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Home Care Supports Senior Oral Health

Home caregiver with smiling client

When we consider the many medical advances contributing to the record longevity of Americans today, it's easy to overlook the importance of modern dental care. And yet, medical historians tell us dentistry ranks close to the development of vaccines and antibiotics in contributing to increased life expectancy. More and more adults are living into their later years with their natural teeth. Denture design and technology also have improved.

Dentures and restorations such as fillings, crowns and implants make mouth care more complex, but it's as important as ever to follow good oral hygiene practices as we grow older.

Oral health and overall health are closely related

People with painful or missing teeth, gum disease or ill-fitting dentures are much less likely to eat a nutritious diet. This makes it hard to maintain a healthy weight and take in the nutrients we need. Poor mouth care also raises the risk for many common illnesses. For example, a recent American Heart Association study showed that people who have their teeth cleaned regularly have a 24 percent lower risk of heart attack and 13 percent lower risk of stroke. Keeping the teeth and gums clean reduces the growth of bacteria that can lead to systemic inflammation. According to nursing professor Rita Jablonski of Pennsylvania State University, "Poor oral health can lead to pneumonia and cardiovascular disease as well as periodontal disease."

As reported in the February 2008 issue of Caring Right at Home, tooth loss has even been linked to increased risk of dementia. A recent New York University study found that gum disease may contribute to brain inflammation and Alzheimer’s disease. Study author Dr. Angela Kamer reports, "The research suggests that cognitively normal subjects with periodontal inflammation are at an increased risk of lower cognitive function compared to cognitively normal subjects with little or no periodontal inflammation."

Tooth and gum disease also have a negative impact on social interaction, communication, emotional health and the general well-being of seniors.

Seniors face challenges to good oral health

Our teeth and gums change as we grow older. Years of wear and tear take a toll, often causing thinning enamel and broken or lost teeth. Teeth with repairs such as crowns, fillings and root canals are less hardy. The gums tend to recede, exposing sensitive areas of the teeth not covered by enamel. Other factors put teeth and gums at risk:

  • Some of the health problems that become more common as we grow older, such as diabetes and acid reflux, also cause body changes that increase the risk of tooth decay and gum disease.

  • Dementia, arthritis, Parkinson's disease, stroke and other conditions cause functional limitations that make it more difficult to brush and floss effectively.

  • Seniors are more likely to take medications. Many drugs older adults commonly take, such as diuretics, antidepressants, pain medications, and drugs to treat high blood pressure and dementia, have the side effect of decreasing salivary flow. Dry mouth (xerostomia) can lead to extensive tooth decay.

  • Smoking doubles the risk of gum disease, cavities and oral cancer, and for seniors who smoke, these problems increase with age.

In addition, many dentists report that in today’s economy, they are seeing a drop-off in visits from their senior patients. Medicare does not cover dental care, and though some Medicare private health plans include dental coverage, most do not. (Note: If paying for dental care is a problem for a senior you know, see the resources at the end of this article to find out about state senior support programs, clinics and dental schools that may provide low-cost care for older adults.)

Five ways home care helps

Many families report that poor oral hygiene was one of the red flags alerting them that their loved one needed help to live safely at home. In-home care addresses several of the challenges:

  1. Regular oral examinations, screenings, cleanings and recommended treatments promote the best possible tooth and gum health. An in-home caregiver can transport your loved one to appointments with the dentist, oral surgeon, prosthodontist, denturist and other oral care professionals.

  2. When a loved one is living with arthritis, stroke or other mobility-limiting condition, a professional in-home caregiver can assist with good oral hygiene and denture care in a respectful manner that encourages maximum independence and a sense of dignity. The caregiver can help with brushing, flossing, rinses and mouthwash, perhaps helping the client use adaptive devices such as a large-handled toothbrush and a floss holder.

  3. Oral care for people with dementia presents an extra set of challenges. A person with Alzheimer's may resist tooth-brushing assistance, perceiving this help as a threat. In-home caregivers are trained to provide care in a way that is calming and reassuring. For example, rather than brushing the client’s teeth, it might be more effective for the caregiver to prompt the client to do it, or to guide the person’s arm unobtrusively.

  4. In-home caregivers help seniors with medication management. They can report if your loved one is experiencing dry mouth or other side effects that the doctor should know about. Oral rinses, special gum and other products may be recommended to treat dry mouth.

  5. Good nutrition is important for good oral health. Fruits and vegetables help clean teeth and gum tissue, while soft, sugary foods promote decay. Folate, vitamin C and B vitamins, protein, calcium and omega-3 fatty acids all support healthy teeth and gums. In-home caregivers can shop for groceries and prepare tempting meals that meet seniors' nutritional needs and dietary restrictions. They prepare foods that are easy to eat for clients who have missing or sensitive teeth.

In-home care supports an all-around healthy lifestyle. Physical activity, socialization and mental stimulation all promote good health. Good dental care and oral health help give us all something to smile about!

Learn more

The American Dental Association website features information on a wide variety of oral health topics.

The National Institute of Dental and Craniofacial Research offers consumer information about oral health, including information about low-cost dental care.

For more information on topics related to home care and healthcare, visit our Home Care and Healthcare Advocacy group on LinkedIn.

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Right at Home, Inc. is a national organization dedicated to improving the quality of life for those we serve. We fulfill that mission through a dedicated network of locally owned, franchised providers of in-home care services.


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