Senior Dental Problems and Taking Care of Elderly
Last Updated: April 4, 2013
There's an old saying about the eyes being windows to the soul.
But the latest medical and dental research shows that the mouth
truly is a window into one's overall health. Looking out for a
loved one's health means not only keeping an eye on their
nutritional intake and physical capabilities, but also on their
teeth and gums. Senior dental problems can be common, from dry
mouth to periodontal disease, and since oral health directly
impacts the health of the rest of the body, these issues need to be
taken seriously. Taking care of elderly teeth and gums is just as
important as heart or digestive health.
Researchers have found that many diseases in the rest of the
body have oral symptoms. With careful examination of the teeth,
gums, and tongue, dentists have found evidence of heart or liver
disease, eating disorders, diet deficiencies, anemia, diabetes,
osteoporosis, and even some autoimmune diseases. "We're now
realizing how they're interrelated," explains Dr. Cynthia M.
Carlsson, assistant professor of geriatrics and gerontology at the
University of Wisconsin School of Medicine and Public Health.
Not only does the mouth tattle on the rest of the body, oral
health can actually affect overall health.
"Nowadays we have fluoridated water, we have better preventative
dental options, there's better insurance," Carlsson says. "But, for
our older adults who maybe didn't have that when they were
children, if they're going to have cavities, that may affect their
For example, recent studies show a correlation between gum
disease and heart disease. In fact, risk factors for periodontal
disease and cardiovascular disease are similar: smoking, stress,
poor diet, excessive weight gain, and low exercise levels. One
study suggests that people with severe periodontal disease face
double the risk of fatal
heart disease, and severe periodontal disease also is
associated with higher rates of stroke in some studies. And in
certain circumstances, a tooth infection has the potential to cause
bacterial endocarditis, which is an infection of the heart's inner
lining or the heart valves. Bacteria in the bloodstream can lodge
on the valves or damaged heart tissue, and it could be serious
enough to damage, or even destroy, the heart valves.
Periodontitis also appears to share risk factors with chronic
degenerative diseases such as ulcerative colitis, and lupus. If a
patient has severe gum disease, they may be advised to take
antibiotics before undergoing invasive dental procedures such as
gum surgery or tooth extraction.
Conversely, other diseases can affect the mouth. For example,
diabetes affects healing, so if a diabetic senior has gum
disease, it may take quite a bit longer to treat that gum
Researchers now urge both doctors and dentists to be alert to
overall health problems when taking care of elderly patients and
encourage behaviors that will promote a healthy body from head to
It's easy for someone to let oral health slide a bit when
they're distracted by other ailments. Perhaps
arthritis makes tooth brushing painful, or they can't stand at
the bathroom sink very long. "They're maybe not quite as vigilant
because of their frailty, which leads to a quick decline in oral
health, and this could be a detriment to systemic health," explains
Dr. Marsha A. Pyle, director of the Training Center for Geriatric
Oral Health and associate dean of Education at the Case School of
Dental Medicine in Cleveland, Ohio. "You can't just treat dental
disease in isolation."
It's best to brush after every meal, says Pyle, not just in the
morning and at night. If a patient is at risk of periodontal
disease, a dentist can prescribe special toothpastes or gels that
help combat dental disease, as well as a daily treatment of
high-fluoride gel or anti-bacterial rinse.
Carlsson advises encouraging your loved one to visit their
dentist on a regular basis either to have their teeth cleaned or to
have their dentures refit. Missing teeth or dentures that don't fit
well can lead to potentially serious senior dental problems. "They
may aspirate the food, where food goes down into the lungs and
causes pneumonia," Carlsson says. Besides encouraging good
nutrition and regular dental visits, watch him eat to see if he's
avoiding something, and try to notice if any of his teeth look
loose or broken.
Ill-fitting dentures can be a culprit in poor nutrition among
seniors. When a person loses his natural teeth, his jaw bones begin
to shrink away, leading to the jaw continually "remodeling" itself.
Dentures that once fit well start slipping. So, a senior may start
limiting the kinds of food he eats because it's too hard to eat, or
because he's embarrassed that others may see him having trouble
"And it happens during a really important stage of a person's
life. These really frail seniors really need their nutrition," Pyle
If a senior does lose her natural teeth, instead of traditional
dentures, she could have implant-supported dentures. These implants
are attached to the jaw bone, and a special denture snaps onto the
implants. These implant-supported dentures fit more snugly than
traditional dentures, so eating different foods shouldn't be a
A less drastic measure places a softer material on the gum side
of traditional dentures so they're more comfortable.
Just a few decades ago, 50 percent of all seniors had no natural
teeth remaining, according to Pyle. That number has now dropped to
27 percent of those over age 65. "It's not a natural part of aging,
I'm happy to say," says Pyle. "People now are aging with a full set
Whether or not your loved one has his natural teeth or dentures,
a little help from you can go a long way toward ensuring that he
maintains good dental hygiene. A healthy smile may affect a
person's confidence and self-image, but, more importantly, it will
pay off not only in her oral health, but in her overall health as
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According to Pyle, one of the major senior dental problems is
dry mouth. "If they have a chronic disease managed by medications,
one of the side effects is dry mouth. There are 400 medications
known to cause dry mouth," Pyle says, including medications for
common problems such as high blood pressure and depression.
While a small amount of gum recession is normal as seniors age,
dry mouth increases that recession dramatically, leaving the mouth
more susceptible to root area cavities. And those root surface
cavities advance more quickly on the soft surface of a tooth.
There are many ways to treat dry mouth, including the use of
products designed to help alleviate the condition:
- Increase liquid intake.
- Rinse mouth frequently with water.
- Use a commercially available saliva substitute.
- Use specially-formulated toothpastes, chewing gum, or
- Apply lip moisturizer frequently.
- Suck on tart, sugarless hard candies.
- Avoid dry, salty foods.