For the last several months, all eyes have been on COVID-19 which restricted routine visits to medical specialists, including dentists. Now that dental offices have re-opened for routine appointments, we thought it would be a good time to remind ourselves why oral health is so important and look at the types of oral and dental issues that often confront our older clients and loved ones.
Caring for the teeth, gums, and mouth is important not only because we value eating — but also because mouth problems that go untreated can impact your general health. According to Oral health: A window to your overall health, on the Mayo Clinic website, when bacteria is allowed to accumulate in the mouth, it can travel to other parts of the body. “…your mouth is teeming with bacteria — most of them harmless. But your mouth is the entry point to your digestive and respiratory tracts, and some of these bacteria can cause disease. Normally the body’s natural defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria under control. However, without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease.” Further, bacteria originating in the mouth may travel into other parts of the body contributing to serious medical conditions including:
Endocarditis: An infection of the inner lining of the heart chambers or valves.
Cardiovascular disease: Heart disease and stroke may be linked to inflammation and infections caused by oral bacteria.
Pneumonia: Bacteria in the mouth can be pulled into your lungs, causing pneumonia or other respiratory diseases.
Common Geriatric Dental Problems
The 5 top dental problems in older people, on the dailycaring website, states “A lifetime of chewing, grinding, gnashing, and general wear and tear combined with medications, medical conditions, and a potential decrease in dental care can cause many oral health problems in older adults” resulting in “significant tooth pain, inflamed or bleeding gums, or gum infection.” These problems include tooth decay, gum (periodontal) disease, receding gums, dry mouth, oral cancer, and even poor nutrition as a side effect of painful dental problems that may cause a senior to be reluctant to eat.
Caring for Your Client or Loved One’s Teeth and Gums
We all know to brush our teeth twice a day and floss before bed. Older adults will benefit from using a soft toothbrush and a pick or pre-threaded flosser rather than regular floss. Seniors may find that certain medical conditions, such as arthritis or hand tremors, may make it difficult to hold a toothbrush. Some helpful ideas are:
- Slide a rubber pencil grip or foam tube over the handle of the toothbrush.
- Use a toothbrush with a larger handle.
- Attach the toothbrush handle to the hand with a wide elastic band.
If your senior wears dentures they need to be rinsed after each meal and brushed daily with denture cleaner. Dentures should always be removed before a nap or bedtime and stored in water. If a person falls asleep wearing dentures they can slip and cause choking.
The American Dental Association’s (ADA) The Caregiver’s Guide to Dental Health addresses the particular challenges faced by caregivers caring for someone else’s teeth and recognizes that whether or how you help depends on the individual. “Some adults may have physical issues that make them unable to hold a toothbrush. Others may have memory issues, so they forget to brush and floss.” The Guide offers the following tips:
- Before beginning, prepare the work area. Set up good lighting and have a flashlight available to help you see into the mouth.
- Have the person sit in a straight-backed chair and drape a towel over their chest to protect clothing.
- Make sure both of you are in comfortable positions. Many opt to have the person seated in front of a mirror with you working from behind or on the side.
- Hold their chin gently with one hand, and show them the brush, floss, or toothpaste.
- Always say what you are going to do before doing it.
When working with older adults the name of the game is flexibility. If one approach is not working, try another. A different time of day may make all the difference. However, “if your loved one resists brushing, it may be because they are experiencing pain or have a dental need. See if they can communicate the issue to you. If not, it may be time for them to see a dentist,” states the ADA Guide.