The mouth is not only a window to the health of the body, but it is also the entry point for nutrition to be brought into the body. The way the teeth and gums are maintained plays an enormous role in keeping patients, especially the geriatric and homebound, out of a dental emergency situation.
As we progress to the “Golden Years,” there are some challenges that arise in the dental arena. Good vision plays an important role in identifying and removing plaque and food debris, as well as making one aware of areas of redness and inflammation, or noticing areas of decay on the teeth. Poor manual dexterity is another struggle that sets in later in life, which makes proper brushing and flossing a real challenge. An automatic toothbrush is a helpful tool to help those folks that can still manage their own oral hygiene adequately, but who could still use a boost due to a lack of manual dexterity.
When visiting family members with dementia issues, it is important to always make sure their teeth are brushed and flossed daily, even if you have to do it yourself as the visitor. Those who work in rehab centers and nursing homes as well as in-home caregivers can often be overworked and caring for numerous patients with a myriad of medical issues, and therefore they may not even have dental care on their radar. Since some of these patients are non-verbal, caring for these patients’ dental needs is not unlike caring for the dental needs of a young child. These patients’ teeth need to be brushed and flossed daily and have a visual check of their teeth for any dark spots that could be cavities or any inflamed areas of redness in the gums. It is helpful to make a calendar or chart and have each day crossed off after the brushing and flossing is completed to ensure it is being taken care of. When gum disease occurs from a lack of proper oral hygiene, pain and bleeding can be the result. Patients can avoid eating when there are painful areas in their mouth which result in malnutrition. Additionally, if plaque and food debris aren’t removed from the teeth, tooth decay or “cavities” can easily occur. When left untreated, cavities can become so severe that they can infect the nerve of the tooth, which can necessitate an emergency root canal or extraction.
Patients in the geriatric population may have removable partial or complete dentures that also need to be cleaned and cared for. People with dentures still need oral exams from a dentist to make sure they are fitting properly and that there are no other areas of pathology. When older patients lose a significant amount of weight as a result of malnutrition, the weight change can also affect the way the denture fits in the mouth. Having a denture relined can help a loose denture fit properly again by adding material to adapt to the change in anatomy. In other cases, a new denture may need to be made or dental implants may need to be placed to help stabilize and anchor in a loose denture. These can be life-changing treatments for patients who cannot properly chew with loose dentures. Some of the most painful sores that happen in the mouth are caused by ill-fitting dentures. It is important to inspect a denture-wearer’s gum tissues when the dentures are removed to ensure there are denture sores. Denture sores are typically either red in color or red along with a white ulceration.
To-Do List for Caregivers/Family Members:
- Make a chart and communicate with caregivers that brushing and flossing need to be done daily and checked off the list when complete. Don’t forget to brush the tongue!
- Always visually look at your family member’s teeth to make sure there are no areas of inflammation, denture sores, or visible cavities. (The flashlight on your cell phone works great to help illuminate the mouth for a better visual).
- Not all cavities can be seen with the naked eye. Some can only be diagnosed with X-rays. If the person is mobile, they should be taken in for a routine cleaning, exam, and X-rays at least twice a year. If not, a mobile dentist may be able to come to the patient at their location.
- If you have any other questions please call our office at (586)-731-9240 or contact us and we would be happy to assist you and/or your loved ones further.