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Oral Health as we Age
A 75 year old patient
of mine asked me to make recommendations which would help her to be able to
chew adequately when she entered a nursing home. She was in relative good
health and wasn’t planning on entering a facility soon. Her concern was that
several of her relatives had bad experiences which she hoped to avoid. I had
never been asked this question in 30 years but had often seen patients’ oral
health deteriorate as they aged, including when they entered long term care
facilities. So after researching and much contemplation I have developed
some observations and some recommendations.
As we age, there are certain inevitabilities. Our manual dexterity decreases
which make it harder to keep our teeth, gums and dental appliances clean.
Our teeth and dental replacements wear and become less efficient in chewing
.We take more medications making our mouth dryer. This leads to greater
friction on our oral tissues resulting in ulcers and sore spots. A dryer
mouth also makes the cavity causing bacterial acids stronger resulting in
higher cavity rates. Receding gums expose more cavity prone root surfaces.
The ability to fight oral infection decreases with some of the diseases that
plague us such as diabetes. The increased bacteria and fungal levels on our
teeth, soft tissues and dentures increase the chances of pneumonia. These
bacteria also enter the bloodstream complicating existing conditions such as
heart disease and diabetes.
Five percent of Americans are in nursing homes currently. By the time we
enter a long term care facility many of the above issues have worsened and
we have to rely on others for our oral hygiene. If a patient cannot feed
themselves, they probably cannot provide their own oral care. Nursing
assistants usually provide this help. Many are not trained and bathing &
eating assistance obviously take precedent over oral hygiene
It sounds pretty hopeless but there are many steps we can take to insure our
future health and quality of life. . The preventive measures we take
throughout our life are the strongest influence on our oral health. Regular
dental visits, regular flossing, using an electric toothbrush and
antibacterial mouth rinses are most important. Get recommended dental care
needs completed when we are younger and can tolerate the necessary
procedures. Dental implants are a wise investment as single tooth
replacements because they cannot get cavities and can be modified to hold in
dentures if other teeth are lost. Nursing home patients with implant held
dentures can eat more nutritious foods because they can chew harder than
patients with conventional dentures. They are less likely to lose their
dentures because they’re not removed as much. Selecting the right long term
care facility and continuously monitoring the care that we or our love ones
receive is crucial to good health, comfort and quality of life.
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