Oral health for older adults

Older adults are at an especially high risk for mouth and tooth infections and the complications that can come with these problems. Losing teeth, which is mainly caused by infection, not only leads to changes in our appearance but may also make it harder to chew certain foods. That can make it harder to receive the nourishment we need to function. Complete loss of all teeth (also known as edentulous) is less common now in developed countries like the U.S., but it still becomes more common as we age regardless of where we may live.

Practicing good oral hygiene, using fluoride treatments, and getting regular dental care reduces oral infections and their complications. A recent article published in the Journal of the American Geriatrics Society offers a helpful overview of oral health for older adults, as well as tips for keeping your teeth and mouth in tip-top shape. Highlights from the article are summarized here.

We know that poor oral health is more common with increasing age--and there's a connection between increasing age and having tooth decay. In fact, we know that dental cavities occur in older adults nearly twice as often as they do in younger adults.

The prevalence of gum disease, or periodontitis, also increases as we age. As many as 64 percent of older adults in the United States have moderate or severe periodontitis, compared with less than 38 percent for younger people. Both cavities and periodontitis contribute to tooth loss.

When dentists treat teeth and other structures in the mouth, bacteria can enter the bloodstream. These harmful bacteria can then travel throughout the body, and could potentially infect body implants you may have, including artificial joints and replacement heart valves. If you have bad oral health, even just brushing your teeth can release bacteria into your bloodstream.

The most important thing you can do to prevent infections is to maintain good oral hygiene. All older adults should be careful about their oral health. Older adults with artificial joints and artificial heart valves need to be extra careful. However, most patients with artificial joints and heart valves do not need antibiotics before having a dental procedure.

Your doctor or dentist should ask you about oral discomfort or tooth pain during your regular medical visits. They should also ask you about dry mouth symptoms during regular medical visits. Reduced saliva and dry mouth increase your risk for tooth decay. If you have dry mouth, check with your medical provider to see if any of the medications you are taking may be making your dry mouth worse.

Here's a checklist of dos and don'ts for maintaining good oral health.

- Don't smoke or chew tobacco.

- Don't use medications that reduce the production of saliva, if possible. (Ask your health care provider for more information.)

- Don't eat foods high in sugar, especially sticky high-sugar foods or candies.

- Chew sugarless candy or chewing gum containing xylitol to stimulate saliva production, especially if you have symptoms of dry mouth.

- Make an appointment with a dentist if you have symptoms of chronic dry mouth.

- Brush your teeth every day with a fluoride toothpaste.

- Use an electric or battery-operated toothbrush, especially if you have problems thinking or making decisions (or if you care for someone who lives with these concerns).

- Floss your teeth every day. Using floss holders may be helpful for people with stiff hands.

- Ask your dentist about prescription-strength fluoride mouth rinses and fluoride varnishes if you have a history of tooth decay.

- Ask your dentist about using a mouthwash containing chlorhexidine if you have gum disease or are at risk for gum disease.

- All older adults should have a dental cleaning performed by a dental hygienist and an oral health assessment by their dentist at least twice a year.

- If you have replacement heart valves or prosthetic joints, you need to be particularly careful about your oral hygiene to prevent the risk of serious infections. Ask your medical provider or dentist about steps you should take before you have your teeth cleaned or undergo any dental procedures.

Remember that good dental hygiene is an important part of healthy aging. There is no substitute for brushing your teeth after each meal and flossing every day.

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This summary is from "The Prevention of Infections in Older Adults: Oral Health.(https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.16154)" It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Patrick P. Coll, MD; Adam Lindsay, MD; Joyce Meng, MD; Aadarsh Gopalakrishna, DDS; Sree Raghavendra, DMD; Pooja Bysani, DDS; and Daniel O'Brien, MD.

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.

Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.

About the American Geriatrics Society

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has--for 75 years--worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.