Dental Care for the Elderly

Care of the mouth and teeth at older age is more important than ever, despite the fact that few elderly people have all or even most of their teeth. For the most part people in their sixties, and certainly into their seventies, have dentures, or other replacement teeth of some description.

 

As you get older it is vital to maintain your oral hygiene, even if you have lost some or perhaps most of your teeth. This is because increasing age, some medications (for high blood pressure for example) and radiotherapy all decrease saliva flows, and as we have seen this hinders acid neutralization on the teeth. Taken together with an increased consumption of sweet hot drinks, biscuits between meals and sweets (mints and cough sweets are a feature of the diets of elderly people), these can all lead to a veritable explosion of tooth decay. Very careful and thorough removal of plaque is vital. Regular rinsing with a fluoride mouthwash at bedtime will also help keep decay at bay.

 

There are additional tooth problems at this older age. Over time, teeth wear down on their biting edges. Typically the enamel wears away on the biting surface and the dentine is exposed. As the exposed dentine is softer than enamel it wears away more quickly, leaving unsupported ledges of enamel which then break off. Once this condition has started it accelerates rapidly. This leaves the teeth with very short crowns, which are both unsightly and inefficient at biting. The exposed dentine also may be very painful. It is both complicated and expensive to remedy this condition.

 

A variant is the loss of enamel at the level of the gum. At this time of life the gum may well be receding, show­ing a considerable portion of the root of the tooth. This gives rise to the description of a person as ‘long in the tooth’. The exposed dentine is not only painful, all too often it also becomes a collar of rampant decay around the root surface, as people find it painful to clean the plaque away from this area. Specialist desensitizing toothpastes must be used, especially as it is very diffi­cult for the dentist to fill these cavities successfully. A new treatment is becoming available, which seals this decay and to some extent reverses the process.

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