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Dental care for seniors involves unique considerations. Seniors are more likely to suffer from a host of oral health issues resulting from the natural aging process, their inability to receive proper oral health care due to financial constraints (no dental insurance) or their inability to provide adequate dental hygiene care for themselves.

These factors, combined with the limited dental benefits provided by state aid programs for the aged, blind or disabled, leave many seniors at risk of ignoring tooth decay and tooth infection until there is no alternative but tooth extraction – which is the only dental procedure covered by many state aid programs such as Medicaid or Medicare.

Tooth Loss, Periodontal Disease and Other Dental Concerns for Seniors

Prior to tooth loss, seniors may experience tooth sensitivity or discoloration due to a loss of enamel and dentin (hard, calcareous tissue beneath the enamel), or root deterioration caused by gum recession.

Seniors are more prone to periodontal disease (gum disease) resulting from improper dental hygiene practices, poor diet, ill-fitting dental appliances and/or diseases such as cancer or diabetes. In fact, the supporting bone structure for the teeth, including the jaw, may shift, which can play havoc on a senior’s bite and may contribute to tooth decay.

Seniors are also more likely to suffer from inflammation of gum tissue, dry mouth syndrome (often caused by medications) or oral thrush (a fungal disease causing ulcers and whitish spots on membranes of the mouth due to its effect on the immune system).

Dental Hygiene for Seniors

• Brush, floss and rinse with mouthwash properly to maintain dental hygiene, as instructed by your dentist.
• Look into special toothbrushes to clean hard-to-reach areas of the mouth.
• Know the warning signs that indicate your mouth, teeth or gums may be in jeopardy, including tooth sensitivity, teeth grinding, pain, mouth sores, bumps (see oral cancer), swelling, loose teeth, jaw popping or clicking, difficulty quenching thirst, swallowing or chewing (dry mouth syndrome).
• Visit your dentist as often as he or she recommends for regular dental hygiene checkups.
• Maintain dental appliances such as dentures and dental bridges properly.
• Consider seeing your dentist before and after surgery.
• Tell your dentist about any medications that you are taking or changes to medication.
• If brushing and flossing are difficult for you, try to elongate the toothbrush with tongue depressors or something similar, or ask for assistance. You may also try using a soft washcloth or gauze to remove debris from the teeth, rinsing frequently. Use this method until you are able to brush your teeth again. People suffering from arthritis or a similar medical condition that limits manual dexterity can try inserting the back end of a toothbrush into a standard tennis ball for better maneuverability. Your dentist may recommend other such innovations designed to make the practice of oral hygiene simple and effective.

A new study led by a University of California, Berkeley, researcher could give women a little extra motivation to visit their dentist more regularly. The study suggests that women who get dental care reduce their risk of heart attacks, stroke and other cardiovascular problems by at least one-third.

The analysis, which used data from nearly 7,000 people ages 44-88 enrolled in the Health and Retirement Study, did not find a similar benefit for men.

Published online in the journal Health Economics, the study compared people who went to the dentist during the previous two years with those who did not.

“Many studies have found associations between dental care and cardiovascular disease, but our study is the first to show that general dental care leads to fewer heart attacks, strokes, and other adverse cardiovascular outcomes in a causal way,” said study lead author Timothy Brown, assistant adjunct professor of health policy and management at UC Berkeley’s School of Public Health.

In the world of health and medical studies, causality is typically determined through randomized controlled trials in which two or more groups of people are essentially equal, except for the receipt of a treatment or intervention, such as a new drug, a periodontal procedure or a health education class. The group that did not receive the treatment – the control group – is compared with the group that did. Differences in outcomes between the groups are attributed to the treatment.

But randomized controlled trials are not always possible, so researchers sometimes turn to a statistical approach called the method of instrumental variables to rule out other potential factors that could account for different outcomes between groups. The use of instrumental variables is common among economists to evaluate the effects of economic policies, but it is less well-known in the clinical setting.

“While relatively short randomized controlled trials of specific types of dental treatment are possible, we can’t run long-term randomized controlled trials of whether general dental care reduces cardiovascular disease events like heart attacks and strokes,” said Brown, a health economist. “Individuals randomized to the treatment group would enjoy general dental care and those randomized to the control group would get no dental care at all. Many, if not most, people in the control group would simply get dental care on their own, destroying the experimental design, and making the results of the experiment worthless. The method of instrumental variables allows us to avoid this problem.”

The method helped researchers rule out self-selection bias, or the possibility that people who seek out dental care are different – perhaps healthier in general – than those who don’t.