In generations past, as we aged there was an expectation to begin to lose our teeth - but more and more of today's seniors have reached their golden years with many or all their adult teeth intact. But to maintain this positive trend, seniors need to be aware of specific oral health concerns so maintaining their teeth can be a realistic goal.
When teeth are not properly cleaned, plaque forms on the tooth’s surface. Plaque can cause irritation of the gums, making them red and slightly swollen – this is gingivitis.More serious forms of gum disease such as periodontitis start with gingivitis.
Signs & Symptoms:
- Red, swollen or tender gums that bleed when brushed or flossed
- Bad breath
Good management of gingivitis is a sign of good oral hygiene. This helps prevent halitosis, bleeding gums and other more serious dental diseases. Remember, there is a link between oral health and overall health.
So how do you prevent periodontal disease? 4 easy steps:
- Rinse with antiseptic mouthwash
- Get regular oral checkups and cleanings from a dental professiona
Bad Breath (Halitosis)
In most cases, the cause of bad breath can be simple. However, if the issue is persistent, it can be a symptom of something more serious, and a problem sign of something to avoid long term.
- Diet places a key role in bad breath, and the food you eat can often affect the smell of your breath.
- Oral bacteria can cause an odour, and also indicate you have plaque build-up.
- Dry mouth often affects your breath, as saliva (or lack thereof) affects plaque buildup and food particles from sticking to your teeth. Read more about dry mouth on the dry mouth page.
- Unclean dentures. Just like teeth, dentures need to be cleaned regularly to keep them feeling, and smelling, fresh.
- Some medical conditions, often affecting your liver or kidneys, can affect your breath. Alerting your dentist of previous medical conditions, or current medications is always a good idea.
Treatment and Prevention:
Daily brushing and flossing is certainly a great place to start, as they assist in removing food particles and bacteria; don’t forget, this includes brushing the tongue. For more information, read up on Brushing Basics. Drinking water regularly is a great way to flush out your mouth, and avoid dry mouth, while sugarless gum or candies help your mouth stay moist as well. Mouthwash throughout the day is effective on short notice, but particularly helpful killing bacteria before bedtime.
If you are worried about your breath, and regular oral hygiene efforts are having little effect, contact your dentist for advice.
Dysphagia (Trouble Swallowing)
Those suffering from dysphagia, or trouble swallowing, can reduce their risk of chest infection or other serious issues by maintaining good oral health by keeping their mouth clean. Other medical issues include neuromuscular conditions, stroke, dementia, traumatic brain injury, gastroesophageal reflux disease, cancers of the head and neck and certain respiratory conditions such as chronic obstructive pulmonary disease. Aspiration pneumonia can also be caused when saliva, food or liquid goes down the trachea into the lungs, instead of the esophagus and into the stomach.
Risk of dysphagia increases with age and frailty, as well as smoking, excessive alcohol use, certain medications and poor oral hygiene including your teeth and dentures.
Possible Signs & Symptoms:
- Difficulty when trying to swallow
- Coughing and choking during or after meals
- Wet voice during or after meals
- Weight loss and/or dehydration
- Difficulty with certain textures of foods
- Pocketing of food in the mouth
- Regurgitating food
- Frequent fevers or chest infection
Dry Mouth (xerostomin)
Dry mouth, or xerostomin is the result of decreased saliva production, which affects up to 60% of older adults. Saliva lubricates the mouth helping to prevent decay and protect tooth enamel. But don’t worry; there are plenty of ways to manage this condition.
Dry mouth can be caused by a variety of reasons, including medications you may be taking, radiation or cancer treatments, smoking, immune deficiency, systemic diseases (such as Diabetes, Parkinson’s, Sjogren syndrome) or salivary gland aplasia.
Signs & Symptoms:
- Red, cracked or swollen gums
- Dry, cracked tongue
- Cracked corners of the mouth
- Lips that stick to the teeth
- Gums that easily bleed
- Bad breath
- Problems wearing dentures
- Difficulty eating, swallowing or talking
- Maintain good oral hygiene with fluoridated tooth paste, and regular flossing (or alternative cleaning aids)
- Sip water or suck on ice cubes throughout the day
- Use water based lip lubricant
- Chew sugar free gum or suck sugar free candy
- Use saliva substitutes
- Use a mist humidifier at night
- Consult with a physician about reducing or changing troublesome medications
- Regular check-ups with a dental professional
Also, avoid alcohol or alcohol products (including mouth rinses containing alcohol), glycerin or lemon toothette swabs, food or drinks promoting dry mouth (caffeine, sweet sticky foods, spicy, acidic or dry foods) and lemon or cinnamon flavoured candy or gum.
It might come as a surprise, but dentures build up plaque and tartar just like natural teeth. Maintaining good oral health starts by ensuring your dentures are clean and fitting properly.
Regular denture care includes daily removal and brushing of the mouth, tongue, cheeks and palate. You should also check the denture for any broken or cracked areas.
- Dentures should be thoroughly cleaned everyday
- Soaking dentures in cleaning solution about 30 minutes before brushing will loosen tartar and plaque
- Brush dentures with a denture brush and liquid soap for foam denture cleaner.
- It is important you use non-abrasive products and materials to prevent scratching
- It is ideal to leave dentures out overnight if possible, or at least 1-2 hours per day minimum.
- This will let gums rest and help prevent denture stomatitis or inflammation
- Clean the cup you store your dentures in at least once a week
- Change denture brush on a yearly basis and denture cup as required
Labelling dentures is something many people likely don’t think about, until it’s too late. In situations where multiple people may have dentures, such as a long-term care facility, it is important for identifying dentures which could have been misplaced or mistaken during meals or while soaking.
Labelling can be done professionally, by either a denturist or at a dental office, or at home. Dental professionals will use an engraving tool and apply acrylic overtop to make it permanent. In addition, denture ID kits are also available.
For those interested in a do-it-yourself project, here’s what you’ll need:
- Spray disinfectant
- Emory board/nail file
- Indelible marker
- Clear acrylic nail polish
- Always wear gloves
- Clean and disinfect the denture
- Use an emery board to roughen the cheek side of the denture at the back
- Print the resident’s name on the area with a permanent marker and seal it with clear acrylic nail polish
- Once dry, clean and disinfect the denture again and rinse thoroughly with cool water
Cold cores are very common for many people and are characterized by small, red blisters on the lips. One common type is herpes simplex. This virus is very common and highly contagious. After the initial outbreak, these blisters can re-occur frequently and there is no cure. However, they tend to heal within 14 days on their own.
Over the counter treatments are available. These products typically contain docosonal or benzyl alcohol and are usually available as gels or creams.
Common over the counter medications are Abreva and Zilactin. For best results, apply products as soon as there is tingling on the lips. This usually indicates a cold sore is starting to develop.
Canker sores can be caused by a number of factors including: injury to the mouth, stress, unhealthy diet, certain medical conditions, come medications, and even nicotine gum.
- Salt water rinses: Mix 1 teaspoon salt to 1 cup of warm water. Swish the solution around the mouth and spit out.
- ½ teaspoon of baking soda mixed with a few drops of water until it makes a thick paste. You can use this paste to cover the canker sore.
- Hydrogen peroxide can be mixed 1 to 1 with water. This solution can be applied to the sore using a cotton swab.
- Milk of magnesia can aid in the healing process and reduce pain. Apply directly 3-4 times a day.
- In severe cases, oral medication can be prescribed by a physician or dentist.
To ease pain promote healing; avoid acidic foods when cankers and cold sores are present.
In Canada, 3400 new cases of mouth cancer are diagnosed each year. About 50% of those diagnosed do not live longer than 5 years after diagnosis because it wasn’t detected early enough.
The most common sites for oral cancer to be found are the tongue (which has the highest prevalence), throat, floor of the mouth and lips. Regular tobacco use (both chewing and smoking), alcohol consumption and prolonged sun exposure all increase risk in addition to age.
Daily Mouth Test (to be completed by someone else):
LOOK: Look on all sides of the tongue, on the floor of the mouth, the cheeks, the hard palate, the soft palate, gums and teeth. Look for anything abnormal or different from the day before – any white or red patches, sores, bleeding, loose or broken teeth.
FEEL: Feel for any lumps, bumps, sores that bleed and do not heal. Check if the person had trouble chewing or swallowing.
TELL: Write down any concerns to discuss with your dentist. If the area of concern is still present or continues to worsen 7-14 days after initial finding, make arrangements to see a dentist of doctor.