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Maintaining Oral and Dental Health in the Elderly

Senior man brushing his teethMaintaining good oral and dental health can get more and more complicated as your loved one ages. At the same time, it becomes more and more important, and caregivers must assume more responsibility. It should not be neglected, because oral health is necessary for good overall health.

At first, regular trips to the dentist and simple reminders to brush twice a day and to floss daily might suffice. Other tips include drinking tap water that contains fluoride and making smart choices about diet. As dementia or other diseases such as arthritis, Parkinson’s, and movement problems progress, it becomes more difficult physically and mentally for an elderly person to take care of their mouth and teeth on their own. Tasks that were once simple to do become challenging or impossible, and help from a caregiver is required.

Several lifestyle changes also can make it more difficult to keep teeth healthy. As the number of medications increase, so can the side-effect of dry mouth, which can be damaging to tooth enamel. Teeth can become less sensitive to pain, making it more difficult for the elderly person to detect cavities and other mouth problems. When you’re caring for someone with a number of health problems, it’s easy to overlook oral health. This can be dangerous, because bacteria from the mouth can be inhaled into the lungs and cause pneumonia.

Medications, Dry Mouth and Cavities

As we age, we become more cavity prone. A frequent cause of cavities in older adults is dry mouth. Dry mouth is not a given in aging. However, it can be a side-effect for more than 500 medications, including those for allergies or asthma, high blood pressure, high cholesterol, pain, anxiety or depression, Parkinson’s and Alzheimer’s. Tell the dentist about any medications your loved one is taking. These are some common recommendations dentists make to help relieve dry mouth and prevent cavities:

  • Consult with a physician on whether to change a medication or dosage.
  • Drink more water. Have water nearby, and don’t wait until you’re thirsty to drink. (The elderly may have trouble recognizing that they are thirsty.) Your mouth needs constant lubrication.
  • Use sugar-free gum or lozenges to stimulate saliva production.
  • Get a humidifier to help keep moisture in the air.
  • Avoid foods and beverages that irritate dry mouths, like coffee, alcohol, soft drinks, fruit juices.
  • Ask the dentist about applying a fluoride gel or varnish to protect teeth from cavities.

Gum Disease

Many elderly adults develop gum, or periodontal disease, caused by the bacteria in plaque. Gum disease can be painless until the advanced stages. If untreated, gums pull away from the teeth and form pockets where food particles and more plaque collect. Advanced gum disease will eventually destroy the gums, bone and ligaments that support teeth, leading to tooth loss. With regular dental visits, gum disease can be treated or prevented.

People with diabetes are twice as likely to develop gum disease. When blood sugars aren’t well controlled, it is harder to fight infections, including infections in the mouth and gums. Infected gums make it harder to control blood sugar. Oral health, blood sugar control and the ability to fight infections are closely related.

Dementia and Dental Care

In the early stages of dementia, focus on regular care and preventing the need for extensive procedures later on. During the middle and late stages of dementia, oral health becomes more challenging. The person may forget what to do with toothpaste or how to rinse, or may be resistant to help from others. Try these tips from the Alzheimer’s Association:

  • Provide short, simple instructions. Explain dental care by breaking directions into steps. “Brush your teeth” by itself may be too vague. Instead, walk the person through the process. Say: “Hold your toothbrush.” “Put paste on the brush.” Then, “Brush your teeth.”
  • Use a “watch me” technique. Hold a toothbrush and show the person how to brush his or her teeth. Or, put your hand over the person’s hand, gently guiding the brush. If the person is agitated or uncooperative, postpone brushing until later.
  • Keep the teeth and mouth clean. Brush the person’s teeth at least twice a day, with the last brushing after the evening meal and any nighttime liquid medication. Gently place the toothbrush in the person’s mouth at a 45 degree angle so you massage gum tissue as you clean the teeth.
  • Try different types of toothbrushes.  You may find that a soft bristled children’s toothbrush works better than a hard bristled adult’s brush. Or that a long handled or angled brush is easier to use than a standard toothbrush. Experiment until you find the best choice. Be aware that electric dental appliances may confuse a person with Alzheimer’s.

Dentures

If the person you are caring for wears dentures, check with the dentist for specific instructions as to their care. Be aware of any signs of mouth discomfort during mealtime. Refusing to eat or pained facial expressions while eating may indicate mouth pain or dentures that don’t fit properly.

This blog is not intended to be medical advice, only to make you aware of the importance of good oral and dental health in yourself and your loved ones. Always consult a dentist or oral specialist if you suspect problems or encounter difficulties with maintaining good oral hygiene.

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