How Important Is Oral Care in the Elderly

05 / 08 / 2019

It’s estimated that 75 per cent of adults age 60 and older have missing teeth. Severe gum disease and other oral health issues contribute to that. Worse, missing teeth tell a story about pain and discomfort (e.g. tooth extraction, toothache, tooth decay).

As a result, it’s crucial to maintain excellent oral health throughout our lifetime if we want to avoid most of that pain and discomfort. In addition, we’re now becoming aware of the link between oral health and cardiovascular diseases. The risks and stakes are indeed getting higher if we neglect our dental health in terms of health and financial costs.

Additional risks and concerns for the elderly

It’s especially the case for seniors where there are additional risks and concerns. For instance, diabetics are a much greater risk for dry mouth and gum disease. Dry mouth (which can be caused by diabetes and medications) can accelerate gum disease, plaque build-up and tooth decay. This has become a major concern because around one in six people aged 65+ reported having diabetes (more than 570,000 people in Australia, source: Australian Institute of Health and Welfare). The natural consequence is that prevalence of dry mouth has become more rampant in recent years and along with that comes tooth decay, plaque build-up and gum disease.

Good thing is that the first stage of gum disease (gingivitis) is easily reversible. However, severe gum disease (periodontal disease, a serious gum infection) may require surgery plus potentially time-consuming and costly medications and treatments. Tooth loss might also result which is irreversible.

It’s true that there are measures to deal with missing teeth (dentures, bridges, dental implants). However, it’s still important to prevent those measures from becoming necessary in the first place. After all, tooth extraction and gum disease treatment are often necessary before a denture, bridge or a dental implant is placed (i.e. tooth loss should happen first). In addition, there are concerns about the safety of tooth extraction for the elderly and compromised patients (e.g. inflammation, healing, medications and the procedure itself is a concern). Although dental professionals can prevent the complications, safety concerns will always be there.

Oral health tips for older adults

Great news is we can still take steps to minimise the number of dental treatments and procedures we would undergo in our lifetime. This requires ongoing work but the results could be wonderful and worthwhile for the long term. Aside from maintaining good oral health, this is also great for our confidence because all or most of our teeth will remain intact.

First step is to visit a dentist so that we’ll know the problems and prevent them from becoming worse. For instance, we mentioned earlier that gingivitis is easily reversible. But as gum disease progresses (reaching the level of periodontal disease), it becomes more difficult to treat. In addition, the treatment will take more of your time and your wallet. It’s best to know the dental problems as early as possible not just to avoid the inconvenience, but also to avoid tooth loss.

We also mentioned earlier that oral care in the elderly requires ongoing work (perhaps more work than we were younger). As we age, we become at greater risk for dry mouth, the simple wear and tear (enamel wears down because of many years of chewing and grinding) and root decay (the teeth’s roots become exposed as the gums recede). As a result, significant lifestyle changes are often required that will benefit our teeth, gums and overall physical health as well. For example, avoiding tobacco and alcohol can help slow down tooth decay. Minimising consumption of sugar-rich foods and beverages will be great not just for our oral health but also for regulating our blood sugar levels.

Fluoridation (along with regular brushing and flossing) and using antibacterial mouthwash also help in maintaining good oral health. In addition, professional dental cleaning twice a year will effectively remove plaque and tartar. After a professional cleaning, the tartar build-up and bacteria will somehow have to start over when it comes to ruining your teeth and gums. Also after the cleaning, the dentist and the patient will then have a dietary and oral hygiene discussion if necessary. The assessment and cleaning is just the first step because after all most of the oral damage happens on a day to day basis.

More and more elderly people are willing to invest more time and effort in their physical health (e.g. strictly controlling their diet, following an exercise regime, yoga and meditation). But often it’s not enough because our oral health should also be prioritised. After all, our oral health is linked with our cardiovascular health. In addition, our healthy lifestyle can be easily disrupted by toothache (e.g. hard to focus on exercise, difficult or impossible to eat fruits and vegetables). It’s important to take care of our oral health as we do with our bodies. This way, we can always smile confidently because we know both our teeth and physical health are in good shape.