Other Free Encyclopedias » Medicine Encyclopedia » Aging Healthy - Part 1 » Dental Care - Factors Associated With Tooth Loss, Effect Of Total Tooth Loss, Problems With Complete Dentures, Prevention Of Tooth Loss

Dental Care - Prevention Of Tooth Loss

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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

ATWOOD, D. A. "The Reduction of Residual Ridges. A Major Oral Disease Entity." Journal of Prosthetic Dentistry 26 (1971): 266–279.

BRANCH, L. G.; ANTCZAK, A. A.; and STASON, W. B. "Toward Understanding the Use of Dental Services by the Elderly." Special Care in Dentistry 6 (1986): 38–41.

CARLSSON, G. E. "Masticatory Efficiency: The Effect of Age, the Loss of Teeth and Prosthetic Rehabilitation." International Dental Journal 34 (1984): 93–97.

CHAUNCEY, H. H.; MUENCH, M. E.; KAPUR, K. K.; and WAYLER, A. H. "The Effect of the Loss of Teeth on Diet and Nutrition." International Dental Journal 34 (1984): 98–104.

DOUGLASS, C. W., and FURINO, A. "Balancing Dental Services Requirements and Supplies: Epidemiologic and Demographic Evidence." Journal of the American Dental Association 121 (1990): 587–592.

DREIZEN, S.; BROWN, L. R.; DALY, T. E.; and DRANE, J. B. "Prevention of Xerostomia-Related Dental Caries in Irradiated Cancer Patients." Journal of Dental Research 56 (1977): 99–104.

FELDER, R. S.; MILLAR, S. B.; and HENRY, R. H. "Oral Manifestations of Drug Therapy." Special Care in Dentistry 8 (1988): 119–124.

GIFT, H. C., and REDFORD, M. "Oral Health and Quality of Life." Clinical Geriatric Medicine 8 (1992): 673–683.

GROSSI, S. G.; SKREPCINSKI, F. B.; DECARO, T.; et al. "Treatment of Periodontal Disease in Diabetes Reduced Glycated Hemoglobin." Journal of Periodontology 68 (1997): 713–719.

KATZ, S. "The Use of Fluoride and Chlorhexidine for the Prevention of Radiation Caries." Journal of the American Dental Association 104 (1982): 164–170.

KIYAK, H. A.; GRAYSTON, M. N.; and CRINEAN, C. L. "Oral Health Problems and Needs of Nursing Home Residents." Community Dentistry and Oral Epidemiology 21 (1993): 49–52.

LESTER, V.; ASHLEY, F. P.; and GIBBONS, D. E. "The Relationship Between Socio-dental Indices of Handicap, Felt Need for Dental Treatment and Dental State in a Group of Frail and Functionally Dependent Older Adults." Community Dentistry and Oral Epidemiology 26 (1998): 155–159.

MORAN, J.; ADDY, M.; WADE, W.; et al. "The Effect of Oxidizing Mouthrinses Compared with Chlorhexidine on Salivary Bacterial Counts and Plaque Regrowth." Journal of Clinical Periodontology 22 (1995): 750–755.

PAUNOVICH, E. D.; SADOWSKY, J. M.; and CARTER, P. "The Most Frequently Prescribed Medications in the Elderly and Their Impact on Dental Treatment." In The Dental Clinics of North America, vol. 41, no. 4. Philadelphia: W. B. Saunders, 1987. Page 702.

PERSSON, R. E.; TRUELOVE, E. L.; LERESCHE, L.; and ROBINOVITCH, M. R. "Therapeutic Effects of Daily or Weekly Chlorhexidine Rinsing on Oral Health of a Geriatric Population." Oral Surgery, Oral Medicine, Oral Pathology 72 (1991): 184–191.

RIPA, L. W.; LESKE, G. S.; FORTE, F.; and VARMA, A. "Effect of a 0.05% Neutral NaF Mouthrinse on Coronal and Root Caries of Adults." Gerodontology 6 (1987): 131–136.

SLOAN, R. W. "Drug Interactions." In Practical Geriatric Therapeutics. Oradell, N.J.: Medical Economics, 1986. Page 39.

TALLGREN, A. "The Continuing Reduction of the Residual Alveolar Ridges in Complete Denture Wearers: A Mixed Longitudinal Study Covering 25 Years." Journal of Prosthetic Dentistry 27 (1972): 120–132.

TAYLOR, G. W.; BURT, B. A.; BECKER, M. P.; et al. "Severe Periodontitis and Risk for Poor Glycemic Control in Patients with Non-Insulin-Dependent Diabetes Mellitus." Journal of Periodontology 67 (1996): 1085–1093.

WAYLER, A. H., and CHAUNCEY, H. H. "Impact of Complete Dentures and Impaired Natural Dentition on Masticatory Performance and Food Choice in Healthy Aging Men." Journal of Prosthetic Dentistry 49 (1983): 427–432.

WEFEL, J. S.; JENSEN, M. E.; TRIOLO, P. T.; et al. "De/Remineralization from Sodium Fluoride Dentifrices." American Journal of Dentistry 8 (1995): 217–220.

WEYANT, R. J.; JONES, J. A.; HOBBINS, M.; et al. "Oral Health Status of a Long-Term Care, Veteran Population." Community Dentistry and Oral Epidemiology 21 (1993): 227–233.

WILSON, A. A., and BRANCH, L. G. "Factors Affecting Dental Utilization of Elders Aged 75 Years or Older." Journal of Dental Education 50 (1986): 673–677.

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