According to the Oklahoma Dental Association (ODA), dentists are experiencing a quiet revolution in their offices as the number of older patients increases steadily. Mature adults possess specific oral health needs that differ from those of younger generations and dentistry is working to meet the needs of this growing population.
"Dentists are increasingly sensitive to the special needs and importance of dental health in the older patient," said Dr. Scott Waugh, ODA president. "The older adult's oral health is an important part of overall health and the dental profession is committed to providing the treatment and guidance older adults need to maintain it. Presently, the ODA is working with our state legislators to expand the ability of the dentists and their auxiliaries to access those who are confined to nursing homes and public health facilities which will expand our opportunity to deliver dental care to this growing group of older citizens."
This burgeoning population group is wearing fewer dentures, and keeping natural teeth longer. Also, patients in this age group require special consideration because reduced mobility and dexterity may make daily oral hygiene difficult. In addition, medical conditions and impairment are factors that dentists take into account for certain patients. Sometimes the lack of awareness about available treatment and techniques leads older patients to make false assumptions about their dental health. This lack of awareness causes tolerance of conditions such as toothaches, bleeding gums and clicking dentures.
To promote increased knowledge of dental health issues for mature adults, the ODA answers some frequently asked questions about older adults and oral health.
1. Isn't tooth loss inevitable in the later years?
No. According to the results of a survey released by the National Institute of Dental and Craniofacial Research, the rate of toothlessness dropped 60 percent since 1960 for persons aged 55 to 64. Today, older adults are keeping their natural teeth longer because of scientific developments and the preventive emphasis in dentistry. Practicing good oral hygiene at home and visiting the dentist regularly will prevent dental problems, save time and money and save your teeth and gums.
2. Should older adults be concerned about cavities?
Yes. Adults of all ages can have cavities, yet the nature of the tooth decay problem changes as people grow older. Mature adults are more likely to have decay around older fillings, and many adults grew up without the benefits of fluoride, so they may have more fillings than the younger generation. Decay of the tooth root is also common among older adults. Root decay occurs when the gums recede, exposing the softer root surface, which decays more easily than tooth enamel.
Tooth decay is also promoted by dry mouth, when the supply of saliva is greatly reduced. Dry mouth can be caused by many types of medications (such as anti-histamines, anti-hypertensives, and anti-depressants) or radiation therapy to the head or neck. A dentist or physician may recommend an artificial saliva and fluoride products to help prevent decay.
3. Why is it important for older adults to brush and floss regularly?
As we age, it's more important than ever to thoroughly brush and floss natural teeth on a daily basis. Plaque, a bacteria that causes tooth decay and gum disease (periodontal disease), can build up quickly on the teeth of older adults, particularly when they neglect oral hygiene. Brush teeth twice a day with a fluoride toothpaste, and clean between teeth daily with floss or interdental cleaners. Choose products that have met the ADA's standards for safety and effectiveness.
4. Gum disease is a major cause of tooth loss in adults, but what can be done about it?
Gum disease or periodontal disease often progresses slowly, without pain, over a long period of time, which is one reason why it's common among older adults. The longer the disease goes undetected and uncontrolled, the more damage it causes. Although periodontal disease is caused by plaque, other factors can increase the risk or severity of the condition such as: food left between the teeth, smoking, smokeless tobacco use, badly aligned teeth, ill-fitting bridges or partial dentures, poor diets and systemic diseases such as anemia. Periodontal disease can be controlled or arrested. In its early stages, it can be reversed using non-surgical, non-invasive periodontal therapy. Treatment of advanced cases may require surgery.
The warning signs of gum disease that require a dentist's immediate care are: bleeding gums when you brush; red, tender or swollen gums; gums that have pulled away from the teeth; pus between your teeth and gums when the gums are pressed; loose teeth or teeth that are moving apart; any changes in your bite; any change in the fit of your partial dentures; constant bad breath or bad taste.
5. My dentures don't feel as comfortable as they once did. Before I see the dentist, is there something I can do on my own?
Dentures are made to fit precisely. If they are cared for properly, they do not change in shape. If dentures become ill-fitting, it is most likely due to natural changes in the gums and bone supporting them. When your dentures do not fit properly, see your dentist as soon as possible so adjustments can be made. Do not try to change the fit of your dentures yourself because damage can occur that makes them unrepairable, costing much more money to buy brand new dentures, rather than an adjustment. Ill-fitting dentures repaired at home can irritate the gums, tongue and cheeks. In emergencies, denture adhesives can be used to keep the dentures stable until you see the dentist.
6. Now that I have full dentures, are regular dental visits still necessary?
Yes, regular dental visits are recommended for those who no longer have natural teeth. At a regular dental examination, the dentist will examine your mouth to check for problems with the gum ridges, the tongue and the joints of the jaw, as well as screen for oral cancer. 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, but many of these cancers are treatable if detected early. Oral tissues are also checked for signs of other diseases that can first manifest themselves in the mouth.
7. What can be done to prevent anxiety about dental visits?
Anxiety over dental treatment is not unusual. Older patients may be less able to cope with the stress due to certain physical conditions such as vision or hearing loss. Patients should share feelings of anxiety with their dentist and the staff. The dental team can adjust treatment and pace to meet any patient's needs. Advances in pain and anxiety control, including many behavioral therapy techniques borrowed from psychology, have made dental visits relatively free of anxiety and pain.
8. Can prescription medications affect dental treatment?
Yes. Blood thinners, heart medications, immunosuppressants, insulin, antidepressants and a variety of other drugs can directly affect dental treatment and outcome. Providing a complete, up-to-date medical history will ensure the most safe and effective method of treatment. Dentists should be aware of the names, doses and frequency of any medications, whether they are prescription or over-the-counter and the name of your physician.
9. Are dental implants a good alternative to dentures?
Dental implants may offer solutions for patients who cannot function adequately with conventional dentures. However, not every patient is a candidate for implants. Patients should ask their dentists if implants are an option. A decision should be based on a careful examination by a dentist, a discussion of the benefits and risks and what the procedure involves.
10. I'm on a limited, fixed income and can't really afford regular dental treatment. Are there any resources available to help me?
Thousands of dentists across the country assist the elderly on fixed incomes by offering their services at reduced fees through dental society-sponsored assistance programs. Call your local dental society for information about where you can find the nearest assistance programs and low-cost dental care locations. Other sources of such information are local social service organizations.
Founded in 1907, the Oklahoma Dental Association has more than 1,400 member dentists. The association is committed to improving the public's oral health and advancing the art and science of dentistry while maintaining the highest ethical standards in the profession. For more information from the ODA, log on to www.okdentassoc.org or call 405-848-8873.
