Comprehensive guide on dental health and care for seniors

Based on the official ADA recommendations and other reputable sources.

Seniors are categorized as individuals over 65. This demographic is growing every year. It is predicted that by 2060 every fourth American will be a senior.

Geriatric dentistry is going to grow in importance immensely in the near future. Being aware of elders’ dental problems and how to deal with them is more important now than ever before.

What puts seniors at higher risk of dental problems?

It is not age itself that makes the elderly more vulnerable to certain dental conditions. Risk factors include:

Medication intake

The average elder takes 4-5 prescription drugs and 2-3 OTC products regularly. Many of those can cause oral issues. Inhalers in particular can lead to fungal infections in your mouth.

Mental disorders

Senile dementia, Alzheimer, and eating disorders all make proper oral care difficult. As a result, mentally ill patients often neglect oral hygiene and are 3 times more likely to lose teeth.

Physical issues

Many elders are physically incapable of taking care of their mouth properly. Illnesses that come with age, for example arthritis, make vigorous brushing and precise flossing difficult.

How is seniors’ dental health connected to systemic diseases?

The state of your mouth is closely linked to your general health. Many systemic diseases can be caused by dental issues.

Pneumonia

Food debris breaking down in the mouth can cause bacteria to be breathed into the lungs.

Heart problems

Cardiac issues (like strokes and attacks) are linked to gum disease, cavities, and missing teeth.

Cancer

Ill-fitting dentures that rub against the gums trigger growth of lesions and lumps.

On the other hand, many conditions that affect the entire body have manifestations in the mouth. This means a dentist might be the first to spot the problem.

Diabetes

Dental symptoms include gum disease and missing teeth.

Anemia

It manifests in the mouth through mucosal pallor and atrophy of the oral mucosa.

Crohn’s disease

Lesions appear on oral soft tissues such as on the gums, tongue, or lips.

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What are the most common elderly dental problems?

Cavities

96% of seniors or older have cavities

Tooth decay is one of the most common elderly dental problems. It shows up as permanently damaged areas on the hard, outer area of the tooth. With time, small holes and openings form..

If left untreated for too long, cavities may lead to further complications, such as sensitivity, abscesses, or increased risk of breakage. Then, your only way to save the tooth may be to visit one of the 24-hour dental offices near you and act immediately.

Seeing the dentist regularly for exams and cleanings allows them to catch cavities when they are smaller, easier, and cheaper to fix.

Causes:
  • poor oral hygiene,
  • not getting enough fluoride,
  • dry mouth,
  • sugary and acidic foods.
Treatment:
  • counteraction to the above-mentioned reasons,
  • topical fluoride application,
  • dental fillings,
  • dental crowns,
  • inlays/inlays.

Gum disease

64% of older adults have gum disease

Untreated periodontitis (gum disease) causes bone loss and makes soft tissues pull away from teeth, creating empty spaces around them. If this is especially severe, dentition can become mobile and loose over time. That’s why this is a leading reason for tooth loss.

Bacteria and food debris then accumulates in the empty “pockets” and causes painful infections. The most common symptoms are inflammation, bad breath, and bleeding when brushing or flossing teeth.

Gum disease can also be responsible for many general conditions, among them heart issues.

Causes:
  • poor oral hygiene,
  • smoking,
  • anemia,
  • cancer,
  • diabetes.
Treatment:

Tooth loss

19% of adults aged 65 or older have no teeth

The average older adult has 19 teeth. Tooth loss strongly affects nutrition. People without natural teeth tend to avoid some foods, including raw fruits and vegetables.

Visible dentition defects can also lower self-esteem and make people less social. This is particularly true as lack of teeth clearly alters the shape of the face, making people look older.

Tooth loss is not a natural part of aging, contrary to what some might think. It is perfectly plausible to have natural dentition as a senior. Edentulism is a result of dental issues that can and should be treated.

Causes:
  • gum disease,
  • tooth decay,
  • trauma.
Treatment:

Dry mouth

27% of elders experience dry mouth

Reduced saliva flow is more common among seniors than in any other age group. Lack of saliva puts you at a much higher risk of getting gum disease, cavities, and other mouth infections. It also leads to trouble with speaking, swallowing, and wearing dentures.

Causes:
  • cancer treatment,
  • side effect of many medications,
  • chronic diseases such as Sjögren's syndrome, diabetes, Alzheimer's disease, anemia, rheumatoid arthritis, Parkinson's disease,
  • using tobacco,
  • dehydration.
Treatment:
  • stay hydrated,
  • avoid alcoholic mouthwash,
  • suck on sugar-free candies or gum,
  • breathe through your nose,
  • use Biotene or other OTC products for dry mouth,
  • cholinergic medications.

Thrush

50-65% of removable denture wearers have thrush

Thrush is characterized by a white rash inside the mouth. It is a yeast infection, which can also occur in other places on the body. The candida fungus resides in your mouth naturally, but some medications can upset the balance, causing this condition.

Causes:
  • corticosteroids or antibiotics intake (common after dental surgery),
  • smoking,
  • uncontrolled diabetes,
  • poor oral hygiene,
  • not removing/cleaning your prosthesis daily.
Treatment:
  • antifungal medications that you take for 10-14 days,
  • removing and cleaning the prosthesis daily.

Oral cancer

The age between 60 and 70 is the peak of oral cancer incidence

Oral cancer shows up in the mouth as a sore or lump that doesn’t go away. It can focus on any soft tissues including the tongue, cheeks, lips, the palate, and the pharynx. Early diagnosis is vital, as this does not have to be a life-threatening disease.

Oral cancer is the eighth most common type in the world.

Causes:
  • tobacco use,
  • excessive drinking of alcohol,
  • family history of cancer,
  • HPV.
Treatment:
  • surgery to remove the lesion followed by radiation,
  • or chemotherapy.

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What are the best dental care tips for seniors?

Elderly dental care is very important but also neglected very often. Do your best to keep your mouth strong and healthy by following these oral hygiene tips.

Maintain dental hygiene

Clean your mouth and gums properly every day. Use fluoride toothpaste and drink fluoridated water to remineralize your teeth and neutralize your mouth. Consider an electric toothbrush as it makes up most of the brushing action.

Visit a dentist regularly

Have your mouth checked out at least once a year, as advised by the ADA. Your dentist will examine your mouth and help plan out potential dental work. You can save on every dentist visit with a dental discount plan.

Take care of your dentures

Remove the denture at night and clean it at least once a day. Wash your hands before putting it in to prevent infections, lesions, and rubbing. Remember to also let a professional inspect it yearly. This helps to determine when it may benefit from an adjustment, reline, or repair.

Do not smoke cigarettes

Popular methods include nicotine patches or gum, counseling, and hypnosis. Patients often go for a combination. Many medical insurance policies cover at least some of the costs of quitting. You can find more information on SmokeFree.gov.

Keep a balanced diet

The following minerals and vitamins should be a part of your diet: calcium, potassium, phosphorus, and vitamins K, C, and A. Spinach, broccoli, and kale are rich in those substances.

Control your alcohol intake

Drink no more than the recommended amount of alcohol units per week and have at least a few regular drink-free days. Don’t brush your teeth immediately after acidic drinks such as wine or juice, as it can cause damage to the enamel.

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Sources and references:
https://www.ada.org/en/member-center/oral-health-topics/aging-and-dental-health
https://www.aafp.org/afp/2008/1001/p845.html
https://www.cdc.gov/fluoridation/index.html
https://www.cdc.gov/nchs/products/databriefs/db197.htm
https://www.cdc.gov/oralhealth/basics/adult-oral-health/adult_older.htm
https://www.cdc.gov/oralhealth/basics/adult-oral-health/tips.html
https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html
https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf
https://health.gov/myhealthfinder/topics/doctor-visits/regular-checkups/oral-health-older-adults-quick-tips
https://www.health.harvard.edu/heart-health/gum-disease-and-heart-disease-the-common-thread
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