Dental care important as teeth age, experts say

Many surveys have shown that one of the first things a person notices when meeting someone new is the other person’s smile. 
   
Unfortunately, many senior adults feel the need to hide their smiles because of tooth loss, discoloration or other problems with their teeth and gums. 
   
While much of dental health education targets young children, older adults also have specific needs when it comes to oral health. 
   
Although existing damage may not be reversible, further problems may be avoided with proper care and treatment.
   
One of the major dental problems in Alabama is access to good dental care, said Barbara Ross, instructor of dental hygiene and dental assisting at Wallace State Community College in Hanceville, Alabama’s only school for dental hygienists.
   
Ross said dental hygienists have the primary responsibility of cleaning teeth. Because of that, they are usually the first clinician to screen for periodontal disease and oral cancer. 
   
Because Alabama law requires a dental hygienist to be directly supervised by a dentist, patients usually must go to a dentist’s office for their routine cleanings and screenings.
   
Especially in rural areas, where the nearest dentist’s office may be many miles away, it can be difficult for people to get proper care for their teeth and gums, she said. In these situations, the difficulty is magnified even more for older adults.
   
“The elderly are especially in need of preventive services, especially those who are homebound and in nursing care facilities,” Ross said.
   
Two of the biggest concerns related to senior adults’ oral health are medications and bone deterioration.
  
According to Ross, some medications, including many for high blood pressure, can contribute to gum disease. 
   
Many medications also cause dry mouth, which is another big problem. The absence of adequate saliva in the mouth allows bacteria to flourish, which can then lead to cavities and contribute to gum disease.
   
Helena Tripp, a registered dental hygienist and president of the American Dental Hygienists’ Association, said recent studies of elderly patients also have shown correlations between periodontal disease and other illnesses, including pneumonia, heart disease and diabetes.
   
“When you have an infection in one part of your body, it’s going to put the rest of your body at risk,” Tripp said. 
   
“When blood circulates through your body, it circulates through your mouth, and bacteria get into your bloodstream and move to other parts of your body.”
   
She said elderly women might be at an even greater risk, because the bones in the mouth and jaw are affected by osteoporosis in the same way as bones in the rest of the body.
   
People with oral health problems also may have nutritional deficiencies because they cannot chew the variety of foods they need. 
   
This problem, in turn, has an impact on the body’s immune system.
   
Another problem for many older adults is their physical ability — or lack thereof — to take good care of their teeth. 
   
For example, many senior adults have arthritis so bad that they can’t hold a toothbrush, Ross said.
   
For those who are having difficulty brushing and flossing, there are many ways to make oral care easier. 
   
Many senior adults find that an electric toothbrush is easier to manipulate than a manual brush. There are, however, other ways to get a good grip on your toothbrush.
   
“It may be as simple as wrapping an elastic bandage or adhesive tape around the handle of your toothbrush to improve the grip,” Tripp said. 
   
“Or you may need to add some type of padding around the handle to make it easier to hold. One way to do this is to cut a tennis ball and insert your toothbrush handle into the slit. A sponge secured around the toothbrush handle works as well.”
  
To aid in flossing, commercial floss holders with wide plastic grips are available in most pharmacies. 
   
Likewise, there are toothpastes formulated to treat specific problems, such as plaque buildup or sensitive teeth. 
   
Those suffering from dry mouth may find that chewing sugarless gum or using oral rinses or artificial saliva products allow them to speak and swallow more easily. 
   
Tripp said individuals might speak to a dentist or pharmacist to get suggestions on products that may be helpful for their specific concerns.
   
She said making efforts to preserve natural teeth or replacing lost teeth with quality implants or dentures is important because of the healthy mouth-healthy body connection. 
   
But the effects of a healthy smile also go beyond just physical health.
   
“An essential part of life is interpersonal communication — language and speech,” Tripp said. “When you meet people, you talk to them. However, if you are missing teeth or have other oral problems, your speech can be affected.” 
   
The psychological impact is dramatic, Tripp said, “but the problem can be treated.”