Dental health is integral to overall health and well-being, and this remains true, if not more so, for older adults. Maintaining good oral hygiene can prevent a range of problems, from tooth decay and gum disease to more serious health complications. Unfortunately, dental health often declines with age due to factors such as medications, chronic illnesses, and physical limitations.

According to a Centers for Disease Control and Prevention (CDC) report, nearly 1 in 10 adults aged 65 or older have lost all of their teeth. In over 75s, this increases to 1 in 5. Furthermore, The National Library of Medicine reports that, as far back as 2012, 64.7 million Americans, 46% of the adult population, suffered from periodontal (gum) disease. Lastly, another National Library of Medicine report showed that, combined with the increasing prevalence of human papillomavirus (HPV), older adults are more susceptible to oral cancers, with the median age at diagnosis being 62. This means half of the cases are diagnosed before age 62 and the other half after.

It's pretty clear, therefore, that ensuring proper oral healthcare becomes increasingly important as we age. This guide aims to equip older adults and their caregivers with the knowledge and practical strategies necessary to promote optimal dental health, contributing to their overall health and quality of life.  

Common  Dental Health Issues in Older Adults

Several oral health challenges are more prevalent among older adults:  

• Dry Mouth (Xerostomia): This is a common side effect of many medications and certain medical conditions. Reduced saliva flow can lead to difficulty swallowing, increased risk of tooth decay, and oral infections.  
• Tooth Decay (Caries): Older adults are more susceptible to cavities, especially around the roots of teeth, which may become exposed as gums recede.  
• Gum Disease (Periodontal Disease): This infection of the gums can lead to tooth loss, bone damage, and has been linked to other health problems like heart disease and diabetes.  
• Tooth Loss: This can affect chewing ability, nutrition, and self-esteem.  
• Oral Cancer: The risk of oral cancer increases with age, particularly for those who use tobacco or consume excessive alcohol.  
• Thrush (Oral Candidiasis): A fungal infection that causes white patches in the mouth, often associated with denture use or weakened immune systems.

The Caregiver's Role in Oral Healthcare

Caregivers can play a key role in helping seniors maintain good oral hygiene. This includes:  

1. Assisting with Daily Oral Hygiene:
   • Brushing: Assist with or provide brushing at least twice a day using a soft-bristled toothbrush and fluoride toothpaste. If dexterity is an issue, consider using an electric toothbrush or a toothbrush with a modified handle.
   • Flossing: Flossing daily is crucial for removing plaque and food particles between teeth. If traditional flossing is difficult, try using floss holders or interdental brushes.  
   • Mouthwash: Using an antimicrobial mouthwash can help reduce plaque and bacteria. However, avoid alcohol-based mouthwashes, as they can exacerbate dry mouth.  
2. Managing Dry Mouth:
   • Hydration: Encourage frequent sips of water throughout the day.  
   • Sugar-free Gum or Candy: These can stimulate saliva flow.  
   • Saliva Substitutes: Over-the-counter saliva substitutes can provide relief.  
   • Humidifier: Using a humidifier, especially at night, can help keep the mouth moist.  
   • Avoid Irritants: Avoid alcohol, caffeine, and tobacco, which can worsen dry mouth.  
3. Denture Care:
   • Cleaning: Clean dentures daily with a denture brush and denture cleanser. Avoid using regular toothpaste, as it can be abrasive.  
   • Soaking: Soak dentures in a denture-soaking solution overnight.  
   • Proper Fit: Ensure dentures fit properly and schedule regular dental checkups for adjustments if needed.  
   • Oral Hygiene for Denture Wearers: Even with dentures, it's important to clean the gums, tongue, and roof of the mouth with a soft-bristled brush.  
4. Monitoring for Dental Health Problems:
   • Regular Inspections: Regularly check your loved one's mouth for any signs of redness, swelling, sores, white patches, or loose teeth.  
   • Reporting Changes: Report any changes in their oral health to their dentist or healthcare provider.
5. Facilitating Dental Visits:
   • Regular Checkups: Schedule regular dental checkups, even if your loved one has dentures.
   • Transportation: Where necessary, arrange transportation to and from dental appointments.  
   • Communication with the Dentist: Communicate any concerns or special needs to the dentist.
6. Dietary Considerations:
   • Limit Sugary Foods and Drinks: These contribute to tooth decay.  
   • Encourage Nutrient-Rich Foods: A balanced diet rich in vitamins and minerals supports overall oral health.  
   • Modify Food Texture if Necessary: If chewing is difficult, consider preparing softer foods or pureeing meals.
7. Medication Review:
   • Discuss Medications with the Doctor: Some medications can affect dental health. Discuss any concerns with your loved one's doctor or pharmacist.  
8. Adapting Techniques for Cognitive Impairment:
   • Clear and Simple Instructions: Use clear and simple instructions when assisting with oral hygiene.
   • Hand-over-Hand Guidance: If necessary, use hand-over-hand guidance to help with brushing and flossing.
   • Positive Reinforcement: Offer positive reinforcement and encouragement.
9. Addressing Physical Limitations:
   • Adaptive Tools: Use adaptive tools such as electric toothbrushes, floss holders, and modified handles to make oral hygiene easier.  
   • Positioning: Find a comfortable position for both you and your loved one during oral care.
10. Oral Care for Bedbound Seniors:
    • Use a Moistened Gauze or Sponge: Gently clean the teeth, gums, tongue, and inside of the cheeks with a moistened gauze or sponge.  
    • Positioning: Position the senior on their side to prevent choking.  

When to Seek Professional Dental Care

Seek immediate dental care if you notice any of the following:

• Loose teeth.  
• Bleeding gums.  
• Pain or swelling in the mouth.  
• Sores or ulcers that don't heal.  
• Difficulty swallowing.  
• Changes in denture fit.

Conclusion

Providing oral care for older adults can be challenging, but it’s an essential aspect of caregiving. It requires patience, attention to detail, and a willingness to adapt to changing needs. You may face resistance from your loved one or be hampered by your own physical limitations. Acknowledge these challenges, but recognize and be encouraged by the contribution you are making to their overall health and well-being.  

With 30 years of experience in senior care products, we at LL Medico have worked with thousands of older adults and caregivers, and we have gained a wealth of knowledge in this area. We have also accumulated a comprehensive range of superior-quality products covering all aspects of senior care.

So, for chewing or swallowing difficulties, browse through our nutritional and enteral products section. We also have a range of vitamins and minerals to address specific dietary deficits and, due to the prevalence of incontinence among older adults, you may also be interested in our range of adult diapers and other incontinence products.  

"As you grow older, you will discover that you have two hands, one for helping yourself, the other for helping others." Audrey Hepburn’s words point to a quality inherent in most humans. That of compassion and concern for the well-being dentof less fortunate or infirm individuals. The work you do helps your loved one maintain not only their al health but also their dignity, comfort, and quality of life.