Senior citizens live longer and lead healthier lives due to changes in lifestyle and improvements in medical and dental care. Oral health is particularly important among the elderly. They are more susceptible to systemic conditions, making them predisposed to developing oral diseases, leading to a diminished quality of life.
Some of the oral problems affecting the elderly are as follows-
- Xerostomia (Dry Mouth)
- Caries (decay) affecting teeth
- Periodontal Disease (Gum Disease)
- Loss or alteration in taste
- Loss of teeth
Xerostomia (Dry mouth)
Xerostomia is not a condition to be taken lightly, the person suffering from it may complain of a sore or burning sensation on the tongue, dry, cracked lips and corners of the mouth an a constant thirst. Dry mouth can interfere with a person’s ability to speak, taste, chew and swallow.
Dry mouth can result as a side effect of medications like anti-depressants, antihistamines, anti-hypertensives etc. Reduced salivary flow can be caused by radiation therapy directed at the head and neck region, which can damage the salivary glands. It can also be caused by neurological disorders, rheumatoid conditions etc. Aging is a contributing factor but not a cause for dry mouth.
When a person has dry mouth it can lead to increased levels of tooth decay and periodontal disease. Patients will also have difficulty in wearing dentures.
People affected by dry mouth are advised to keep the mouth wet and take the following precautions to reduce decay and gum disease-
- Brush and floss after every meal
- Wet mouth frequently with water
- Chew sugarless gum (Orbit by Wrigley’s has been recently introduced in our country)
- Avoid tobacco, alcohol, and foods high in sugar content
- Brush and rinse dentures after each meal
Caries (decay) affecting teeth
There are a number of reasons why the elderly are more prone to caries than any other segment of society. Firstly as we age, there is less nerve tissue in our teeth due to a reduction in the size of the pulp chamber. This reduces our ability to feel discomfort, till a considerable amount of tooth tissue is damaged. Secondly, due to gum recession, a portion of the root is exposed. This surface is not covered by enamel but by cementum, which is softer and easily prone to decay. Root surface decay will also easily reach the nerve tissue, thus these teeth may require root canal treatment. This involves removal of the nerve and filling the root canal with an inert material. Subsequently, capping of the tooth is required to prevent breakage of the tooth. Finally, a change in the consistency and amount of saliva causes food debris to stagnate between teeth and at the gum line thus increasing the risk of tooth decay.
Periodontal Disease (gum disease)
The most common cause for loss of teeth in adults is gum disease. This is caused by plaque, a sticky film of bacteria that constantly forms on teeth. If plaque is not removed with thorough daily cleaning between teeth, the gums become inflamed. The inflamed tissue can separate from the teeth and form spaces called pockets. Bacteria move into these spaces and continue the destructive process, leading to bone loss. If this condition is left untreated it can lead to the eventual loss of the tooth. Adults above the age of 35 are prone to gum disease. The elderly are more prone to this condition due to smoking, poor diet & poor oral hygiene habits. It is important for them to have regular dental checkups.
Loss or alteration in taste
Many seniors have an alteration or loss in taste. However, the cause of this is usually not because of a reduction in taste buds as was thought earlier. Certain medications can cause an alteration in taste sensation. Dentures and other removable appliances also affect taste sensation. Finally olfaction
(smell) plays a key role , as we age olfactory performance comes down leading to an alteration in taste sensation.
Loss of teeth
Loosing teeth was once considered a part of aging. However, loosing teeth at any age is because of disease like advanced gum disease or teeth decay. Dentistry has made great strides in the last decade, thus teeth can be saved like never before.
If teeth are lost due to decay, gum disease or trauma, there are a number of ways in which they can be replaced. The treatment plan depends on the area and the number of teeth lost. If a single tooth is missing it can be replaced with either an implant or a fixed bridge. Removable dentures are usually not recommended for this. If multiple teeth are missing and a fixed bridge is not possible, the only choice that was available earlier was a removable denture. However, due to the recent advances, implants can be placed and a fixed bridge can be given. An implant is a screw or a cylinder made of titanium, which is placed in bone. After a healing period ranging from three to six months during which time the implant fuses with bone, the crown, bridge or denture can be placed on top. Implants have become an effective alternative to removable dentures. Patients who have lost all their teeth need not wear complete dentures. Multiple implants can be placed in the upper and lower jaws and a fixed prosthesis can be given. Implants can also be used to stabilize the dentures so they are more comfortable to wear. This is very effective for people who have been wearing dentures for an extensive period of time and whose jaws have shrunk to point where the dentures are very loose. This is especially true of the lower dentures. There is no age bar for the use of implants.