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Family Health Magazine - DENTAL HEALTH

Healthy Teeth, Healthier You
What seniors should know about oral care

We are living longer, more active and productive lives than ever before. Still, as we age our bodies change. We are likely to notice if vision becomes less sharp or hearing isn’t as good as it once was. We are aware that our responses are slower, or that our sense of touch and ability to grasp objects is fading. Usually, we are able to adjust what we do and how we do it.

All dental diseases can be prevented if we are careful with our daily oral care, watch what we eat and see an oral care professional
regularly.

Yet we may not be aware of changes to the health of our mouth, gums and teeth. Oral tissue can thin and become more inclined to wear and tear. The mouth may feel dry because medication is affecting saliva flow. The senses of smell and taste may diminish. Teeth can become more fragile and discoloured. As gum tissue recedes, root surfaces are more exposed and teeth more at risk of root cavities. In spite of all these changes, people are keeping their teeth into very old age, if not for their entire lifetime.

Medical and dental research has found a definite link between oral and general health. Oral disease has a definite impact on cardiovascular (heart) health, diabetes, kidney disease, respiratory disease, oral side effects of cancer therapies and other areas of health.

Keeping your mouth healthy helps reduce the side effects of many illnesses or diseases. It is also part of a positive sense of well-being and self image.

Changes to the senses

Sharpness of the five senses of vision, hearing, touch, taste and smell decline with age and the onset of medical conditions. Each directly or indirectly influences the state of your oral health.

Vision

Your vision affects how well you can care for your mouth. The ability to focus on near objects, judge distance and depth, tell the differences between colours, and adapt from light to dark can all decline. Use a few simple techniques to make sure that you are cleaning your teeth well.

First, increase the brightness of the lights in the bathroom. You will be better able to see if brushing has removed all the soft food particles and plaque from your teeth. If you still cannot see well enough, use your sense of touch and smell. Run your tongue along the tooth surfaces to feel if they are clean. Clean teeth feel slippery and smooth. If they are not clean they might feel gravelly or fuzzy.

If you smell a foul odour on your dental floss, that area needs more frequent attention. Odour also can indicate decay or gum disease.

Even the colour of the bathroom plays a role in how well you see. Decorate with soft colours in non-glare paint to reduce glare and reflected light.

In this case, an ounce of prevention is worth a pound of cure. Preventing problems is much less expensive than extensive dental repair.

Use a magnifying mirror to help you look closely at the health of your teeth and surrounding tissue. Check for unusual deposits and stains that cannot be removed with a toothbrush. Look for ulcers, white plaques (patches), and brown, red or white spots that do not go away within two weeks. If you spot any of these, visit a dental professional as soon as possible. Even if there is no pain, the problem area should still be checked.

Normal healthy tissue should be pink or coral pink in colour. Gum tissue that is bright red and bleeds easily may indicate disease. Continual bleeding may also be the first sign of illness, a reaction to medication, or chronic periodontal disease (infection of the gum tissue). See a dental professional for proper diagnosis. Early diagnosis is important, particularly if a medical condition is the problem.

Hearing and hearing aids

Hearing loss does not have a direct relation to oral health. However, wearing a hearing aid may create problems with playback if you use an electric toothbrush. Turn off your hearing aid before brushing.

Inner ear hearing aids may present problems after new dentures have been fitted, particularly if the length of your face changes. Pressure caused by an inner ear hearing aid can cause pain in the ears following placement of dentures. Always let the dentist know that you wear an inner ear hearing aid, especially if you are having a new denture made. If you take the aid out before the dental impression is made, you may find that the hearing aid does not fit properly when you get your new denture. This may result from changes in the ear canal caused by the fit of a new denture.

Taste and smell

Oral conditions like periodontal infection, decreased saliva, poorly fitting dentures and changes from disease can reduce the ability to smell and taste. Aging can further affect these abilities, lowering quality of life, oral and overall health.

The scent of food is valuable as it stimulates appetite. Once food is in the mouth, taste and smell play a vital role in determining the flavour and appeal of foods and beverages. They also affect the selection of nutrients, and warn of toxic vapours and spoiled food.

If you cannot taste how much sugar is present, it becomes difficult to control sugar intake. Tooth and root decay can result. Being unable to smell can affect your desire to eat and drink, leading to malnutrition, weight loss and dehydration. Lacking vitamins (vitamin B, folic acid and vitamin C) can lead to cracked lips, a burning feeling in the mouth, and less ability to heal. A sharp reduction in taste and smell may be the first warning of illness and should be reported to your dentist or doctor.

Loss of papilla on the tongue

As people age, the number of papillae on the tongue is reduced. The tongue may look smooth, shiny, and glazed, and taste may be reduced. This condition is often associated with poor nutrition, lack of nutrients (especially B complex vitamins) and the loss of saliva flow.

Fissures in the tongue may increase the amount of plaque on it, leaving a yellow or white coating. It is important to brush the tongue daily with a toothbrush or tongue scraper. Bacteria living between the papillae on the tongue can lead to bad breath and gum disease. Tongue scrapers can be purchased in most pharmacies. Ask your dental hygienist about them during your next appointment.

Chewing, swallowing and loss of saliva

Ill-fitting dentures, lost teeth, or sores in the mouth can make it harder to chew. A preference for soft rather than textured food can result. Continually eating soft foods and not eating enough fibre leads to constipation and other problems. People who have all their teeth chew more efficiently than those with lost teeth, or partial or complete dentures. The condition of your teeth plays a greater role than age in how well you chew. However, advanced aging influences how long a person chews and the number of strokes.

In a healthy person, once food is chewed well enough, it is moved to the back of the throat by the tongue and cheek muscles and swallowed. Medical conditions such as multiple sclerosis, Alzheimer’s or Parkinson’s disease can interfere with the working of the senses. This has more of an effect on the ability to swallow than does aging.

Swallowing is a complex process involving three stages: first the mouth, then the throat and finally the esophagus (the tube from throat to stomach). Each must work effectively to ensure a safe and efficient swallow. The teeth, amount of saliva and the strength of the tongue and muscles of the face all play a part in creating the right consistency of food for swallowing.

Medications rather than aging often reduce the quality and quantity of saliva. Less saliva flow can increase dental decay, oral infections like candidiasis, tissue injury, and trouble swallowing.

Choking may be a worry if you do not have enough saliva or muscle strength to mash food into a moist consistency. There are still ways to swallow safely and efficiently. Cut food into small portions, add gravies and sauces to moisten food, and take a small sip of water with each bite. Dentures must fit properly, and teeth and gums must be healthy.

If medications reduce saliva flow, food may stick more easily to the teeth. Tooth and root decay will quickly result if food particles are not removed daily. Dental professionals recommend rinsing your mouth vigorously with water after every snack to dislodge loose particles. If you are out for lunch or dinner and don’t have a toothbrush, swish with water. If you do have a toothbrush handy, use it after every snack and meal.

Changes in movement

Arthritis or nerve problems may interfere with your ability to use your fingers, hands and arms. Trouble grasping small objects can make it hard to manipulate a toothbrush. If your wrist or arm is immobile or you have difficulty raising your arm, it can be almost impossible to rotate a toothbrush to the right angle to effectively remove debris.

Electric rather than manual toothbrushes are recommended since no wrist action and little pressure is needed to clean the teeth. To make up for poor grasp and strength, toothbrush manufacturers are making the handles larger.

When purchasing an electric toothbrush, check that the off/on switch slides rather than rotates. Pull off the brush head to see if it is easily removed for cleaning. If it has to be screwed off it may not be suitable, especially if you lack mobility in your wrist, hand or arm. Turn the brush on to see if you can handle the vibration of the brush in your hand. It is not uncommon to hear seniors comment about difficulty tolerating the strong vibration of some toothbrushes.

If it is hard to hold your arm and elbow parallel to your teeth as you brush, sit down in a chair in front of the sink and rest your elbow on a counter. Now, you can brush your teeth without placing extra strain on your arm.

Some people gag when the brush is placed on the inside of the teeth near the tongue. Sucking on an ice cube before beginning to brush will reduce the gagging sensation.

Flossing is the only way to clean the surfaces between your teeth. Most food and plaque sticks to and most decay begins in this area. Flossing can be hard if you have large fingers or problems with finger stiffness. Floss wands can make flossing easier and provide better access to the back teeth.

Floss comes in waxed and unwaxed versions. Both are equally effective in removing soft deposits and plaque from between the teeth. Flat, tape-like flosses are also available. They slip more easily between teeth, particularly if teeth are heavily filled or have rough surfaces. Some are flavoured with mint or cherry. Flavouring adds a pleasant taste but does not make it any more effective in cleaning the teeth. Choose the type of floss that best suits your needs.

Root exposure and gum recession

If you have exposed roots, your teeth are more at risk for decay. Roots are softer than enamel and decay spreads more rapidly. If neglected, teeth can be lost.

If your teeth are sensitive, have them examined by a dental professional. Early diagnosis may mean you can prevent loss rather than removing teeth. Fluoride varnishes and gels can be applied to the teeth to help prevent further decay. Your dentist or dental hygienist may also recommend concentrated fluoride toothpaste if your risk for decay is high.

Aging presents challenges to us that require extra care and patience. All dental diseases can be prevented if we are careful with our daily oral care, watch what we eat and see an oral care professional regularly. In this case, an ounce of prevention is worth a pound of cure. Preventing problems is also much less expensive than extensive dental repair. Dental professionals are qualified to diagnose your oral problems. They can provide excellent preventive care and education, and help you to select the most appropriate dental aids to suit your needs.


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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2015, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6    [DH_FHd12]
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