What You Should Know: Dentistry Lecturer Chrisleen Rayner Takes A Look At Oral Health For Older Persons
Chrisleen Rayner, Kuils River resident and lecturer in oral health at the largest dental school in Africa - that would be the University of the Western Cape’s (UWC’s) Faculty of Dentistry - encourages the public to take special care of the oral health of the older person
With the first week of October being Older Persons Week, and with National Oral Health Month (September) just behind us, UWC would like to raise awareness around the importance of the changing needs in oral health care for older people - especially how prescribed medication for common conditions can affect their oral health.
Since older people live longer than in the past (thanks to better health care and living standards) and tend to retain their own teeth for much longer, there is a greater need for better oral health care.
As you grow older, Rayner explains, one experiences a thinning of the skin, and the same thing happens inside the mouth - which results in older people being much more prone to mouth sores and ulcers in the mouth. This can complicate matters like making use of dentures, for instance.
Dental conditions associated with aging include dry mouth (xerostomia), root and coronal caries, and periodontitis; patients may show increased sensitivity to drugs used in dentistry, including local anesthetics and analgesics.
Dry mouth can lead to mucositis, caries, cracked lips, and fissured tongue.
Recommendations for individuals with dry mouth include: regularly drinking or at least sipping regular water throughout the day; and limiting alcoholic beverages and drinks high in sugar or caffeine, such as juices, sodas, teas or coffee - especially when sweetened.
Another challenge is medication for common conditions that older people suffer from.
These include meds for diabetes, hypertension, cardiac conditions, Alzheimer’s disease and arthritis.
Diabetes and hypertension are two conditions in which xerostomia or dry mouth is a side-effect.
Diabetes. Diabetes medication can make patients prone to oral infections. The side effects of these medications lend themselves to further oral health complications: the immune system is lowered and there is a greater risk of opportunistic infections. For this reason adequate oral health care is essential.
Hypertension. Infection in the mouth as a result of meds prescribed for the condition.
Other issues affecting the elderly
Older bedridden patients. Older people who are bedridden should have proper oral health care and their carers should be educated in this regard. Carers or family members should be on the lookout for sores that don’t heal and lesions or white patches, and alert a dentist.
Dentures. Older people who wear their dentures for too long may find that the bone inside the mouth resorbs as one ages - resulting in dentures not fitting properly. The solution? Don’t sleep with your dentures in your mouth, advises Rayner. Clean them and allow the gums and tissue to rest, prolong the fit of the dentures.
Retained teeth. For the older person who retains their own teeth longer - and especially for those who want to retain them even longer - it is important to go for check-ups, have fillings maintained and ensure they receive a good oral health examination.
Tips for better oral health care - especially for the elderly
Brush twice daily. An electric automated toothbrush may simplify oral health care for the elderly - it may be a more expensive option, but it’s extremely helpful.
Include a flossing regimen. Elderly patients could struggle manipulating floss - but there are devices that will assist with flossing.
Try an interdental brush for widened spaces. Adapt the needs to that of the patient.
Mouthwashes (and remember, non-alcoholic mouthwashes are also available) assist with good oral health.
Avoid sucking on sweets for dry mouth. Medication can give rise to a dry mouth, which may result in the elderly often opting to suck on sweets. This is not advised, since plaque and sugar produce acids which will cause tooth decay.