Dental health/oral hygiene is particularly challenging as we age. Seniors are less prone to cavities than younger people but are more susceptible to serious dental conditions such as gingivitis, gum disease, and root decay. Some of these problems may be due to poor dental hygiene but many conditions are the result of normal changes in the mouth as we age. Adding to this problem is the fact that Medicare and many other insurances do not cover basic dental care, such as cleanings, fillings, tooth extractions, or dentures.
DENTAL HYGIENE REQUIREMENTS CHANGE AS WE AGE
As we age, the gums of our teeth often begin to recede exposing the root surface. This condition is called periodontal disease. If left untreated, the gums begin to pull away from the teeth and form deepened spaces called pockets where food particles and plaque may collect. This in turn may cause the roots of the teeth to decay and rot. Periodontal disease is particularly insidious because it is often painless until the advanced stages when teeth begin to loosen and possibly come out.
Another age related change to the mouth is the build up of a sticky colorless layer of bacteria called plaque. Plaque is often described as the fuzzy feeling people get on their teeth before brushing in the morning. Over a period of time, plaque destroys tooth enamel causing teeth to decay. It can also develop on the tooth roots under the gum and cause the breakdown of the bone supporting the tooth.
A final change that may occur as we age is dry mouth. This condition, called xerostomia, occurs when saliva in the mouth is reduced. Saliva is needed to lubricate the mouth, helping in swallowing, and in washing away foods and neutralizing acids. Xerostomia is not in itself a condition of older people but it is often caused by some illnesses such as Parkinson’s disease and diabetes. Xerostomia is also caused as a side effect of more than 1000 medications, both over the counter and prescription drugs. Some of the biggest culprits include many antihistamines, antidepressants, pain medications, and cough suppressants.
DENTAL CARE IS NOT COVERED BY MEDICARE
Although these dental conditions are quite serious, the treatments are often not covered by Medicare and are often too expensive for many seniors to afford. The consequences are dire. People who begin to suffer from loose teeth or painful chewing are often unable to eat nourishing food, which in turn causes them to suffer nutritional deficiencies and makes them more prone to illness. Other consequences of poor dental hygiene are less tangible; it often causes many seniors to lose their self-esteem and increases social isolation.
Although these situation may create difficulties in dental health, they are not insurmountable. Many organizations across the country have developed low cost dental clinics that cater to seniors. Some of these are programs are affiliated with dental schools, hospital clinics and community health networks. In Brooklyn, N.Y., Methodist Hospital in Park Slope, Brooklyn Hospital in Fort Greene, and Kings County Hospital in East Flatbush all offer dental services. In Manhattan, New York University Dental School and New York Presbyterian/Weill Cornell offer service to low-income people and the elderly as well.
Of course prevention is an important part in dental care for seniors. To maintain good oral health, each person should brush his teeth at least twice a day preferably with toothpaste that includes fluoride. Seniors should use a soft bristled toothbrush and brush for at least two minutes to make sure all teeth are clean. After each brushing it is advisable to floss and use an antiseptic mouthwash.
Careful oral hygiene does not always guarantee healthy teeth, but with a little knowledge on how to care for your teeth and where you can get inexpensive dental treatments, seniors are better able to take charge of their dental health.