Julie Hayes is the Editorial Assistant at Benjamin Rose Institute on Aging.
You are probably familiar with the inside of more than a few doctors’ offices as a caregiver for an older adult. Appointments with a regular M.D. and specialists tend to go hand-in-hand with handling a chronic condition or another health concern. You want to do everything you can to keep your loved one in good health. But with such a full plate, are you giving the same attention to his or her oral health care? While attending to your loved one’s oral care may seem less pressing in the scheme of things, seeing a dentist twice a year and practicing proper care at home are very important to maintaining overall well-being, boosting self-image and enabling proper nutrition.
Why oral care matters for older adults
The majority of older adults today have missed out on a number of developments in oral health care that had not yet occurred during their childhood years. They were not able to reap the benefits at a young age of such innovations as fluoride, teeth aligners and advances in detection and treatment of cavities and gum diseases. Because of this, many of them are now dealing with cavities and gum disease and decay, and may also be missing teeth, which means they have to wear dentures.
Studies show that not only can poor oral health result in additional health complications, but certain health conditions can also in turn have a negative impact on your loved one’s oral health and cause them additional pain and discomfort. For example, adults with diabetes and respiratory diseases have a greater risk of gum disease, and adults with osteoporosis have an increased risk of severe jaw pain. Gum disease is also a risk factor in cardiovascular disease and strokes (Dolan TA, Berkey D. Planning for the future. In: Friedman PK, ed. Geriatric Denistry: Caring for Our Aging Population. Ames, IA: John Wiley & Sons; 2014:303).
Oral health also plays an important role in appearance, social engagement and nutrition. A loved one with poor oral health may feel less confident in their self-image and have a lower desire to interact with others. Poor oral health can also lead to difficulties in chewing, eating and swallowing, which can in turn lead your loved one to cut back on their food and beverage intake, putting him or her at risk of malnutrition (Polser I, Schimmel N, Müller F, Biffar R. Edentulism as part of the general health problems of elderly adults. Int Dent J. 2010;60[3]:143-155).
Factors that may stand in the way of oral care
As important as oral care is for older adults, factors that may stand in the way include:
- The expense. Dental care is not currently covered by Medicare, and many retirees no longer have access to dental insurance.
- Low prioritization. Both older adults and their caregivers may consider routine or specialized oral health care as less pressing than care for a chronic health condition, or treatment for another disease. Oral health is also typically held as a lower priority in long-term care facilities, with residents generally having very limited access to dental care (Dirks SJ. Nursing facility dentistry. Generations. 2016;40[3]:52-59).
- Perception. A study on perceptions of oral health showed that adults with low health literacy and education were likely to have inaccurate perceptions of oral health and a higher tendency to fail to recognize their own oral health symptoms.
- Health considerations. Depending on the condition of your loved one’s health, he or she may find it hard to use a toothbrush and dental floss, or to remember to use both regularly.
- Mobility and transportation issues. Many older adults may have trouble getting to and from a dental clinic, especially in rural areas where these clinics may not be widely available.
What you can do to help your loved one
Consider the following tips to help your loved one stay on top of good oral care:
- Schedule twice-yearly dentist appointments
- See to it that he or she brushes and flosses regularly
- Ask whether your loved one has any mouth pain
- Pay attention to whether he or she can use a toothbrush and dental floss without difficulties
- Assist with brushing or flossing, if necessary, or ask another trusted family member or friend to do so
If the cost of dental care is an issue, discuss payment plans for non-emergency procedures with the dentist and ask for estimates in advance so that you can plan a budget. You may also want to consider exploring low-cost dental schools, public dental clinics, or the Donated Dental Services Program, which provides free dental care to adults over the age of 65 with permanent disabilities or severe health conditions.
If transportation is a problem, reach out to your loved one’s family and friends to find out whether anyone is available to give rides to appointments. You could also check into ridesharing companies that offer special services for those traveling to health appointments, such as Uber Health. If your loved one receives Medical Assistance, the Medical Assistance Transportation Program is another option.
There are also certain tools you can use to make your loved one’s oral care simpler. A team from Benjamin Rose Institute on Aging, led by Dr. Farida Ejaz, assessed the effectiveness of Daily Dental Care oral lozenges, a supplemental oral care product which promotes strong teeth and healthy gums, on the dental health of older adults. Introducing oral health supplements such as lozenges and mouthwashes into your loved one’s routine can help eliminate bacteria in tandem with his or her daily brushing routine.
If using dental floss or toothbrushes is difficult, water flossers and electric toothbrushes may be simpler to manipulate. If you are unfamiliar with these products, ask your loved one’s doctor for recommendations and more information.
By ensuring that your loved one maintains good oral health, you will not only contribute to his or her overall well-being, but to a sparkling smile and positive self-image.
