Oral hygiene and oral care essential for the elderly

Couples often remind their child to brush his teeth at least twice a day to prevent cavities, but few realise it is just as important to encourage good oral hygiene among their own parents.

Research has shown that poor oral hygiene is linked to Aspiration Pneumonia, which is essentially a lung infection that occurs as a result of food, fluids or saliva entering the airway and into the lungs.

Pneumonia has been described as the "Captain of the Men of Death" by William Osler back in the 1910s. However its description still holds true today. Studies have shown that the risk of developing pneumonia increases with age. Those aged 75 years and above have approximately six times as much risk as those below 60 in developing pneumonia.

The risk of death from pneumonia has also been found to increase with age. A swallowing disorder (which may arise from conditions such as stroke, dementia, Parkinson's disease) further increases the risk of Aspiration Pneumonia.

Individuals with a swallowing disorder may be fed through other means such as a feeding tube that is inserted through the nose and into the stomach. As no food enters through the mouth, many people hold the misconception that there is no need for proper oral hygiene.

However, individuals with swallowing problems often also have a reduced ability to manage their own secretions and may also be dependent on others to maintain good oral hygiene. As a result, there may be an increase in oral bacteria in the saliva, which may eventually enter the airway and the lungs, thus leading to Aspiration Pneumonia.

Good news

The good news is that practising good oral hygiene can reduce the risk of Aspiration Pneumonia. Research has shown that through the improvement of oral hygiene in the elderly, an encouraging figure of 1 in 10 cases of death from pneumonia can be prevented.

So how can we maintain good oral health? The following steps are recommended:

  1. Gargling 
  2. Gargling is a quick and easy way to rid the oral cavity from bacteria. Products that contain thymol may be used. However, precautions have to be taken for individuals with swallowing problems as their ability to control the liquid in their oral cavity may be reduced, placing them at risk of the liquid entering their airway.

  3. Brushing teeth / Cleaning of dentures 
  4. Adopt the good habit of brushing teeth at least twice a day. For individuals with dentures, brush the dentures after every meal if possible. It is important to remove dentures daily to prevent infection.

  5. Cleaning all surfaces in the oral cavity 
  6. This is especially important for individuals with dentures as the inner surfaces of the oral cavity are often overlooked when performing oral hygiene. Food residue often gets lodged between the dentures and the gums. After removing the dentures, a toothbrush, oral swab or cloth can be used to clean the inner surfaces, including the tongue and the gums.

  7. Visit the dentist 
  8. Regular dental checkups are essential in maintaining good oral health.
    Prevention of Aspiration Pneumonia begins by adopting these four simple steps of achieving good oral hygiene and oral care.