Oral care for older adults

Oral care for older adults by Mercedes R. Del Valle, DDS

 

    Taking care of others is an extraordinary job. Essential to overall health and comfort is good oral health. Healthy teeth and gums enable a person to eat a variety of nutritious foods and speak clearly, which improves the quality of life. 

    Having an attractive smile and fresh breath boosts confidence and increases the enjoyment of time spent with family and friends. You can make a difference by providing effective daily oral care. 

Poor oral health can lead to overall health concerns. Dental plaque is a sticky, colorless film of harmful bacteria and food particles that constantly forms in the mouth. Plaque can lead to bad breath, cavities, and periodontal or gum disease. 

     Cavities at any age can become painful and infected. Older adults are at increased risk for cavities on the root surface of their teeth due to receding gums and medication use. 

     If plaque is not removed, it can harden into a deposit known as calculus or tartar. This can lead to an inflammation of the gums called gingivitis; gums become red, inflamed, and bleed easily. If left untreated, it can progress to periodontitis. Gums can eventually recede, and teeth become loose. 

    Brushing teeth or chewing can injure gum tissue and allow bacteria in the mouth to enter the bloodstream. Research indicates that bacteria may travel to other parts of the body, worsening existing health problems or causing additional health concerns. In recent studies, gum disease has been linked to diabetes, possibly heart disease, stroke, pneumonia, and other respiratory diseases. 

 

Providing Effective Oral Care

    Teeth should be brushed at least twice a day before bed, being the most critical time. Many seniors in assisted living can take care of their teeth. Please check on them regularly. Remember that our ability to maintain our own effective daily oral care may change as we age. 

Proper Positioning

    Proper positioning makes the job more comfortable for the caregiver and more effective for the adult needing help. Make sure that supplies are nearby and adequately labeled. Toothettes are helpful for cleaning and massaging areas of the mouth without teeth but are not meant to replace a toothbrush for cleaning natural teeth.  Lemon glycerin swabs should not be used because of their adverse effect on teeth and gums.  Mouthwash does not replace brushing and flossing, but it can be used with patients who do not have chronic dry mouth and can spit. 

    Drape the patient with a towel and keep a damp washcloth handy. Use a pea-size amount of Fluoride toothpaste on an ADA-approved soft bristle toothbrush. We must clean around the gum line to get all the plaque off. 

Natural Teeth

    When brushing Natural teeth, use small circles at a 45° angle concentrating on the gum line. Continue to brush even if bleeding occurs.  For patients who have difficulty holding their mouth open, try using two large, handled toothbrushes. They can also be used to hold the cheek to reduce the chance of being bitten. 

    Use dental floss daily to remove plaque and food from between teeth. Slide the floss up and down gently against the tooth and under the gum line.  Floss each tooth with a clean section of floss. Other oral care aids are available to help remove plaque and food. 

 

Partial dentures

    Partial dentures must be cleaned daily. Carefully remove the partial denture before cleaning the natural teeth. Brush all surfaces of the denture using a denture brush. The denture should be kept out of the mouth overnight soaked in cold water in a denture cup.

 

Complete Dentures 

    First, carefully remove the lower denture, then the upper denture, and gently brush gum tissue with a toothbrush or a Toothettes. Clean dentures with a denture toothbrush with toothpaste or denture paste under running cold water.  Put a towel on the bottom of the sink to prevent breakage if accidentally dropped. Be careful to squeeze dentures. This could potentially cause Dentures to be kept out of the mouth overnight soaked in cold water in a denture cup. Commercial denture cleaning tablets can be beneficial but do not replace brushing. Dentures should be labeled with the patient’s name. Ideally, a permanent label should be added during the fabrication process. 

 

No teeth or Dentures 

Assisted living residents who do not have natural teeth or dentures should have their mouths cleaned daily with a soft toothbrush or Toothettes. 

 

    It is recommended that assisted living residents be examined by a dentist regularly. 

Inform the appropriate staff member if you notice any unusual sores or discoloration on the gums or tissue inside the mouth that does not improve in a few weeks. 

    Let someone know if you see loose or broken dentures. They can be very uncomfortable and dangerous, affecting a person’s ability to chew and speak. 

    Medications can lead to dry mouth. Drinking water or sucking on ice can help it. 

If they use gum or candy, it needs to be sugar-free.

 

    Being able to eat a healthy diet, speak clearly, and feel good is essential for everyone.  

You can help make this happen by providing effective daily oral care!