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ORAL HEALTH & AGING AWARENESS by Michelle Martin RDH, MPH. “Elderly suffer a disproportionate & debilitating amount of oral disease.”. - Alliance for Aging Research. Oral Health Trivia. TRUE or FALSE?. People with Diabetes are at a greater risk of developing gum disease.

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oral health aging awareness by michelle martin rdh mph

ORAL HEALTH & AGING AWARENESSby Michelle Martin RDH, MPH

“Elderly suffer a disproportionate & debilitating amount of oral disease.”

- Alliance for Aging Research

oral health trivia
Oral Health Trivia

TRUE or FALSE?

  • People with Diabetes are at a greater risk of developing gum disease.
  • Healthy eating can contribute to the condition of a an individuals mouth.
  • Hypertension (High Blood Pressure) medications can affect your mouth.
one last trivia question
One Last Trivia Question???
  • Among new military recruits in 2010, what percentage were not deployed because of significant dental issues?
        • A. 0-40%
        • B. 40-60%
        • C. 60% +
bacteria in the mouth
Bacteria in the Mouth…
  • Heart Disease
  • Stroke
  • Pneumonia
  • Diabetes

“… providing mechanical oral hygiene may prevent 1 in 10 deaths from pneumonia in dependent elderly people and show similar pneumonia prevention effect.”

(Sjogren, P., et al: JAGS 2008 (56); 2124-30)

periodontal disease gum disease
Periodontal Disease (Gum Disease)
  • 35% of all Americans have some form of PD
    • 13% have severe periodontal disease
  • 75% of all Americans have inflammation of the gums (gingivitis)
  • Progression of gingivitis to bone loss:
    • Pockets form around the teeth
    • Pockets gradually deepen, ulcerate
    • Bone loss visible on x-rays
gum disease diabetes and our hearts
Gum Disease , Diabetes and our Hearts
  • Nearly 1/3 of people with diabetes have severe bone loss (CDC)
  • Diabetics are 3 - 4 times more likely to develop periodontal disease (gum disease)
  • Develop infections easier
  • Can contribute to heart disease
  • Can contribute to pneumonia

(http://www.perio.org/consumer/mbc.diabetes.htm)

slide9
“A feeling that there is not enough saliva in the mouth, all or most of the time.”

Xerostomia:

Dry Mouth

(NIH Senior Health, 2003)

risk factors for dry mouth
Risk Factors for Dry Mouth

A side effect of certain diseases and infections:

  • Sjögren's syndrome
  • HIV/AIDS
  • Alzheimer's disease
  • Diabetes
  • Anemia
  • Cystic fibrosis
  • Crohn’s disease
  • Systemic Lupus Erythematosis
  • Rheumatoid arthritis
  • Hypertension
  • Parkinson's disease
  • Stroke
  • Scleroderma
  • Hepatitis
risk factors for dry mouth1
Risk Factors for Dry Mouth

A side effect of over 500 medications:

  • Antidepressants
  • Antihypertensives
  • Narcotics
  • Anticholinergics
  • Antipsychotics
  • Anti-Parkinson
  • Antiasthmatics
  • Anorexiants
  • Anticonvulsants
  • Antacids
  • Hormone replacements
  • Diuretics
  • Sedatives
  • Inhalants
  • Decongestants
  • Glaucoma eye drops
  • Antihistamines
  • Pseudoephedrine

(USDHHS, 2008)

signs of dry mouth
Signs of Dry Mouth
  • Dry, sticky oral tissues
  • Thick saliva
  • Ulcers in mouth
  • Cracking of the corners of the mouth or tongue
  • Bad breath
  • Frequent yeast infections
  • Red gums that bleed easily
  • Increased tartar build up

Increased dental decay

symptoms of dry mouth
Symptoms of Dry Mouth
  • Sore or burning mouth, lips or tongue
  • Sleep interruptions due to thirst or oral discomfort
  • Difficulty chewing, speaking, swallowing and wearing dentures
  • Difficulty clearing leftover food in the mouth
  • Patient may avoid eating dry foods
oral cavity problems
ORAL CAVITY PROBLEMS

Dry mouth may contribute to:

  • Inflammation
  • Yeast infections
  • Tooth decay
  • Gum disease
severe decay
Severe Decay

…the longer one waits

prevent or manage dry mouth
Prevent or Manage Dry Mouth

Over the counter products might be sufficient

Talk with doctor/ dentist for prescriptions

mints and hard candies
Mints and Hard Candies

AVOID SUGAR CANDY

Sugar-Free Candies Okay!

denture care
Denture Care
  • Dentures need to be kept moist when not worn
  • Handle with great care – very expensive
  • Brush & rinse dentures daily – soft bristles designed for dentures
  • Clean with denture cleanser – NOT toothpaste
denture care1
Denture Care

Put in denture case NOT a Kleenex/paper towel!

  • Remember to still brush gums and palate

Important to remove to allow oxygen to get to tissues

  • ONLY a dentist/ prosthodontist should adjust dentures
antibiotics
Antibiotics
  • Conditions with a high risk of infection  antibiotics are recommended prior to some dental procedures
    • Most conditions of the heart, pace makers, heart valves etc.
  • Check with doctor/dentist

(http://www.mouthhealthy.org/en/az-topics/p/Premedication-or-Antibiotics)

dementia and oral health
Dementia and Oral Health
  • Aging in general increases the risk of oral cancer
  • Dry mouth from RX’s
  • Eventually dependant on care giver
dementia and oral health1
Dementia and Oral Health
  • Early stages  help remind about daily brushing
  • Increase fluoride treatments
  • Use alcohol-based pen to write name on dentures
daily prevention habits
Daily Prevention Habits
  • Be SMART brushers
    • 2x day for 2 minutes
  • Floss daily
  • Prevent dry mouth
    • Biotene or generic brand
    • Keep mouth moist!
  • Eat healthy fruits & vegetables
helpful tips
Helpful Tips

Studies show professional teeth cleaning lowers inflammation and pain in Arthritis patients…

  • Use floss holders
  • Arthritis or other conditions that limit movement…
    • Electric toothbrush
    • Duck tape a golf ball securely to handle of regular toothbrush
  • NEVER put your fingers between teeth

(http://www.arthritistoday.org/news/gum-disease.php)

helpful positioning
Helpful Positioning

(South Australian Dental Service, 2009)

changed behavior
Changed Behavior

Fear if being touched

Not opening mouth

Not understanding or responding to directions

Biting the toothbrush

Grabbing or hitting out

(South Australian Dental Service, 2009)

managing changed behavior
Managing Changed Behavior
  • Talk clearly, mime
  • Allow resident to inspect the items
  • Right environment
  • Body language
  • Overcoming fear of being touched
    • Bridging
    • Chaining
    • Hand over hand
    • Distraction
    • Rescuing

(South Australian Dental Service, 2009)

document and report
Document and Report
  • Bleeding gums
  • Sore mouth or tongue
  • Sore corners of mouth, tongue
  • Thrush (candidiasis)
  • Gum disease (gingivitis) or severe gum disease (periodontitis)
document and report1
Document and Report
  • Ulcers and sore spots
  • Dry mouth
  • Tooth decay, root decay, retained tooth roots
  • Dentures that are ill-fitting or require attention
nutrition contributes to overall wellness
Nutrition Contributes to Overall Wellness
  • Physical condition
  • Memory
  • Bone health
  • Eye health
  • Blood circulation
  • Immune system
  • ORAL HEALTH

Maintain a healthy diet in order to maintain good:

nutrition guidelines
Nutrition Guidelines
  • Half of plate = fruits and vegetables
  • At least half of grains = whole grains
  • Vary protein choices
  • Cut back on foods that are high in sodium or fat
  • Drink plenty of fluids
    • As we age, we start loosing our sense of thirst.
  • Exercise!

(USDA MyPlate, 2013)

thank you

Thank You!

Any Questions???

http://www.mouthhealthy.org/en/adults-over-60/healthy-habits.aspx