Dad's dental hygiene troubling
Published 5:22 pm, Thursday, March 13, 2014
Q: I am really struggling with my dad. He is 74 now and overall healthy. He hates doctors, does not have one he goes regularly to and he does not believe in medications. He has been fine until a few months ago. He started having a lot of stomach pains and finally went to see my regular physician. This is when we learned that the reason for my dad's problem may actually be his teeth. We all knew that he did not brush them regularly and did not see a dentist, but what we did not realize was that he also has very serious gum disease. The doctor who saw my dad stated that, without dental care, my dad will get very sick. He even talked about heart disease. My dad adamantly refuses to go to the dentist. Is there a way to help convince him that it is necessary for his health?
More InformationFact box
A: The dental health of seniors is a major concern. Although things are improving, there are still 27 percent of people older than 65 with no natural teeth. Yes, 20 years ago that number was closer to 50 percent, but it is still very high. We also need better education about denture care. There are new studies done by prestigious universities connecting poor dentition with heart and liver disease, peptic ulcer, anemia and recurrent pneumonia.
There are some changes more likely to happen in our teeth and our mouth when we get older. Teeth can get darker, due partly to many years of eating foods that stain them and partly to changes in dentin (the main bone-like tissue teeth are made of). Tooth decay and loss can happen, as well. Seniors have problems with dry mouth, often due to the side effects of the medications they take. Dry mouth can be also due to such illnesses as Sjogren's syndrome or to delayed effects of chemotherapy or radiation therapy for cancer.
Older people also often experience a decline in their senses of taste. Out of the four major taste categories -- sweet, sour, bitter and salty -- only sweet stays strong late in life. This is also why mature people like sweets so much -- because they can actually taste them.
Just like Beth's dad, many seniors may have periodontal or gum disease. Our mouth has a lot of bacteria in it. Bacteria and saliva and mucus cause plaque, the sticky substance covering our teeth. Proper brushing and flossing will keep it under control, but, at times, inflammation and infection happen. When it is just confined to the gums, we call it gingivitis, but when it gets deeper it is called periodontitis. This means infection has spread from the gums to the ligaments and bone surrounding the teeth. If not controlled, the bacteria will eventually destroy the structures supporting the teeth, causing the teeth to fall out.
Some people are predisposed to gum disease genetically, meaning they get it from their parents. Others can have diabetes or diseases that affect the immune system, both of which make periodontal disease more likely. Smoking is another big risk factor. Hormonal imbalance may also play a role, as can side effects of certain medications.
The symptoms of gum disease include bad breath, pain, blood when brushing teeth and loose teeth, as well as swollen gums. Treatment may be as simple as proper regular and vigorous brushing and flossing, or as complicated as surgery and other medical interventions.
Due to arthritis., mature patients may have problems brushing. This is when an electric toothbrush or a special handle for a regular toothbrush may prove helpful. Ideally, one should brush and floss after each meal. Rinsing the mouth with an antibacterial wash can also reduce the bacterial load.
Visiting your dentist on a regular basis is crucial. Medicare, the major insurance for patients over 65, does not cover routine dental care. This may be one of the reasons seniors have less access to dental health care. However, some private insurance plans cover dentist visits. Dentures are usually an out-of-pocket expense. Since more sophisticated dental work like bridges, crowns and implants can be very expensive, no wonder not everyone can afford it. Some dentists offer special discount plans for seniors others may offer free consultations.
Even seniors who do get dentures when they need them may end up not taking good care of them. Dentures need to be brushed and rinsed daily. A soft-bristled brush needs to be used to avoid damaging them. Soap or dishwashing liquid may be too harsh, so a special denture-cleaning liquid may be best. If in doubt, look for the seal of the American Dental Association on any product. This means the product was evaluated for its safety and effectiveness.
Dentures also need to be kept moist in a special liquid when not worn. Otherwise they may lose their shape or get very dry and painful to put in.
When a person loses weight, dentures may no longer fit. Dentures may be adjusted to some degree, but one should never do it at home.
Let's go back to Beth's father and his situation. There may be an element of fear in his reluctance to see a dentist. Also, in patients with such conditions as memory loss or anxiety, there may be more challenges to a dental visit. Having said that, I am a major scaredy cat, and even I can go to the dentist and have a very positive experience. Numbing medications are used universally for dental work now and there is no pain whatsoever. Given the overwhelming evidence that proper dental care is essential to senior health, there is just no excuse to postpone a dental visit any longer.