DID you know that the mouth can show early signs of diabetes, cancer, immune disorders and complications from medications? It shows up in the gums, teeth, throat and tongue.
Additionally, untreated gum disease can result in stroke as well as heart and lung problems.
That’s why it is very important to maintain good oral health.
In addition, teeth aren’t just eating. The role of natural teeth includes communication and social functioning. Loss of natural teeth is associated with significant disability and may be associated with altered nutrition.
Good oral health affects the ability to speak, smile, chew and swallow competently, and without pain, as well as having good general health and self-esteem.
Hence, oral health is very closely linked with the quality of life and health of older adults.
Oral complications in older adults can be attributed to changes that occur as a result of the ageing process, disease, or medications prescribed to treat one or more chronic conditions.
Here are some oral problems:
- Diabetes and HIV/AIDS can be detected in the mouth. In fact, it may first be detected by the dentist.
- Wearing ill-fitting dentures and having loose and/or missing teeth can cause poor nutrition.
- Poorly-maintained ill-fitting dentures can also predispose to fungal infections like candidiasis or thrush.
- The occurrence of gum disease and oral cancer is higher in smokers than non-smokers. Smoking is associated with chronic periodontal diseases.
- Extensive use of medications that inhibit salivary flow can cause dry mouth (xerostomia). Dry mouth can cause lips and angles of the mouth to crack and bleed. It also causes difficulty in swallowing because of a lack of lubrication, difficulty speaking and sleeping and tooth sensitivity. Dry mouth can also increase the risk of tooth decay.
Other consequences of poor habits and ageing:
- Root decay caused by gum recession, poor oral hygiene and sugary diet.
- Tooth wear from years of associating with eating, bruxism (teeth grinding).
- Gum or periodontal disease progression.
- Tooth staining due to long-term exposures to coffee, tea or nicotine (in smokers).
- Oral cancer is also related to age and risk factors like sun exposure, tobacco smoking, alcohol and betel quid chewing.
What to do
In most cases, the prevention of specific dental diseases in older adults conforms to the same basic rules as for younger adults: Good oral hygiene, a healthy diet and regular dental visits can help to maintain oral health for life.
Here are some good oral health practices:
- Brush your teeth at least twice every day.
- Use a fluoride toothpaste.
- Brush last thing at night before sleep so that the fluoride toothpaste remains in the mouth when asleep because the salivary flow is reduced.
- Brush on one other occasion, such as before breakfast.
- Avoid brushing immediately after taking fruit juice or acidic drinks to avoid tooth sensitivity.
- Use floss or interdental brush to clean in between teeth.
- Clean the tongue with a soft toothbrush or a tongue cleaner.
- Change toothbrush often when the bristles are splayed or bent. (*The lifespan of a toothbrush is usually three months.)
- Rinse with water after every meal.
- Powered toothbrush can be used for those with poor manual dexterity, such as those with arthritic joints.
For denture wearers:
- Remove dentures and rinse with water after eating.
- Gently brush and clean dentures every day.
- Clean your mouth after removing dentures. Use a soft toothbrush to clean natural teeth and surfaces of the tongue, cheeks and palate.
- Remove dentures before going to sleep. Soak dentures overnight in a container filled with water or a mild denture-soaking agent. (Follow manufacturer’s instructions.)
- Do not use hot water, abrasives or bleaching agents to soak the dentures.
- Rinse dentures before putting them back in the mouth.
2. Dietary control
- In general, adopt a healthy well-balanced diet daily for good health.
- Reduce both the frequency and amount of sugary intake to prevent tooth decay.
- Limit the frequency of sugary intake in between meals.
- Restrict sugar intake mainly to mealtimes.
- Limit acidic foods and drinks to mealtimes to prevent tooth sensitivity from tooth wear or erosion.
- Take whole fruits (not juices) and vegetables. Current dietary advice recommends at least five portions of fruits and vegetables per day.
- Drink plenty of water.
- Sugar-free chewing gum and foods that promote salivary flow can be considered for those who have dry mouth to lubricate the mouth and protect against dental caries.
- Choose foods and drinks with low potential for caries like bread, pasta, rice, starchy staple foods, cheese, fibrous foods (raw vegetables), fresh fruits, savoury foods, water, milk and unsweetened tea.
3. Quit smoking
It is never too late to quit smoking. No matter how old or how long a person has been smoking, quitting can significantly lessen the risk of smoking-related illnesses and death. For non-smokers, it is also important to avoid second-hand smoke.
4. Regular dental visits
Visit the dentist at least once a year for advice and a routine examination as well as early detection and management of oral diseases.
Older adults need to be physically active in order to stay healthy and independent. No matter how old a person is, it is never too late to practise a healthy lifestyle with good oral health practices to enjoy quality of life through healthy ageing.
Dr Noriah Haji Yusoff is a lecturer with the Department of Dental Public Health at the Faculty of Dentistry in Universiti Kebangsaan Malaysia.