Geriatric Dentistry

Geriatric Dentistry

Americans are living longer and continuing to enjoy the lifestyles they have grown accustomed to, in large part thanks to advances in modern medicine and dentistry. No longer are seniors housebound, forced to live out their senior years watching television in the recesses of an isolated, dark living room.

Advances in dentistry have not only created the opportunity but also the expectation of maintaining oral health throughout a lifetime. People expect to enjoy active lifestyles, which include the enjoyment of fine dining and the youthful look a full dentition provides by supporting facial structures and thus retaining a youthful appearance. Medicine has consistently demonstrated that nutrition is a key factor in maintaining health, and healthy dentin is essential for this function. The oral-systemic relationship is well established; chronic inflammation or infection in the mouth can affect the entire body. Periodontal disease, a chronic inflammation, has been proven to increase the likelihood of stroke, heart attack, diabetes, and other maladies. Infection in the mouth increases the rate of prosthetic joint failure and rejection. Examples of the correlation between oral health and overall health are endless.

Seniors, however, provide increased challenges in maintaining a healthy, comfortable, functioning dentition. Several factors contribute to the increased rate of dental decay, periodontal disease, and the overall decline in dental health. Seniors have become one of our most “needy” dental patients. Manual dexterity dramatically decreases as we age. Diseases such as arthritis reduce one’s ability to maintain daily hygiene at levels common throughout life. A more sedentary lifestyle and the absence of a large family unit at home can decrease the motivation to prepare healthy meals. Seniors often eat simple, pre-prepared meals full of empty calories and processed sugars, which can make them more prone to cavities. Saliva is one of our best defenses against dental decay. Many, many families of drugs create a dry mouth as a side effect of their intended benefits. Combine declining home care, a high-caloric diet, with dry mouth secondary to medication, and it is not uncommon to witness a lifetime of health and care decline and failure in a very short time.

As dentistry has become more aware of these issues, the profession has become proactive in addressing and preventing them. The days of a manual toothbrush are gone. Rotary or battery-operated toothbrushes, used daily, provide a level of bacteria-laden plaque control that is almost equal to professional prophylaxis. Supplemental fluoride rinses and prescription-level fluoridated toothpaste are highly effective in mitigating the effects of dietary changes and dry mouth. Educating our patients about their age-specific risk factors and providing them with ways to prevent these issues has eliminated numerous problems before they occur.

One must not forget that advances in modern dentistry also contribute to keeping our seniors healthy. Lifelike porcelain crowns recreate beautiful, youthful smiles that have been compromised by a lifetime of wear and possibly neglect. Composite, or white fillings, replace ugly silver amalgam restorations and bond the remaining tooth structure together. Advances in endodontics, or root canals, make preserving and saving teeth much more of a possibility than even 20 years ago. Bridges and removable partial dentures replace lost teeth with precision, a feat previously unachievable only a few years ago. Implants are one of the greatest advances in modern dentistry. Implants can be used to support a single crown, replacing a lost tooth. A complex of implants can support an entire dental prosthesis and improve the quality of life for our patients, a feat not possible until recently.

“Old age” is no longer a prescription for poor oral health. Advances in dental care and the understanding of the special needs of mature patients make it possible to preserve, protect, and restore dentition to a level of form and function that Mother Nature provides.