TIPS FOR GOOD ORAL HEALTH
Floss and brush your teeth with fluoride toothpaste daily.
According to the American Dental Association, a person’s risk of developing a cavity increases with age. One of the reasons is dry mouth, a common side effect of many prescription medications. Use a toothbrush with soft bristles and a small head. Consider an electronic toothbrush if you have a condition such as arthritis that limits movement.
Clean dentures daily.
The same bacteria that can stick to your teeth also can stick to full or partial dentures. Avoid cleaning them with household cleaners. Use cleaners made specifically for dentures.
Remove your dentures for at least four hours every 24 hours to keep the mouth’s lining healthy. Check with your dentist for instructions.
Get regular dental checkups.
It’s best to visit your dentist at least annually; more frequently if there is a problem. As a person ages, the nerves inside the teeth become smaller and less sensitive. Your dentist can also look for signs of gum disease and oral cancer.
Your dentist may find it helpful to have the following:
A list of medications, including vitamins, herbal remedies, and over-the-counter medications
A list of medical conditions and allergies
Information and phone numbers of all health care providers, doctors, and your previous dentist
Information about your emergency contacts, someone who can help make decisions on your behalf in the case of a medical emergency
Dental insurance or Medicaid cards
Your dentures or partials, even if you don’t wear them
* Source: American Dental Association
Resources:
American Dental Association, www.ada.org
Georgia Dental Association, www.gadental.org
Dr. Kevin Hendler’s average patient is in his or her 80s.
His oldest patient is 106.
Hendler, director of geriatric dentistry at the Ina T. Allen Dental Center at Wesley Woods of Emory University, is among a growing number of dentists who are turning their attention to oral health care for older Georgians.
No matter one’s age, “what happens in your mouth can affect the rest of the body,” he said.
And it is expected to become more of an issue as the state’s population continues to gray.
By 2030, one in five residents in the Atlanta region will be over 60, according to the Atlanta Regional Commission. Seniors 65 and older represented the second fastest growing segment, rising by 45 percent since 2000, according to the ARC, the planning agency for the 10-county area.
"We want to keep our older adults out of the emergency room, and if they don't have regular access to (dental) care, that's where they will end up," said Dr. Judith A. Jones, a dentist and expert on elder care for the American Dental Association. "And that's the wrong place to treat dental disease."
And not only is the aging population growing, but they are living longer and more are keeping their natural teeth. But even without natural teeth, oral care is important. A dentist can detect oral cancers and gum disease and can make sure dentures are clean and fitting properly.
Bacteria and infections in the mouth may be associated with cardiac disease, stroke, diabetes and pneumonia, ailments that may be common in older adults, according to the ADA. Older adults are especially vulnerable because certain medications can cause dry mouth.
In rare cases, regardless of age, a dental problem can lead to death.
In 2007, 12-year-old Deamonte Driver of Maryland died after bacteria from an abscessed tooth reached his brain. His mother couldn’t afford the $80 procedure because her Medicaid had lapsed and she didn’t have private insurance.
The Atlanta-based Georgia Dental Association recently launched a volunteer program for dentists to visit nursing homes to train caregivers on how to clean and care for their patients' mouths, including how to brush and floss their teeth and how to care for their dentures and partials.
After training is completed, said Nelda Greene, associate executive director of the association, a DVD training kit is left at the nursing home for use by new employees and as a refresher. So far, 41 dentists in Georgia are participating in the initiative.
Part of the problem is that basic Medicare doesn’t cover most dental care, procedures and supplies. So seniors must pay out of pocket, use private insurance or be enrolled in a dental plan. Many have lost dental coverage after retirement. As a result, some consider dental care as an added and lower-priority expense, Hendler said.
“We get a lot of patients who, when they find out we’re not free, just turn around and walk out,” Hendler said. “They’re going without care and living with chronic pain.”
Older adults with the worst oral health are those who are poor, lack insurance, minorities, disabled, homebound or in nursing homes, according to the Centers for Disease Control and Prevention.
Based on a 2011 report, nearly 40 percent of adults ages 65 and older have not visited a dentist in the past year, although that’s lower than in previous years.
The dental needs of a 24-year-old can vary greatly from that of someone who is 69, said Edan Barshan, founder and CEO of the Universal Dental Plan, a membership-based plan that provides low-cost dental coverage through a network of dentists. He said a younger person may just need routine care, while an older adult may need more restorative work and greater care.
As many as 65 percent of its members are over the age of 65.
When Hendler treats an older patient, he first wants to know what medication they’re taking. For instance, a dentist should know if a patient is on blood thinners or any other medication that might affect care. He said he has worked with patients who have dementia, which poses its own set of problems. He said those patients may be more agitated and harder to treat.
The benefits of good oral care are varied. Good oral hygiene and a healthy mouth can help in the socialization process and affect eating and nutrition, Hendler said. He recalled a older patient who lost her dentures and refused to go to an event in her honor. He still remembers her smile when he presented her with a new pair. “I’m back,” he recalled her saying.
“We should really respect our elders, treating them with dignity, and in the grand scheme of things, dental care is less expensive than the medical care that may result from infections in the mouth,” he said. “If you have to go to the hospital because of a dental problem, that will be expensive.”
Alex Lindsay, 93, a retired marine surveyor, doesn’t want to end up there. He makes sure to keep regular dental appointments and avoids soft drinks and sugary snacks.
“I try to take good care of them,” he said of his teeth. “Seeing the dentist is good prevention.”
Another patient, Edna Weaver, 90, a retired nurse, has dentures and a single bottom tooth, which she calls “my anchor.”
“I’m going to take care of my teeth as long as I can,” she said.
