In a very interesting study, the first of its kind in the world, researchers at a prestigious New Zealand university surveyed the oral health of people living in aged residential care and found those with dementia, and older men in general, have dirtier and more decayed teeth.
Otago University Head of Department of Oral Sciences and lead author, Professor Murray Thomson, describes poor oral health as one of the "geriatric giants" with the situation a "major clinical and public health problem which is going to get worse." Older people have higher rates of cognitive and physical impairments that can adversely affect their oral self-care and complicate the provision of oral care, the study found. They said:
"Neither the aged care sector nor the dental profession, in most countries, is
prepared. Not only do we have more and more older people every year, but
more and more people are entering old age with their own teeth, rather than
full dentures, as was the situation just a couple of decades ago.
"In some ways, dentistry has been a victim of its success -- we have long
emphasized the idea of 'teeth for life' without much thought to what happens
towards the end of life."
Of those examined in the study (representative of the more than 14,000 New Zealanders living in aged care), recently published in the journal "Gerodontology," about half had severely impaired cognitive function, and more than a third required fillings or extractions. Those with severely impaired cognitive function had greater numbers of teeth with decay. They also had higher oral debris scores, reflecting poorer daily oral hygiene care.
The study found greater rates of tooth decay can result in dental and facial infections, poorer quality of life, malnutrition and difficulties in communication. The researchers also found that even the most cognitively impaired participants were able to be examined fairly easily, meaning that regular, routine removal of oral debris by carers should not be difficult.
To be sure, this situation exists all over the world.
It's a very complex situation involving a lot of players -- the insurers, Medicare, the dental profession, and the public. I know from my own experience that as they age, many people need help from their adult children or caretakers in making health care decisions, or even getting to the office of a practitioner.
Anecdotally, I’ve had many patients who had come to me for years, but as they aged and became more frail, I would see them less because their children didn’t think they’d need to see the dentist unless they had a complaint. They simply don’t realize that this can have traumatic impact on the dental health of their parent, who may have a spiraling of oral disease and other systemic disease, which can feed off each the inflammatory bacteria present in both.
Moreover, older adults are usually on many medications, a lot of which can have the side effect of drying the mouth, which makes the prospect of oral disease increase dramatically.
If you’re the child or caretaker of an older person who hasn’t had a dental appointment in the past six months, you should remind them to make one, help them make one and/or drive them to one. It’s important for their good health, their appearance, their confidence, and quality of life.
Our West Hartford Center office is fully ADA compliant, with free off-street handicapped parking, an elevator, and is easy in and out of. Contact us to set up an appointment, or give us a call at 860-561-2121 today!
Keep smiling,
Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut. She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121
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