Prepared by Daniel Leffingwell MS, RN
Revised June 25 2017
Introduction:
Recent surveys show that ninety percent of adults have, on average, 23.5 teeth. 1
Almost a third of adults have all 28 teeth, and fifty percent age 55 and older wear partial or complete dentures. 1
Periodontal infections are more common in the elderly; about 23% of 65-74 year olds have several periodontal diseases. 5
Nearly one-third of all adults in the United States have untreated tooth decay. One in seven adults aged 35 to 44 years has gum disease; this increases to one in every four adults aged 65 years and older. 6
About 30% of individuals 65 and older have lost all their teeth. 5
The incidence rate of oral and pharyngeal cancers is higher among seniors than for other age groups. Seniors who are 65 years and older are seven times more likely to be diagnosed with oral cancer than younger individuals. 5
The vast majority of payment for dental services is out-of-pocket for older people. Medicare does not cover cost for oral health services and dental care, with only rare exceptions. For most people who have dental insurance coverage as a benefit of their employment, that coverage ends upon their retirement.5
While 61% of the population reports having a dental visit in the past year; only 45% of seniors 75 years and older report having a dental visit. 5
Causes of Oral Health Problems;
Tooth Decay: Occurs because of old eroding fillings and chipped teeth/bondings. Teeth are covered in a hard, outer coating called enamel. Every day, a thin film of bacteria builds up on your teeth.
Root Decay: This is caused by exposure of the tooth root to decay-causing acids. The tooth roots become exposed as gum tissue recedes from the tooth.7
Gum Disease or periodontal disease/gingivitis: Caused by plaque and made worse by food left in teeth, use of tobacco products, poor-fitting bridges and dentures, poor diets, and certain diseases, such as anemia, cancer and diabetes, this is often a problem for older adults. 7
Denture-induced stomatitis. Ill-fitting dentures, poor dental hygiene, or a buildup of the fungus Candida albicans cause this condition, which is inflammation of the tissue underlying a denture. (Thrush: Diseases or drugs that affect the immune system can trigger the overgrowth of the fungus Candida albicans in the mouth). 7
Diminished sense of taste. While advancing age impairs the sense of taste, diseases, medications, and dentures can also contribute to this sensory loss. 7
General Oral Health Tips
Brush your teeth every day with a fluoride toothpaste - get a suggestion from your dentist for your particular needs.
Gently brush your teeth on all sides with a soft-bristle brush and fluoride toothpaste.
Brush your tongue?
Floss your teeth every day - talk to your dentist or oral hygienist about the right floss to use.
Snack smart – limit sugary snacks
Get enough calcium
Eat a well-balanced diet.
Don't smoke or chew tobacco
See your dentist regularly
Ask your doctor if your medicines have side effects that might damage your teeth. (For example, anticholenergic medications or radiation treatments for cancer may cause you to have a dry mouth.) Examples may include antidepressants and medications that are used to treat bladder control problems. Suck on hard sugarless candy or chew sugarless gum. Try sipping water or sugarless drinks. Stay away from drinks with caffeine. Don’t smoke and avoid alcohol. Some people are helped by sucking sugarless hard candy or chewing sugarless gum. Talk to your dentist or doctor for other ideas on how to cope with dry mouth.
Use small circular motions and short back-and-forth strokes.
Take the time to brush carefully and gently along the gum line.
Lightly brush your tongue to help keep your mouth clean.
Dentures:
Sometimes, dentures (false teeth) are needed to replace badly damaged teeth. Dentures may feel strange at first. In the beginning, your dentist may want to see you often to make sure the dentures fit. Over time, your mouth will change and your dentures may need to be adjusted or replaced. Be sure to let your dentist handle these adjustments.
When you are learning to eat with dentures, it may be easier if you:
Start with soft, non-sticky food.
Cut your food into small pieces.
Chew slowly using both sides of your mouth.
Be careful when wearing dentures because they may make it harder for you to feel hot foods and liquids. Also, you may not notice things like bones in your mouth.
Keep your dentures clean and free from food that can cause stains, bad breath, or swollen gums. Brush them every day with a denture care product. Take your dentures out of your mouth at night and put them in water or a denture cleansing liquid. Partial dentures are used to fill in one or more missing teeth. Take care of them in the same way as dentures.
Dentures—full or partial—should be brushed daily with a soft toothbrush or denture cleaning brush, using a commercially prepared denture powder or paste, hand soap, or baking soda. Toxic or abrasive household cleaners should never be used. Dentures should be brushed inside and outside, and rinsed with cool water.
Remaining natural teeth and gums, especially those teeth supporting a partial denture, should also be brushed.
When not in use, dentures should be covered with water or a denture cleaning solution to prevent drying.
Talking to Your Dentist
Your dentist should conduct a thorough history and oral examination. Questions asked during your dental history should include: 7
The approximate date of your last dental visit and reason for the visit
If you have noticed any recent changes in your mouth
If you have noticed any loose or sensitive teeth
If you have noticed any difficulty tasting, chewing or swallowing
If you have any pain, discomfort, sores or bleeding in your mouth
If you have noticed any lumps, bumps or swellings in your mouth
You may want to take a list of questions and concerns with you to the dentist. This way you will not forget any questions that you have. Folks tend to be nervous in the dental seat and forget to ask important questions that they have.
Finding a Dentist:
See if local dental schools have student clinics. Visit www.nidcr.nih.gov/HealthInformation/FindingDentalCare.
Contact your county or State health department to find dental clinics near you that charge based on income.
Call 888-275-4772 (toll-free) or visit www.ask.hrsa.gov/pc/ to locate a community health center near you that offers dental services.
Check your State or local dental association at www.ada.org/ada/organizations/searchcons1.asp to find dentists in your area who have lower fees for older adults.
Also, check your local phone book, the internet or your local dental society (checking under [name of state] dental society or [name of state] dental association or [county or region] dental society or association).
The American Dental Association's website (www.ada.org) provides links to state dental associations local societies, and state dental schools. 7
References:
Senior Oral Health ADHA
Dental Health MedlinePlus
Mouth and Teeth: How to Keep Them Healthy Familydoctor.org
Taking Care of Your Teeth and Mouth National Institute on Aging, U. S. Department of Health and Human Services National Institutes of Health January 2007
Ageism
in Healthcare: Are Our Nation’s SeniorsReceiving Proper Oral Health
Care? Remarks
Before the Special Committee on Aging United States Senate Richard H.
Carmona, M.D., M.P.H., F.A.C.S.
Surgeon
General U.S. Public Health Service Department of Health and Human
Services
Adult Oral Health Centers for Disease Control and Prevention Division of Oral Health