Dental Diseases

There are two main types of dental disease that can affect the elderly.

Gum (Periodontal) Disease

Gum Disease
 Gum disease can cause inflamed and bleeding gums, gum recession (gum tissue is reduced such that the roots of the teeth become exposed), loose teeth and bad breath. It is caused by the build-up of dental plaque (a combination of food debris and bacteria). Plaque leads to gum disease if it is not removed by daily efficient brushing and flossing. This gum disease is known as periodontitis.

Tooth Decay (Dental Caries)

Tooth decay
 When a person takes in sugary food and drinks, it leaves dental plaque on the teeth. Bacteria in the plaque feed on sugar and produce acid. When proper dental care is not done, this acid produced by dental plaque attacks the tooth and eventually causes decay in the tooth. If there is gum recession at the same time, this increases the chance of decay at the necks of teeth. To prevent tooth decay, it is important to keep the mouth clean.

Both gum disease and tooth decay cause discomfort or pain and can lead to infection. Other problems that are caused by poor dental care include:

  • Poor nutritional status, as a result of food not chewed thoroughly
  • Low self-esteem, not feeling good about oneself
  • Difficulty in improving control on diabetes
  • Increased risk of pneumonia, especially in elderly with swallowing problems, which can lead to increased hospital stays
  • Worsen confusion associated with elderly with dementia, when there is pain and infection

GENERAL TIPS ON GOOD DENTAL CARE

  1. Brush the teeth twice daily
  2. Care for dentures through the following:
    • Remove dentures and rinse with plain water after meals
    • Brush dentures thoroughly before bedtime and soak them in a denture cleanser at night
    • Brush dentures using a soft toothbrush. DO NOT use toothpaste as it can damage the denture. Food remnants should not be left on any surface of the denture
    • Use a soft toothbrush to clean the gums, tongue and roof of mouth
    • DO NOT wear dentures to sleep as it will cause unhealthy bacteria to build up in the mouth

Visit a dentist regularly to get timely advice on

  • How to brush properly
  • Types of toothbrush to use e.g. manual vs electric, interdental brushes, etc.
  • Types of toothpaste to use, whether mouthwash is necessary
  • How to brush for your ward, if you are a caregiver
  • Management strategies to brush properly for older adults with behavioural issues e.g. dementia
  • Signs to look out for to determine oral health problems

Note: In older adults with difficulty brushing, either get them to brush by themselves first and have a caregiver check and brush again later, or have the caregiver brush their teeth for them. Take into account their feelings as much as possible; try to maintain their ability to perform independent tasks for as long as possible.