Oral Health Care and Prevention in the Elderly

     The number of elderly patients receiving treatment in dental departments is steadily increasing. Oral diseases are classified as one of the non-communicable diseases (NCDs), often leading to tooth loss and decreased chewing efficiency. Furthermore, conditions such as dental caries, tooth spacing, and gaps between teeth cause discomfort, inconvenience, and aesthetic concerns, all of which can significantly impact daily life.

Changes in Oral Health Among the Elderly

• Dry lips, cracked corners of the mouth, and ulcerations at the corners of the mouth.
• Darker tooth color and tooth wear.
• Thinning of the gums, gum recession, thinning of the alveolar bone, and bone resorption, especially in edentulous areas.
• Dryness and thinning of the oral mucosa.
• Smooth, fissured tongue; decreased number of taste buds; slower tongue movements, which can cause swallowing difficulties and increase the risk of food and water aspiration.
• Decreased salivary flow, which may also be a side effect of certain medications. Reduced saliva production results in difficulty speaking, chewing, and swallowing, and is a major risk factor for increased incidence of dental caries.
• Degeneration of the masticatory muscles and temporomandibular joints, leading to reduced and slower chewing force.

Oral Health Care in the Elderly

• If natural teeth are still present, brushing with fluoride toothpaste is recommended at least twice daily, particularly before bedtime.
• The use of interdental cleaning aids such as interdental brushes, dental floss, and tongue cleaning is encouraged. An electric toothbrush may be used in cases where wrist or hand weakness is present.
• Elderly individuals with removable dentures should clean their dentures with a soft-bristled toothbrush after every meal, in addition to brushing any remaining natural teeth.

Basic Recommendations for Managing Dry Mouth

• Adjust water consumption and diet, such as sipping water throughout the day, drinking water during meals, and incorporating more water-rich foods. Frequent mouth rinsing is also beneficial.
• Avoid spicy and salty foods.
• Refrain from smoking and consuming caffeinated beverages. The use of saliva substitutes or artificial saliva may also be considered.

Management of Worn and Spaced Teeth

     Natural teeth that remain may be worn, thinned, shortened, and more susceptible to decay, resulting in gaps that trap food debris and hinder chewing. In some cases, dental fillings may be sufficient to address the problem. However, in instances where there is significant tooth structure loss or abnormal occlusion, treatment may require prosthodontic rehabilitation with dentures.

Dental Visits for the Elderly

     Visiting a dentist allows for the early detection of problems and assessment of oral health, facilitating the planning of care, prevention, and treatment measures to enhance quality of life.

Reference:
Department of Dental Public Health, Department of Health

Last Revised:
28 August 2023