Oral Health for Seniors

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;



  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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





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:

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

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:



The American Dental Association's website (www.ada.org) provides links to state dental associations local societies, and state dental schools. 7





References:



  1. Senior Oral Health ADHA

  1. Dental Health MedlinePlus

  2. Mouth and Teeth: How to Keep Them Healthy Familydoctor.org

  1. 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

  2. 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

  3. Adult Oral Health Centers for Disease Control and Prevention Division of Oral Health

  4. Dental Health: Dental Care for Seniors WebMD

  5. NIHSeniorHealth.gov