ORAL HEALTH & AGING AWARENESS

by Michelle Martin RDH, MPH

“Elderly suffer a disproportionate & debilitating amount of oral disease.”

- Alliance for Aging Research

People with Diabetes are at a greater risk of developing gum disease.

Oral Health Trivia

Hypertension (High Blood Pressure) medications can affect your mouth.

TRUE or FALSE?

Healthy eating can contribute to the condition of a an individuals mouth.

Among new military recruits in 2010, what percentage were not deployed because of significant dental issues?

A. 0-40%

B. 40-60%

C. 60% +

One Last Trivia Question???

Why is oral health so

important?

Heart Disease Stroke Pneumonia Diabetes

Bacteria in the Mouth…

“… providing mechanical oral hygiene may prevent 1 in 10 deaths from pneumonia in dependent elderly people and show similar pneumonia prevention effect.”

(Sjogren, P., et al: JAGS 2008 (56); 2124-30)

35% of all Americans have some form of PD 13% have severe periodontal disease

75% of all Americans have inflammation of the gums (gingivitis)

Progression of gingivitis to bone loss: Pockets form around the teeth Pockets gradually deepen, ulcerate Bone loss visible on x-rays

Periodontal Disease (Gum Disease)

Nearly 1/3 of people with diabetes have severe bone loss (CDC)

Diabetics are 3 - 4 times more likely to develop periodontal disease (gum disease)

Gum Disease , Diabetes and our Hearts

Develop infections easier Can contribute to heart disease

Can contribute to pneumonia (http://www.perio.org/consumer/mbc.diabetes.htm)

Oral Health as We Age

“A feeling that there is not enough saliva in the mouth, all or most of the

time.”(NIH Senior Health, 2003)

Xerostomia:Dry Mouth

Sjögren's syndrome

HIV/AIDSAlzheimer's diseaseDiabetesAnemiaCystic fibrosisCrohn’s disease

Systemic Lupus Erythematosis

Rheumatoid arthritisHypertensionParkinson's diseaseStrokeSclerodermaHepatitis

Risk Factors for Dry MouthA side effect of certain diseases

and infections:

Antidepressants Antihypertensives Narcotics Anticholinergics Antipsychotics Anti-Parkinson Antiasthmatics Anorexiants Anticonvulsants Antacids

Hormone replacements

Diuretics Sedatives Inhalants Decongestants Glaucoma eye

drops Antihistamines Pseudoephedrine

Risk Factors for Dry MouthA side effect of over 500 medications:

(USDHHS, 2008)

Dry, sticky oral tissues Thick saliva Ulcers in mouth Cracking of the corners of

the mouth or tongue Bad breath Frequent yeast infections Red gums that bleed easily Increased tartar build up

Signs of Dry Mouth

Increased dental decay

Symptoms of Dry Moutho Sore or burning mouth, lips or tongueo Sleep interruptions due to thirst or oral

discomfort o Difficulty chewing, speaking, swallowing and

wearing dentureso Difficulty clearing leftover food in the mouth o Patient may avoid eating dry foods

Dry mouth may contribute to:

Inflammation Yeast infections Tooth decay Gum disease

ORAL CAVITY PROBLEMS

Severe Decay …the longer one waits

Over the counter products might be sufficient

Talk with doctor/ dentist for prescriptions

Prevent or Manage Dry Mouth

Mints and Hard CandiesAVOID SUGAR CANDY Sugar-Free Candies

Okay!

Handle with great care – very expensive Brush & rinse dentures daily – soft

bristles designed for dentures Clean with denture cleanser – NOT

toothpaste

Denture Care

Dentures need to be kept moist when not worn

Important to remove to allow oxygen to get to tissues

ONLY a dentist/ prosthodontist should adjust dentures

Denture Care

Put in denture case NOT a Kleenex/paper

towel! Remember to still brush gums and palate

Conditions with a high risk of infection antibiotics are recommended prior to some dental procedures Most conditions of the heart,

pace makers, heart valves etc.

Check with doctor/dentist

Antibiotics

(http://www.mouthhealthy.org/en/az-topics/p/Premedication-or-Antibiotics)

Aging in general increases the risk of oral cancer

Dry mouth from RX’s Eventually dependant on

care giver

Dementia and Oral Health

Early stages help remind about daily brushing

Increase fluoride treatments

Use alcohol-based pen to write name on dentures

Dementia and Oral Health

Promoting Healthy Habits

Be SMART brushers◦ 2x day for 2 minutes

Floss daily Prevent dry mouth

◦ Biotene or generic brand◦ Keep mouth moist!

Eat healthy fruits & vegetables

Daily Prevention Habits

Use floss holders Arthritis or other conditions that limit movement…• Electric toothbrush• Duck tape a golf ball securely to

handle of regular toothbrush NEVER put your fingers between teeth

Helpful Tips

(http://www.arthritistoday.org/news/gum-disease.php)

Studies show professional teeth cleaning lowers inflammation and pain in Arthritis patients…

Helpful Positioning

(South Australian Dental Service, 2009)

Changed Behavior Fear if being touched Not opening mouth Not understanding or

responding to directions

Biting the toothbrush Grabbing or hitting

out

(South Australian Dental Service, 2009)

Managing Changed Behavior Talk clearly, mime Allow resident to inspect the items Right environment Body language Overcoming fear of being touched

◦ Bridging◦ Chaining◦ Hand over hand◦ Distraction◦ Rescuing

(South Australian Dental Service, 2009)

Bleeding gums Sore mouth or tongue Sore corners of

mouth, tongue Thrush (candidiasis) Gum disease

(gingivitis) or severe gum disease (periodontitis)

Document and Report

Ulcers and sore spots

Dry mouth Tooth decay, root

decay, retained tooth roots

Dentures that are ill-fitting or require attention

Document and Report

Maintain a healthy diet in order to maintain good:

Nutrition Contributes to Overall Wellness

• Physical condition• Memory • Bone health• Eye health• Blood circulation • Immune system • ORAL HEALTH

Half of plate = fruits and vegetables

At least half of grains = whole grains

Vary protein choices Cut back on foods that are

high in sodium or fat Drink plenty of fluids

◦ As we age, we start loosing our sense of thirst.

Exercise!

Nutrition Guidelines

(USDA MyPlate, 2013)

Thank You!

Any Questions???http://www.mouthhealthy.org/en/adults-over-60/healthy-habits.aspx