Dental Care
Prevention Of Tooth Loss
An important strategy for maintaining a healthy, natural dentition is regular dental visits with oral hygiene instruction. Depending upon the medical and dental condition of the individual, older adults should visit the dentist every three to six months. This frequency enables the dentist or dental hygienist to diagnose potential tooth decay and gum disease before it can become a major problem. Because both decay and gum disease are caused by accumulations of mouth bacteria (dental plaque), proper oral hygiene instruction is crucial.
Aimed at preventing both gum disease and tooth decay, oral hygiene begins with mechanical plaque removal. This is best accomplished with brushing the teeth and cleaning between the teeth. Dental floss, between-the-teeth brushes, and toothpicks can be used to remove plaque from between the teeth. Daily, effective removal of dental plaque is critical in preventing dental disease. For those with physical handicaps, a caretaker may be required to assist in daily oral hygiene.
The role of saliva in maintaining dental health is crucial. Saliva is essential in controlling and clearing bacteria from the mouth. For older adults who suffer from dry mouth, the protective action of saliva is compromised. Regimens to replace or stimulate salivary flow include sips of water, chewing sugarless gum, and using sugarless mints. Sugar-free gums and mints are crucial for individuals with natural teeth, because disease-producing bacteria readily metabolize sugar to end products that cause tissue destruction.
Another strategy to control the levels of mouth bacteria is the use of antibacterial mouth rinses. Numerous over-the-counter preparations are available, and one phenolic rinse has been shown to significantly reduce oral bacteria for short periods of time (Moran et al.). If indicated, the dentist may prescribe a more powerful oral rinse, chlorhexidine. Chlorhexidine rinse at 0.12 percent strength is the most effective, sustained antibacterial agent available (Persson et al.).
While saliva and antibacterial rinses target both gum disease and tooth decay, fluoride preparations are specifically used to fortify and strengthen tooth structure, a process called remineralization. Older adults should be encouraged to use fluoride-containing toothpaste. Remineralization with fluoride toothpaste has been well documented (Wefel et al.).
Over-the-counter 0.05 percent fluoride rinses have been shown to reduce tooth decay and remineralize tooth structure (Ripa et al.). Fluoride gels, applied at home or in the dental office, have been shown to prevent decay and significantly remineralize tooth structure in extremely susceptible cancer patients (Dreizen et al.; Katz).
The loss of all permanent teeth and the wearing of complete dentures is not without serious functional and social limitations. Research indicates that a healthy, functional, natural dentition is important to good general health, adequate nutrition, and a sense of well-being in the older adult. The maintenance of a permanent, natural dentition can be accomplished through tested and verified strategies that are available from the dental professional.
JEFFREY D. ASTROTH
See also NUTRITION.
BIBLIOGRAPHY
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Additional topics
Medicine EncyclopediaAging Healthy - Part 1Dental Care - Factors Associated With Tooth Loss, Effect Of Total Tooth Loss, Problems With Complete Dentures, Prevention Of Tooth Loss