a decrease in the saliva flow which suppresses the normal buffering action of the saliva," said Fred Margolis, DDS, one of 50 featured clinicians at the Academy of General Dentistry's annual meeting, president of the Illinois Foundation of Dentistry for the Handicapped (IFDH), and staff dentist at a residential facility for the developmentally disabled. "The resulting dry mouth condition can lead to dental decay and dry mouth, which can lead to tooth loss."

"Special mouthrinses can be prescribed to increase the saliva flow and reduce plaque build-up," said Dr. Margolis.

Adult tooth loss is often a result of oral disease and not the aging process.

Regular dental visits are essential for senior citizens, even for the 44 percent of elderly adults who no longer have their teeth. Dentists can adjust uncomfortable dentures and screen for oral cancer: each year, more than 8,000 people die of oral and throat cancer according to the Center for Disease Control (CDC).

In order to avoid oral diseases and maintain their natural teeth, seniors who do not have a regular dentist should select a dentist and schedule a consultation visit, advised Dr. Margolis. "Talk to the dentist, make sure you feel comfortable. Explain your condition, concerns and bring your medication list." Homebound seniors can contact local dental societies regarding mobile dentistry programs.

Seniors planning to enter a nursing home should inquire about the dental consultant and their personal care giver. Currently, 1.5 million seniors receive care in 16,700 nursing homes and 50 to 77 percent of those nursing home residents experience total tooth loss.

Family members should play an active role in encouraging the oral health of homebound seniors or those in nursing homes by helping them schedule regular dental visits.

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Temporal Arteritis: Don't Let This Disease Fool You

Could your reoccurring headache be a sign of a much more severe disease? Older individuals who experience variable signs, symptoms, and pain in the head and jaw could be suffering from temporal arteritis, a disease characterized by inflammation in and damage to the walls of various blood vessels. Headaches typically are the characteristic feature in 60 percent of temporal arteritis cases.

Though the cause is unknown, dentists who encounter patients with puzzling complaints that are not explained by oral and physical findings may encourage their patients to take additional steps in order to properly diagnose this disease. Patients with temporal arteritis should be referred for medical evaluation and treatment before serious complications occur such as sudden blindness.Temporal arteritis is a disease that usually affects individuals older than 70 and increases in frequency with age.” Women, however, are three times more likely than men to suffer from this disease.

Signs of Temporal Arteritis:

	Headaches
	Pain in the mouth
	Pain when combing hair
	Weight loss
	Anemia

It is recommended that if the clinical symptoms suggest the possibility of temporal arteritis, the patient should be referred to a physician for sedimentation or a C-reactive protein (CRP) test. Both are blood test designed to detect the amount of CRP released in the blood due to the inflammation of blood vessels.

January/February 2007 issue of General Dentistry, James Allen, MD,

Plaque Can Cause Aspiration Pneumonia

In research on a group of 95 elderly persons from nursing homes who were hospitalized for severe aspiration pneumonia, investigators concluded that the bacteriology associated with their disease could have sprung from micro-organisms that had been colonized in either their dental plaque or oropharyngeal cavity at the time of aspiration. Many older institutionalized patients have deterioration in their activities of daily living, It is quite plausible that poor oral health, because of the difficulty of accessing professional dental care and insufficient or poor oral hygiene, leads to an environment that promotes colonization of dental plaques by anaerobic and Gram-negative organisms.
June 2003 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine, Ali El-Solh, M.D., M.P.H., of the Division of Pulmonary, Critical Care, and Sleep Medicine, University of Buffalo School of Medicine, Buffalo, New York

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