By: Dr. Scott R. Harden
The title of this article is certainly a rhetorical question but an important one to ask? For over twenty years I have always enjoyed treating older patients listening to their candid opinions about dental treatment coupled with the wonderful stories they tell about their lives and their history. An interesting sentiment of many older patients is that they are initially somewhat reluctant to focus on their dental health care needs.
Sixty year olds born in the 1940’s, seventy year olds born in the 1930s, and eighty year olds born in the roaring ‘20s, graciously termed our senior citizens, have lived through tough times that most of cannot imagine or truly relate to. Momentous circumstances such as The Great Depression and World War II shaped their lives and have bestowed upon them a sense of conservativeness based upon their life experiences. For many of them, the ability to do without is still deeply ingrained, and that tough facade they have worn throughout their lives still promotes sacrifice over extravagant lifestyles even today.
I had the pleasure of meeting several new senior patients today, Sue and Jana, who both were great examples of my article in progress. Sue is a recent widow, and relocated here in Georgia to live in with her daughter Lisa, an existing patient of mine. Sue admitted openly that although her dental health was a constant consideration through the years, her “sacrifices” took precedence, and caused the “deplorable condition her mouth was now in”. She had teeth extracted years ago and never replaced, which caused her remaining teeth to shift and drift into very unnatural positions and complicated her treatment needs significantly. “Now is my time” she said today, “and although I truly regret waiting too long to get my teeth fixed, I am excited about getting them restored now”.
Jana, after grossly neglecting her teeth through the years, underwent a lengthy surgery today to remove all her upper teeth and replace them with an upper denture. This came as a result of extensive decay, badly fractured teeth, severe gum disease and bone loss and loose teeth. Surprisingly, in little pain when she originally presented for her initial visit about a month ago, Jana’s condition epitomizes the terrible outcome of avoiding the dentist and a professional dental examination on a regular basis. Her departure today after surgery was solemn, but ironically happy, because she did the right thing for herself and improving her health. She gave me an appreciative hug for being kind and considerate during her surgery and providing her the moral support she needed during such a tough time.
My best advice for elderly patients is to realize that the golden years is your time. You’ve raised the kids and sacrificed a lot during your parental years. I often joke with elderly patients that as you get older the one thing you can always enjoy is eating. Taking care of your teeth is not extravagant; it is simply and fundamentally maintaining good health.
Enjoying the later years of life with the simple pleasure of being able to eat comfortably, requires people to maintain their teeth and good oral health. Sadly, many senior citizens have a terrible dental condition because they have “let their teeth go”.
The effects of progressive decay and gum disease have burdened many patients I have seen this year alone, such as Sue and Jana, with the challenge of loosing several or many of their teeth. If only they had come in earlier, their dental condition would have been much more favorable. Worse is the fact they are living day-to-day with serious infection in their mouths that can lead to much more serious medical illness, as recently suggested in recent research performed by the Harvard School of Public Health.
There are some facts to know about oral health and senior citizens. Elderly often have a decreased saliva flow that contributes to a higher rate of bacteria, because the saliva is not washing them off their teeth as well, and thus promotes more cavities and more gum disease. Elderly often have a decrease in their immune system response to oral bacteria that may contribute to a higher number and more aggressive bacteria in their mouths with related complications. The increased usage of medications often associated with elders may have an effect on their oral chemistry and may increase the quantity and harmful strains of oral bacteria. Decrease in dexterity is more prominent with geriatric patients and will often contribute to poor oral hygiene at home, translating to cavities and gum disease. Elderly patients often have less sensitive teeth and consequently they are often not aware of serious dental problems that are present. Gum disease is typically a painless condition in all ages. If it ain’t hurt, don’t fix it is not a good old saying for elderly patient’s teeth. All these issues are good reasons for elderly patients to ensure they go to the dentist on a regular basis. If you are elderly or have a family member that has not been to the dentist for over six months, it is time to make an appointment for a good dental check up.
Potentially serious signs for an elderly patient to visit a dentist include bad breath, which could be from a tooth abscess and/or from gum disease. Be aware of gums that bleed during brushing or flossing, and gums that are red and swollen or that have receded. Further signs of impending infection and the need to visit a dentist include teeth that are loose or have changed position, gaps forming between your teeth, and teeth that don’t support your dentures the same as they used to. My new patient experience with Sue today revealed most of these issues, and interestingly enough, she was aware of most of them.
Dental problems are better treated early than late. The elderly will benefit more than anyone by keeping their teeth and gums healthy because they especially do not need all the bacteria circulating through their system.
Call your dentist today for a professional dental examination.