When working at a skilled nursing facility, one of the biggest frustrations voiced by our families and residents was the lack of staff diligence in assisting with oral hygiene.
We really tried to improve our care when we learned that these concerns were justified as poor oral hygiene could significantly negatively impact one’s health. For example, a factsheet from the Washington Dental Service Foundation noted that neglecting one’s teeth could contribute to severe gum disease. Gum disease is common in about 23 percent of seniors between the ages of 65 to 74, and may contribute to the loss of natural teeth. Gum disease, sensitive teeth, diabetes, nutrition challenges, along with dry mouth are just some of the conditions that stress the importance of oral health in older adults. As well, the risks for conditions such as cardiovascular disease and diabetes increase with poor oral health.
According to data from the American Diabetes Association, often as a result of poorly controlled blood glucose levels, there is an increased prevalence of gum disease among diabetics. Furthermore, gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes (ADA). Dry mouth is another condition that can compromise one’s oral health including increased risk for tooth decay, gum disease and bad breath. Older adults may acquire a dry mouth as a result of taking certain over the counter and prescription medications. This condition can make it more difficult to chew, swallow or even speak.
To further reinforce the necessity of practicing good oral health a 2016 study from the University of Louisville concluded that inflammation from gum disease and subsequent build up of oral bacteria may increase the risk for heart disease and stroke (multiple sources). For people who, due to decay or gum disease, wear dentures be mindful to not to wear them when sleeping. Studies suggest that bacteria in the mouth that causes tooth decay may be inhaled into the lungs and may increase the risk for developing pneumonia.
Because of the potential for negative outcomes should oral care be neglected, regular dental check-ups are highly recommended. Unfortunately, while routine dental services are covered for those on Medicaid, and only a handful of Medicare Advantage Plans (check with the plan provider), with some limited coverage through purchasing dental insurance, it is not a benefit provided by traditional Medicare. Therefore, many older adults may find that as a result of costs, along with other more pressing financial needs, they may not have their dental needs met timely, if at all.
This does not bode well for the patient, as the dentist can play a key role in helping reduce pain due to decay, be proactive in reducing dental “crises” through oral health education along with diagnosing oral disease and many oral and pharyngeal cancers. A report from the Centers for Disease Control noted that than 30 percent of older adults have untreated cavities with similar figures pertaining to older individuals who have lost their teeth.
Some tips outlined by the American Dental Association to help maintain a healthy mouth as one ages include brushing twice daily with fluoride toothpaste, flossing regularly, using a mouth rinse with fluoride, and drinking fluoridated water instead of sugary drinks. Those who experience dry mouth are advised to share this information with a health care provider who can help to develop a plan that may include using saliva substitute, chewing sugarless gum and mints, and to stay hydrated.
If physical or cognitive limitations are impeding effective oral hygiene, share this concern with a health care professional who may recommend a referral to an occupational therapist. Please also see the links below to find a dentist who can provide any needed accommodations.
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Marci Vandersluis is a licensed social worker and has a master’s degree in gerontology. She is employed as a care manager assisting older adults in the community connect with needed services. Email: email@example.com.