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Geriatric dental care: Is it a necessity?

Australia’s population is not only growing, it’s also aging. With the “baby boomer” generation living longer than their less numerous predecessors, the age group 65 and older is growing the fastest. The Australian Bureau of Statistics records that, over the past two decades, the number of Australians living beyond the age of 85 has almost doubled!

As part of the health system tasked with managing a rapidly growing aging cohort of patients with multiple chronic medical conditions, dentists are faced with many more senior teeth to treat. And as dental health is directly linked to overall physical health, geriatric dental care is indeed an absolute necessity, especially given the strong links between gum health and cardiovascular health and diabetes – two common diseases in the elderly. Then there’s the very basic connection between the ability to chew effectively and the enjoyment and digestion of food.

But what are the challenges of getting the elderly to attend to their dental health? Firstly there is the problem of stoicism and/or apathy, then there’s physical and mental impairment and altered diet, and finally there is the matter of mobility.

Often the elderly don’t complain about problems with their dentures, teeth or gums, or even recognise a problem at all, so their dental needs are often not met – unless they have the support of family members, carers or young friends who can prompt their loved one to look out for any problems and who can facilitate access to treatment.

Older people can also struggle to maintain their own oral hygiene, mainly because impaired manual dexterity, a failing memory or poor eyesight make thorough cleaning of their teeth and/or dentures difficult without help. Considering the combination of this poor hygiene with a higher incidence of dry mouth (a product of aging exacerbated by many medications), frequent snacking and an increased yearning for sweet foods, it’s no wonder elderly people’s teeth can deteriorate particularly rapidly. And these decaying teeth seldom give pain until it’s too late – resulting in the need for removal.

Gum (periodontal) disease also is more prevalent and severe in the elderly, for the same reasons as those mentioned above. In the aged care setting where so many elderly people live, oral hygiene is often neglected as the resident forgets to clean their teeth or dentures and the staff have little or no training in this area and many other tasks to attend to. With poor saliva to lubricate the mouth, and weakened muscle control, food and bacteria tend to stagnate in between loose teeth and under dentures, leading to extensive decay, worsening gum health and diseased soft tissues.

Finally, perhaps the greatest impediment to geriatric dental care for most elderly people is the fact that they don’t drive a car and many are unable, or not confident, to use public transport. So getting to a dentist for seniors is something they usually cannot do alone, and again that’s where family or carer support comes in.

As a seniors’ dentist, we take very seriously the importance of providing appropriate dental treatment and home-care guidelines to the respected elderly members of our community.

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