Senior Care: Oral Health for Seniors

Senior Oral Care1

Dentures do not have to be a fact of life. With proper oral hygiene, many seniors are keeping their natural teeth healthier and longer than previous generations. A healthy mouth is important for maintaining quality of life, especially for the sick, the elderly and residents in long-term care homes. For those wearing full or partial dentures, it is still important to have a clean mouth and to get regular check-ups to prevent oral health problems.

Please do ask us any questions that you may have with respect to your oral health and update us on any changes to medications that you may be taking. If you are caring for an elderly parent, ask about ways for you to support their oral health care.

Staying healthy and looking good are two main wishes of today’s seniors. To achieve the health component it is important to maintaining an active lifestyle combined with a routine exercising and eating right. Equally important is good oral care of teeth and gums. Simply by brushing twice a day with fluoride, toothpaste and flossing daily seniors can avoid many oral health problems. Regular dental checkups and having their teeth professionally cleaned are also important.

As we age, subtle to serious changes occur in the mouth, gums and teeth. Teeth may lose their whiteness and darken in colour as we age. Also, plaque a colourless layer of bacteria builds up on teeth faster as we grow older. The risk of gum disease also is higher as we grow older. The bacteria found in plaque create toxins that inflame the gums and cause gum tissue to separate from the teeth. Left untreated, gum disease may damage the bone that holds teeth in place, possibly causing tooth loss. Other factors contributing to gum disease are dentures that do not fit, poor oral hygiene, illnesses and many medications. More than 400 prescribed drugs, many popular with seniors, can interfere with good dental health. Seniors should let their dental professional know what medications they are taking.

Oral health is an important part of overall health. Most people don’t connect their mouths to the rest of their bodies. There is growing evidence linking periodontal (gum) disease to a variety of serious health conditions including heart disease, stroke and respiratory disorders. Diabetes and oral health are also connected. Gum disease may worsen existing diabetes or increase complications associated with diabetes. Regular professional cleanings, proper diet and a diligent homecare program are recommended to reduce the risk of cavities and gum disease.

General oral concerns among seniors

Dry Mouth (xerostomia): 
Dry mouth is caused by reduced saliva (spit) flow, which can lead to tooth damage, but can also affect chewing, speaking, swallowing and ability to taste. This condition can also be caused by medications (see Medications on this list). Saliva helps wash away acids caused by plaque. Saliva also contains minerals that rinse tooth surfaces and keep them strong. When saliva flow is in short supply, teeth can decay more easily. To help relieve dry mouth, sip water throughout the day, chew sugarless gum or suck on sugarless mints, or use oral lubricants available over the counter.

Cavities & Decay:
Due to the lack of fluoride when many of today’s seniors grew up, they had a higher tendency to develop tooth decay at a younger age, and consequently have more fillings than many of today’s younger population. Two types of decay or cavities are prevalent in adults. Root decay and decay at the edges of fillings. Cavities in older adults appear most frequently on the roots of the teeth at the gum line. Years of brushing too hard and the natural effects of aging can cause gums to recede, exposing the roots of the teeth, which are more susceptible to decay because they are not protected by enamel. Tooth or root decay is caused by bacteria (plaque), which should be removed thoroughly on a daily basis. Decreasing food and beverages high in sugar will also help to reduce cavities.

Periodontal Disease(gingivitis and periodontitis):
Periodontal disease is one of the most common diseases in humans. Over time, a build-up       of bacteria or plaque on the teeth can cause inflammation of the gums that can spread to the underlying bone and lead to tooth loss. Swollen bleeding gums, loose or shifted teeth, bad breath and gum recession are signs of periodontal disease. It is important to keep teeth and gums as plaque free as possible with professional cleanings and daily brushing and flossing.

Oral Cancer:
The incidence of oral cancer is higher among seniors. Regular dental visits can help to spot early signs of oral cancer and pre-cancerous conditions. Dental professionals perform regular screening for oral cancer. However, between visits, individuals should check their mouths and watch for red or white patches, sores that do not heal after a few days, swelling or changes in colour. Also, check lips, all areas of the tongue, gums, palate, floor of the mouth and inside the cheeks. Report any changes to a dental professional. For a variety of reasons, many older adults are more susceptible to oral diseases, including oral cancer. About 95 percent of all cancers are found in people over age 40. Again pointing to the importance of a regular dental checkup, dentists can examine oral tissues for cancerous or pre-cancerous lesions. As with all cancers, early detection is key to survival.

Medications:
Prescribed medications that contain sugar can cause dry mouth, both of these factors that can influence oral disease. Common medications contributing to dry mouth are anti-depressants, anti-histamines, pain medications and cancer therapies… just to name a few. It’s important to tell your dentist about any medications you are taking and other possible symptoms, such as abnormal bleeding, taste alterations and soft-tissue symptoms like swelling and discoloration.

Diet:
Unfortunately, many seniors may begin to experience mouth or teeth problems that make them less likely to consume a healthy diet, which further leads to a negative impact on oral health. Some of the reasons for this include a decrease in appetite, physical disabilities, dementia, such as Alzheimer’s, or untreated tooth decay. All the more reason if possible to for our aging population to try and keeping their natural teeth longer in life. By virtue of being able to use their teeth, seniors make better nutrition choices, allowing them to continue to enjoy a wide variety of foods that further support ongoing oral health.

Health conditions:
While diseases of the mouth and surrounding areas are a serious health risk, their relationship to overall general health is often not considered important or is simply overlooked. Gum disease that is left untreated can lead to an increased risk of diseases of the respiratory system. This is primarily caused when the toxic bacteria that are contained in plaque make their way from the mouth to the lungs. The result is either respiratory infections or worsening of already existing cardiovascular conditions. Seniors that have diabetes are more susceptible to experience the affects of periodontal disease. Diabetics with uncontrolled gum disease are therefore more susceptible to tooth loss. Seniors that may have compromised immune systems due to existing chronic ailments or medications are more susceptible to getting fungal and viral infections of the mouth.

Sensitive Teeth:
A high percentage of our senior population, complain of experiencing tooth sensitivity. The sensitivity is usually the result of a lifetime of wear and tear of the teeth and gums caused by factors such as brushing too aggressively, lack of oral hygiene leading to receded gums and overall gum disease, broken and fractured teeth, bruxism (grinding of teeth), acidic foods and complications resulting from certain dental treatments. The triggers for tooth sensitivity can be anything from thermal stimulation (hot or cold foods or drink), sugary or acidic foods, even just breathing in cold air.

Dentures:
Many seniors who have lost some or all of their teeth are wearing removable dentures to replace those missing teeth. The proper care and maintenance of these partial or complete dentures is paramount to maintaining the health of the mouth. Poorly fitting dentures, and those that are not removed regularly to allow oral tissues and existing teeth to be adequately cleaned, can lead to further dental and oral tissue problems. Seniors that wear dentures are advised to continue regular dental visits to ensure proper fit and function of their dental prosthesis.

Dental Implants:
Dental implants are a popular and successful alternative for replacing missing teeth. They are special titanium posts that fuse directly to the bone and, unlike some procedures, do not destroy other teeth. An implant is treated like a natural tooth but is not as strong, so it is important to brush and floss gently. As the trend toward implants escalates, so too does the specialized knowledge required by the dental hygienist to advise clients before, during and after choosing implants.

Tips for seniors and caregivers:

  • Regular dental visits are a perfect time to speak to the dentist about concerns that you may have with regards to your oral health (or that of someone under your care) and will help to spot trouble early. It is also a time to update the dentist as to any medical issues or medications that you may be taking that could adversely affect your oral health.


  • Brush, floss and rinse. Brush natural teeth twice a day with a soft toothbrush and fluoridated toothpaste as instructed by your dentist or dental hygienist. Always choose a soft toothbrush, run the bristles under warm water so as to further soften the brush against gum tissue, and remember to replace worn brushes every 3 to 6 months.

If your suffer from any condition that makes holding the toothbrush a challenge (e.g. arthritis or any other health conditions), speak to your dentist or dental hygienist about other options and consider these tips:
    1. Use an elastic band to attach the toothbrush handle to the hand
    2. Enlarge the toothbrush handle for a wider grip
    3. Use an electric or battery powered tooth brush
    4. Use disposable floss picks for flossing.
    5. Rinse with fluoridated mouth rinse to decrease cavity susceptibility, if recommended by a dental hygienist.
  •  Denture care, for your dentures. To avoid accidental breakage should they fall, make sure to have a folded towel or fill your sink with water over which you handle your denture. Avoid letting your dentures dry out. When not worn, do not simply leave them out exposed to the drying affects of air. Remember to soak them in a glass with water or a denture cleaning solution. Never place your dentures in hot water, as that will cause the denture material to warp. Brush, clean and rinse your dentures daily. Dentures, full and partial, accumulate food and plaque and need to be cleaned. Dentures should be brushed thoroughly to loosen food debris and reduce odours. Do not use toothpaste or cleansers that can scratch, and never use bleach to clean or soak dentures as it. Commercial denture cleaning solutions do not replace the need to manually brush dentures. Dentures should be brushed thoroughly twice a day using warm water and mild soap or denture paste. When not wearing dentures or at night, soak them in water or a denture cleaning solution to prevent drying. After any soaking, rinse dentures in warm water. Denture cleansers may be toxic if ingested. They should not be gargled or swallowed.

Proper care of dentures can extend their life and contribute to a healthy mouth. The average life span of dentures is five to seven years. Dentures may need to be relined or replaced as the mouth changes with age.

Message to Caregivers
If you are caring for a senior who is faced with physical or cognitive deterioration, please take note of their oral health by simple observation inside their mouth for any problems. Their oral health does impact the quality of their lives, and upon their overall systemic health. Maintain their regular dental visits in order that any problematic or troubling symptoms can dealt it with early. If possible, attend the dental visit with the elder in your care in order to provide as much relevant medical information as possible.

Closing remarks on general oral health
Follow the same simple rules tat have supported you throughout your life including:

  • Maintain a daily regimen of brushing and flossing
  • Avoid alcohol or drink only moderately
  • Avoid tobacco
  • Eat a healthy and balanced diet that incorporates fruits, vegetables and fiber-rich foods.
  • Limit sugar-intake
  • Visit the dentist regularly.
  • Be vigilant to age related changes; general changes in their body physiology
  • Dealing with the effects of disease and drug therapy; seniors may become more susceptible to oral disease such as decay, gum disease and oral cancer.
  • Additionally or increased use of medications, physical and cognitive deterioration and changes in diet may begin to impact oral health.
  • Due to incapacity to be mobile, seniors may not be able to always receive proper and timely dental care.

If you still have any questions pertaining to oral health, do not hesitate to contact us.  In Our Care – Home Care Services can provide you with up to date information on effective oral health techniques, tips, and services we provide to maintain today’s seniors oral care.