Geriatric Dental Issues – Newton, Wellesley, MA


There’s a commonly understood recipe for living a healthy life as we get older, and it goes something like this: Exercise, eat healthy food in moderation, don’t smoke, get plenty of sleep, maintain a good social network and engage in mentally challenging activities.

Yet, according to Dr. Ryne Johnson, prosthodontist  and managing partner at Newton Wellesley Dental Partners, “there’s another, largely overlooked, ingredient: oral health care”.
Because our bodies become more vulnerable as we age, decay, infections and bacteria that occur in teeth, gums and mouth can grow into serious problems that impact overall health. Plus, there are issues seniors have that exacerbate problems and inhibit a senior’s ability to brush, floss or visit the dentist. Medications can create dry mouth. Arthritis limits dexterity and creates transportation and mobility issues. And a lack of dental insurance can halt regular dentist visits.

“Many of older adults are getting used to living in pain,” says Johnson. “They have active infections that have been going on for five, 10, 15 years. Poor oral hygiene is particularly harmful to seniors”.

Poor oral hygiene can increase risks for diabetes, pneumonia, infections elsewhere in the body and strokes, he says. Also, mouth cancers — which can be discovered through regular dental checkups — can go undetected. Many seniors wish they had access to better dental care. But often, after retirement, they lose dental insurance and can’t afford new coverage. Medicare, for instance, doesn’t cover most dental work. In 2012, a survey indicated that being able to afford dental care was the No. 1 health issue for seniors, even more than general medical care (38 percent to 30 percent).

Among the primary oral-health issues older men and women face are:

Dry mouth: Having a drier mouth can be part of the aging & geriatric  process. But older people tend to be on more medications, and hundreds of those medications inhibit production of saliva, which protects against tooth decay and controls bacteria. “That creates an environment that is very acidic, because the saliva is not there anymore,” says Johnson, “That leads to more tooth decay, gum disease and an increase in bacteria”.
Some studies have shown gum disease can lead to heart disease. And an increase in bacteria has been linked to a higher risk of pneumonia (with bacteria breathed into the lungs) and diabetes. It’s important for seniors to drink more water to battle dry mouth. Also, seniors should provide their dentist a list of medications they are taking.

Oral cancer: Rates increase with age, so if seniors skip regular dental checkups, they run the risk of cancers going undetected early. And even seniors who have no natural teeth and use a full set of dentures should continue regular checkups for mouth cancer.

Caregivers: it’s important for the people who care for seniors to help them with brushing and flossing, and to make certain they see a dentist regularly.  “Very often, I have a family member telling me, ‘My mom or dad was scrupulous with their health and took excellent care of their teeth, and now they’re in horrible condition,’” says Johson. “A lot of decay, a lot of periodontal illness because they just lost the capacity to take care of themselves. It takes some active intervention on the part of their families or others.”

“The importance of education can’t be overstated. The baby boomers’ tsunami wave is coming,” says Johnson. “This is a problem that is upon us, whether we want it or not. We have to continue improving the educational process to avoid potential problems.”

The Centers for Disease Control offers a checklist for seniors to maintain good oral health that includes:
• Drink fluoridated water and use fluoride toothpaste to protect against tooth decay.
• Brush and floss regularly to reduce dental plaque and prevent periodontal disease.
• See your dentist regularly, even if you wear dentures and have no natural teeth.
• Avoid tobacco and limit alcohol to lower risk of oral and throat cancers.
• Caregivers should provide daily oral hygiene for seniors unable to take care of themselves.
• If medications produce a dry mouth, ask your doctor if there are alternate medications that can be substituted. If not, drink plenty of water or chew sugarless gum to keep your mouth moist.

For additional information on this topic visit the American Dental Association: www.mouthhealthy.org/en/adults-over-60.  For additional blogs by Dr. Johnson or to contact the office, visit: www.NewtonWellesleyDentalPartners.com

Original article: San Diego Union-Tribune
Artwork: yourdentalpartners.com


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