Dental Health for Seniors
Maintaining good dental health for seniors is important as it impacts many aspects of their physical health. As we age, our teeth, like other parts of our body, wear out. Those fortunate enough to obtain professional dental care resort to dentures, partials, implants, and other restorative measures to insure that their mouths remain healthy, which allows them to continue their intake of dietary requirements. Unfortunately, many seniors don’t receive daily oral hygiene, let alone professional dental care. Financial, physical and pharmacological barriers make it difficult for the elderly to maintain their dental health.
For those seniors on Medicare, the cost of visiting a dentist every six months may be a strain on their finances, as Medicare does not cover routine dental care—checkups, cleanings or fillings. Some Medicare Advantage plans will cover routine dental services, so check with them about specific coverage. Medicare will never pay for dentures. However, Medicare may pay for the cost of the extraction depending upon the reason. It is always advisable to have your dentist/oral surgeon check on coverage prior to having the procedure. Medicare may pay for some hospitalizations related to dental care, such as an infection that develops post-extraction. Again, coverage varies from situation to situation.
Another barrier to maintaining good oral hygiene and subsequent dental health are physical limitations that prevent seniors from brushing and flossing effectively. Arthritis and Parkinson’s are two diseases that can impact manual dexterity and interfere with good technique. In addition, seniors who have cognitive impairment have difficulty not only remembering to perform oral hygiene, but also with carrying out the activity. They may require cueing and/or hands on assistance to complete the task.
Due to the fact that many seniors are on multiple medications (polypharmacy) they may experience a symptom known as Xerostomia or dry mouth syndrome. Having dry mouth syndrome can not only affect a senior’s quality of life, but can also affect their tolerance to dental prosthesis, alter their sense of taste, impact their nutritional status, and increase their susceptibility to dental caries (cavities). According to Mayo Clinic recommendations, when this condition exists it is wise to have medical professionals review the senior’s medications to see if the dosage can be adjusted or even eliminated (www.mayoclinic.com/health/dental/DE00001). If this is not possible, there are several measures that dentists suggest to help relieve the symptoms of dry mouth. Using fluoride gel toothpaste (ProDen Rx) and a fluoride mouthwash (ACT) are beneficial in preventing cavities. The use of an oral spray such as Biotene will help alleviate dry mouth symptoms. This spray is best used before meals and as needed. In addition, avoid spicy or salty foods as they can cause discomfort in a dry mouth and avoid caffeinated beverages which contribute to dry mouth, as do smoking and alcohol.
Proper oral hygiene is necessary for all seniors, but especially for those with dry mouth syndrome. Brushing and flossing should be done at least twice a day. Replace your toothbrush every three to four months or sooner if the bristles are frayed. Avoid sticky, sugary foods as much as possible. Visit your dentist for a check-up at least twice a year. If you are a denture-wearer, make sure that the dentures are removed at night, brushed, and then soaked in denture cleaner. Report any sores or irritations caused by your dentures to your dentist immediately. Good dental health is important in that it is a “window to your overall health” and might affect, be affected by, or contribute to various diseases and conditions from cardiac to diabetes to Alzheimer’s. (www.mayoclinic.com/health/dental/DE00001).
By Nancy Hanley, RN
Geriatric Care Manager