Basic Dental Health for Older Adults:
Good Oral Hygiene and Dental Care is valuable to the health and well-being of older adults. Many older people have significant dental challenges. These challenges may be removed or improved through simple oral care and or routine care by a dental hygienist or your dentist.
Changes in Teeth and Supporting Tissue:
Tissues in your mouth, like other body tissues, change as you grow older. Soft tissues (gums and cheeks) lose their ability to stretch, and muscles become soft and weak. The amount of saliva produced by glands in your mouth is frequently reduced. As a result, chewing may become more difficult, and your mouth may become more easily irritated and heals more slowly than when you were younger.
Nerve tissue and blood vessels are found in the pulps of teeth. In a younger person these nerves were very responsive to pain or to anything hot or cold. As your aged progressed, the pulp gradually became smaller with fewer blood vessels and less nerve tissue supplying the teeth. As a result, your teeth have less fluid content and have become brittle, therefore the teeth may be easily broken or chipped. Fortunately, due to the reduced nerve tissue, little if any pain is experienced even with severe fractures
Teeth wear because of the grinding action of chewing. Tooth enamel becomes thinner. In severe cases, the hard enamel covering is completely worn away leaving a softer part of the tooth (dentin) exposed. Dentin can be dissolved by acidic oral fluids. Teeth with only a fragile enamel shell are easily chipped or broken.
Tolerance to Dentures:
If you wear a complete or partial, removable denture, you want it to be comfortable and working well. The satisfaction with dentures depends largely on the ability of the remaining bone ridges and the supporting tissue in your mouth to provide the necessary support.
After teeth are removed, the remaining bone (ridge) continuously shrinks (resorbe) to a smaller size. The gum tissue covering the ridge is more easily irritated because it is thinner. The rigid dentures become progressively less adapted to the mouth. As a result, chewing hurts and you don't chew as well. It is estimated that nearly half of the dentures worn by elderly persons are ill-fitting and potentially harmful do to increased bone loss.
Systemic Diseases:
Evidence of a disease occurring elsewhere in the body may be noted in the mouth. Disorders such as those of the blood system (anemia) or diabetes may be accompanied by inflammation and reduced healing capacity of the gums.
Drug Therapy:
Treatment of some diseases (heart disease, high blood pressure, depression, Parkinson's disease and others) uses a regimen of many medications. A common side effect of these medications may be decrease in the amount of saliva, which results in a very dry mouth. An increase in periodontal disease and an inability of gums and ridges to tolerate dentures can be expected.
Brushing:
A medium soft brush and dental paste is recommended. For those incapable of gripping the handle, a rubber strap can be fastened to fit snugly around the hand. If limited arm movement is a problem, a longer handle should be used. Teeth, gums and tongue should be brushed at least once a day.
Rinsing:
With a decrease in saliva, food particles adhere more readily to the teeth and gums. Rinsing with warm water or salt water will dislodge the particles. This is especially important if you have difficulty brushing. Rinsing, however, is not a substitute for brushing. Use of mouth washes may prove irritating to dry tissue because of their high alcohol content. Dilute the mouth wash with water
Wiping with a Gauze:
In some severe cases, where it is impossible for older adults to brush or rinse with assistance. Wiping teeth and gums with a wet piece of gauze may remove some of the debris from around the teeth and gums.
Dental Aids:
Many mechanical aids have been developed to improve oral hygiene. Some have very good practical application for the elderly.
Electrical Tooth Brushes:
Have been shown to be effective in cleaning teeth. The larger handle can be held more easily and the mechanical movement of the brush compensates for those with limited dexterity.
Water Picks:
Can be useful in removing particles from between teeth. If you have pockets between your teeth and gums, use the water pick with care. Rather than being washed away, food particles can be forced into those pockets and can cause severe irritation.
Interdental Cleaners:
Interdental Cleaners with small changeable brushes are helpful to clean between the teeth This may be helpful when the gums have receded, creating large spaces between the teeth.
Oral Lubricants:
Can ease some of the problems created by a dry mouth. This will ease the irritation caused by dentures rubbing on the underlying tissue or dry cheeks rubbing on the denture teeth. Several prescription medications are available as a saliva substitute or stimulate the production of saliva.
Denture Care:
Denture care is necessary for good oral hygiene and can not be neglected. Dentures should be removed after eating and rinsed with warm water. The mouth should also be thoroughly rinsed.
Dentures accumulate calculus. Dentures should be scrubbed with a stiff tooth brush to remove these deposits. This can be done with tooth paste or simple soap. Commercial denture cleaning solutions by themselves may not adequately clean dentures.
For more detailed information on any of the dental aids or cleaning procedures, consult your dentist.
