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Dental Care for the Elderly


Dental Care for the Elderly
This is a good news - bad news story. The good news is that preventive dentistry has worked so well that we now routinely see people in their 80's and 90's with many teeth, if not, a full compliment of teeth. They have had the advantage of good dental care and thankfully, at this time, can chew their food well and enjoy a lifetime of comfortable eating and smiling.

The BAD NEWS is that this population, when debilitated either mentally or physically, have unique challenges for caring for their existing teeth. In the past, the elderly simply took their teeth out at night and ate softer foods. Now, if you are elderly and having a physically challenging time taking care of your teeth or have a loved one who is mentally challenged and cannot fully care for themselves, the chances for cavities/broken fillings on teeth is high.

Our nursing homes have a great challenge, as they have historically only needed to deal with dentures in their resident population. We have developed a different scenario to care for a person that has remaining teeth but, they themselves can no longer care for their own dental health.

First, let's take the scenario that one can mentally take care of themselves, but due to arthritis or stroke, is having a difficult time. The new automated toothbrushes have two very positive features. The first, is that the handle is large so that an arthritic or debilitated hand can still hold the brush well in either the left or right hand. The second is that the bristles will automatically vibrate and do the job of cleaning the teeth if simply held on the teeth and then the gums. If you or someone you know is having a hard time holding on to a toothbrush to properly clean teeth, it may be a tremendous advantage to simply hold the toothbrush very firmly (and I stress, very firmly) against the gum and teeth on both cheek side and tongue side for about three minutes twice a day. If your diet is good, with low refined sugars (stay away from hard candy), these toothbrushes may keep your teeth very healthy.

Next, let's take the scenario of the elderly individual who mentally or physically can no longer care for themselves. There is an easy four-step process to maximizing the chances of comfortably having teeth for a lifetime. First, is diet. The exposed roots on most people, once they reach 80 years old, is significant and that root structure is much softer than the hard enamel of the teeth. It is very susceptible to cavities if the diet has frequent sugars. Because of dry mouth or increased idle time, many seniors suck on hard candy or have frequent sugary substances in their mouths. This is probably the biggest reason why the elderly get cavities along the gum line. In the nursing homes, the practice of giving nightly ice cream to the residents prior to bed is probably not the best idea for those who have teeth. A softer cheese, like mozzarella, can satisfy the evening craving without hurting the teeth. Secondly, a prescription strength concentrated fluoride toothpaste used nightly would protect those soft roots against the insult of bacteria and sugars that are very difficult to remove adequately. There are new prescription type, fluoride toothpastes, like Prevident 5000, obtained from your dentist that have great tooth strengthening properties. Thirdly, and the most obvious, is to find a way to brush the teeth two times a day. This is sometimes the most difficult, especially in nursing homes, where staffing is a challenge. The electric toothbrush can do an excellent job and when the mouth is rinsed after with water. a very adequate job can be completed in approximately one and a half minutes.

Lastly, a regular examination and dental cleaning by a dentist or hygienist can greatly assist in maintaining the teeth and minimizing the effect of gum disease. Luckily, in the elderly, the loss of bone from gum disease does not progress rapidly, due to the body's loss of response to the bacteria that causes gum disease.

This challenge, in caring for the elderly, is one that we are now just beginning to address. Future generations will all have this problem with caring for remaining teeth and when we as caregivers, can accept the challenge and find efficient, practical and low cost ways to care for this very deserving population, it will greatly assist in allowing our elderly population to have, dentally, the quality of life that they have been accustomed to and deserve.

Today is the first day of the rest of your life.