Older adults have special oral health needs and concerns, but with the right care and hygiene habits, they can keep smiling through the years. The University of Michigan School of Dentistry faculty listed here can address many aspects of oral health in older people. Contact them at the telephone numbers and e-mail addresses given at the end of each item.
CHANGE YOUR HABITS. Even if you've had good teeth all your life, your
oral health habits need to change as you age, says Jonathan Ship, associate
professor of dentistry. Gum tissues tend to recede with age, exposing more
tooth surface and larger areas between the teeth. In addition, the exposed root
of the tooth is covered with cementum, a mineralized material that is less
resistant to decay than tooth enamel. "People with receding gums are not
necessarily going to get more cavities, but they're at greater risk," says Ship.
Careful brushing and flossing become more important than ever, and special
devices such as floss threaders and small brushes to clean between teeth may be
necessary. Older people also may need to use fluoride rinses or have their
dentists coat their teeth with fluoride varnishes to help prevent cavities.
Contact Ship at (734) 764-1543 or jship@umich.edu.
REDUCE YOUR RISK OF INFECTION. Brushing and flossing may be the
farthest thing from the mind of someone facing surgery for a hip or knee
replacement. But good oral hygiene is especially important for people who have
total joint replacements, says Jed Jacobson, associate professor of dentistry.
A major cause of failure in joint replacements is infection. This can happen
when bacteria travel to the site of the replacement from other parts of the
body---including the mouth. Jacobson, who helped draft an American Dental
Association statement on this problem, says that patients who plan to have a
total joint replacement should make sure that their dental health is good.
Practicing good oral hygiene after the surgery is equally important---especially
for the first two years. To further reduce the risk of infection, dentists may
advise some joint replacement patients to take antibiotics before certain
procedures, such as having a tooth pulled or having oral surgery. However,
this is a decision the dentist must make for each patient, taking into account
the patient's general health and medical history and the type of procedure that
is being done. Contact Jacobson at (734) 763-3313 or jedjj@umich.edu.
LONGER LIFE SPANS PRESENT CHALLENGES for older people and their
dentists. The percentage of older Americans without their natural teeth has
dropped dramatically---from 70 percent to 40 percent---over the last four
decades. But because more people than ever are living into their 80s and
beyond, the actual number of older people without teeth has increased, Kenneth
Shay noted in a presentation at a recent meeting of the American Dental
Association in San Francisco. The longer a person lives without natural teeth,
the greater the likelihood of bone loss in the ridge that runs under the gums.
This problem is made worse by osteoporosis, a widespread condition among older
women. Bone loss under the gums can lead to a host of problems that
interfere with the fit of dentures, says Shay, an adjunct associate professor in
the School of Dentistry and chief of dental service at the Ann Arbor Veterans
Affairs Medical Center. For example, the gum tissue may become soft and flabby
or the tongue may enlarge. Other problems, such as infection and calluses in
the mouth, result when people wear poorly fitting dentures for too long. For
these reasons, it's important that even people who have lost their natural teeth
see their dentists once a year. The yearly visit also is a good time for the
dentist to check for signs of oral cancer, which is more common in older people,
but can be treated effectively if caught early. Contact Shay at (734) 761-7925
or kenshay@umich.edu.
BEFORE YOU TURN OUT THE LIGHT, KISS YOUR DENTURES GOODNIGHT. Removing
dentures before going to sleep is a must for good oral health. Yet many
denture-wearers have never let their spouses see them toothless. "If you
understand that the undersurface of the denture is a great place for bacteria
and yeast to grow, you'd want to get that denture out at night and give your
mouth a rest," says Jonathan Ship, associate professor of dentistry. Contact
Ship at (734) 764-1543 or jship@umich.edu.
TELL YOUR DENTIST WHAT YOU TAKE. Finding relief from dry mouth, oral
irritation, taste changes or gum disease may be as simple as reviewing your
medication list with your dentist. Hundreds of common medicines---from
antihistamines to hormones to heart drugs---can have effects on oral health and
comfort, says John Gobetti, professor of dentistry. "People with these problems
go through all kinds of extensive testing and emotional trauma and don't realize
that the simplest thing to do is to check the medications they're on," says
Gobetti. "Some 450 to 600 drugs, including many of the most commonly prescribed
drugs, have oral side effects, from dry mouth to irritation of the mouth and
even enhanced gum disease." Patients should be sure to tell their dentists
about all the medicines that they are taking, including herbal remedies and
over-the-counter medications. In some cases, dentists can cooperate with a
patient's physician to make medication changes that will relieve the
problem. When such changes are not possible, dentists can recommend other ways
of finding relief and preventing further problems, such as chewing sugarless
gum, letting sugarless hard candy dissolve in the mouth, or using artificial
saliva products. Contact Gobetti at (734) 763-3375 or jgobetti@umich.edu.
CARE-GIVERS, OFFER EXTRA HELP. People with physical limitations or
memory problems may need extra help taking care of their teeth. Care-givers who
notice that the people they care for are neglecting their oral hygiene should
first try to figure out why, says Jonathan Ship, associate professor of
dentistry. "Is it because they can't grip the toothbrush and need to get a
special one with a larger handle? Do they need an electric toothbrush that will
do the work for them? Do they lack the hand-eye coordination they need to floss
their teeth?" Mouth pain, diet changes, and dry mouth also can affect older
people's oral health. In some cases, a care-giver may need to do the brushing
and flossing for the person. It's important, too, says Ship, for a care-giver
to go along on dentist appointments, to get any special dental care
instructions. Contact Ship at (734) 764-1543 or jship@umich.edu.
University of Michigan
412 Maynard St. Ann Arbor, MI 48109-1399
October 30, 1998
Contact: Nancy Ross-Flanigan
Phone: (734) 647-1853
E-mail: rossflan@umich.edu.