Lasting Impressions

Lasting Impressions is the program sponsored by the Massachusetts Dental Society (MDS) designed to promote the importance of good dental health for senior citizens of the Commonwealth.

Healthy teeth and gums are important to people of all ages, including seniors. A healthy mouth plays an important role in chewing food, in speaking, and in everyone’s overall health.

The Dental Professional’s Role in Mature Mouths

Dentists are experiencing a transformation in their offices as the number of older patients increases more steadily and treatment focuses more on natural teeth. The dental profession understands that the older population is wearing fewer dentures and is keeping their natural teeth longer. Dentists also realize that some seniors require special consideration because reduced mobility and dexterity may make daily oral hygiene difficult. In addition, medical conditions and impairments are factors that dental professionals take into account for certain older patients.

Sometimes, lack of awareness about available treatments and techniques may lead older patients to make false assumptions about their dental health and to tolerate conditions such as toothaches, bleeding gums, and improperly fitting dentures when these conditions can be easily corrected.

Today, dentists are increasingly sensitive to the special needs and the importance of dental health in the older patient. These adults are more health conscious as a group than ever before. Their oral health is an important part of their overall health, and the dental profession is committed to providing the treatment and guidance that seniors need to maintain it.

The MDS feels it’s important that you and your smile make a Lasting Impression now, and for a lifetime.

Oral Hygiene Information for the Young at Heart

Because tooth decay and cavities are problems that affect everyone, including the elderly, it’s especially important for seniors to practice a thorough dental health routine.

Toothbrushes
Toothbrushes should be replaced when bristles begin to fray, usually every three months. An easy way to remember this is to change toothbrushes with the start of each new season.

If it’s necessary, an existing toothbrush may be adjusted to meet the needs of older adults, while also providing them some independence. For seniors who have a difficult time grasping their toothbrush handle, the handle may be enlarged with a sponge or rubber ball. Additionally, adhesive tape can be wrapped around the handle to increase its size.

Some seniors with dexterity problems may find that using an electric toothbrush is easier to manipulate than a manual brush.

Brushing and Flossing
Older adults are more likely to have decay. That’s why brushing and flossing regularly are very important. Removing plaque from teeth and gums every day will help prevent periodontal disease.

Brushing: Brush teeth at least twice a day with a soft-bristled toothbrush. Always brush the top or biting surface of the teeth and the tongue, too.

If seniors need assistance, gently brush their teeth with a massaging motion on the outside surfaces of the teeth, touching the cheeks and the inside surfaces of the teeth that come in contact with the tongue.

Flossing: Daily flossing is just as important as brushing because it removes plaque and food between the teeth and gums. There are two types of floss—waxed and unwaxed. Waxed floss is recommended, since it does not fray and slides more easily between the teeth.

Many seniors have manual dexterity problems and will need assistance to floss.

• To assist someone with flossing, start with a strand approximately 18 inches long.
• Wrap the floss around the middle finger of both hands.
• Use your thumbs and forefingers to control the floss.
• Gently ease the floss between the patient’s teeth using a gentle back and forth motion.
• Carefully rub up and down, gently moving the floss from under the gum line to the top of the tooth. Repeat this step between all teeth.

Fluoride

Tooth decay remains the most common and costly oral health problem in all age groups. Therefore, whether you are 6 or 60, fluoride use is one of the best defenses against tooth decay throughout one’s life. Research has shown that fluoridated water reduces cavities in all age groups, including up to 35 percent in adults and seniors.

Fluoride works on the tooth structure to reverse the early stages of tooth decay by promoting the remineralization of enamel. In this process, fluoride increases the enamel intake of calcium and phosphorus to repair weakened spots. As the gums recede with age or as a result of gum disease, the newly exposed tooth root surfaces become vulnerable to acid attack. Fluoride inhibits the development of cavities on these surfaces, as well—a benefit especially important to older adults.

Fluoridated water is the most practical and cost-effective source of fluoride. According to the American Dental Association, a recent study showed a 31 percent reduction of dental disease in adults with a continuous lifetime exposure to fluoridated water as compared to adults with no exposure to water fluoridation.

For an updated list of fluoridated towns and cities in Massachusetts, click here.

If your town or city does not have fluoridated water, speak to your dentist about other possible sources of fluoride.

Dentures

For seniors who have lost all of their natural teeth, whether from periodontal disease, tooth decay, or injury, dentures can replace missing teeth and significantly improve one’s smile.

Replacing missing teeth will benefit not only someone’s appearance, but also their overall health.

There are two types of complete dentures:

• A conventional full denture is made and placed in the patient’s mouth after the remaining teeth are removed and tissues have healed.
• An immediate full denture is inserted immediately after the remaining teeth are removed. The dentist will take measurements and make models of the patient’s jaw during a preliminary visit. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.

The great thing about dentures is that they can be made to closely resemble your natural teeth. There may be little change in your appearance, and full dentures may even improve the look of your smile.

Taking Care of your Dentures

Like natural teeth, dentures must be properly cared for to last. Dentures are very delicate and may break even if dropped just a few inches.

When handling your dentures, stand over a folded towel or a sink filled with water. When you’re not wearing your dentures, store them in a safe, secure place.

Daily brushing will remove food deposits and plaque and helps prevent the artificial teeth from becoming permanently stained. While it is best to use a brush made specifically for cleaning dentures, a toothbrush with soft bristles can also be used. Avoid using hard-bristled toothbrushes that can damage dentures.

Some denture wearers use hand soap or mild dishwashing liquid, which are both acceptable for cleaning dentures. However, be sure to avoid other powered household cleaners, which may be too abrasive. Your dentist may recommend a denture cleaner, as well.

To clean the denture, rinse off loose food particles. Moisten the brush and apply the cleanser. Brush every surface gently to avoid damage.

Don’t let dentures dry out or they could lose their shape. When not wearing your dentures, place them in a denture cleanser soaking solution or in plain water. Never soak dentures in hot water, which can cause them to warp.

Denture Adjustments
See your dentist immediately if your dentures break, crack, chip, or if they become loose. Poorly fitting dentures can cause sores in the mouth and may make eating and speaking difficult.

Do not try to adjust dentures yourself. This can damage the dentures further and could cause oral health problems. Over-the-counter glues often contain harmful chemicals and should not be used on dentures.

Eventually all dentures will need to be relined or remade due to normal wear and tear. That’s why it’s important to visit a dentist regularly, so he or she can make sure the dentures are in good condition.

Taking Care of Your Mouth if You Have Dentures
If you wear full dentures, you still need to take good care of your mouth. Brush your gums, tongue, and palate every morning with a soft-bristled brush before you insert your dentures. This stimulates circulation in your tissues and helps remove plaque. Eating a nutritious diet is also important for maintaining a healthy mouth.

Regular Dental Visits

Even if you have lost some or all of your teeth, routine dental visits are necessary. The mouth and gums are still subject to many serious problems and should be examined regularly.

Your dentist will advise you on how often you should have checkups. During the visit, the dentist will examine your mouth to see if your dentures still fit and determine if any adjustments are necessary. Your dentist will also examine your mouth and look for any signs of problems, such as gum disease or oral cancer.

Dry Mouth

Reduced saliva flow that results in a dry mouth is a common problem among older adults. It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, painkillers, and diuretics.

Some of the common problems associated with dry mouth include a constant sore throat, a burning sensation, problems speaking, difficulty swallowing, hoarseness, or dry nasal passages.

Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive decay can form.

Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum may stimulate saliva flow, and moisture can be replaced by using artificial saliva or oral rinses.

Why Do My Teeth Seem Darker?

One of the changes you may notice as you grow older is that it’s harder to keep your teeth clean and white. This is because the sticky, colorless layer of bacteria, also known as plaque, can build up faster and in greater amounts as we age. Changes in dentin, the bone-like tissue that is under your enamel, may also cause your teeth to appear slightly darker.

Your Taste Buds

You may find that you are losing your appetite due to a change in your sense of taste. Several factors can cause this change. Besides an age-related decrease in the sense of taste and smell, certain diseases, medications, and dentures can contribute to a decrease in your sense of taste.

Nutrition

Maintaining proper nutrition is important for people of all ages. However, due to difficulty chewing or swallowing, as well as digestive problems, many older adults do not eat balanced diets and avoid meats, raw vegetables, and fresh fruits. Problems with chewing or swallowing may be caused by ill-fitting dentures, dry mouth, or changes in facial muscles. Because of these factors, the diets of some older adults are many times lacking in calcium, protein, and other nutrients essential to one’s total well-being. Seniors need a balanced diet based on the five food groups of dairy, breads and cereals, meats, fruits, and vegetables. Older adults may need a multi-vitamin or mineral supplement. However, use a supplement only after consulting your physician first.

Cosmetic Dentistry for Seniors

One aspect of older adulthood is the acceptance of aging and the development of realistic expectations for appearance. However, older adults can benefit from many of the options available today for improving the look of their smile. Your dentist can describe and discuss with you the range of treatment that would be right for you. Coupled with good oral hygiene and regular dental visits, cosmetic techniques can help improve your appearance and self-confidence.

When should you contact a dentist?

If you notice any of the following, seek dental assistance:

• Bleeding gums
• Red, swollen, or tender gums
• Gums separating from your tooth
• Pus around the tooth near the gum line
• Lack of taste or particularly bad halitosis (bad breath)
• Loose or chipped teeth
• A change in the fit of dentures or partials
• Dry, cracked, swollen, or blistered lips
• Difficulty chewing

Good oral hygiene and regular dental care are important throughout everyone’s life. By brushing and flossing regularly, taking proper care of your dentures, and eating right, your smile will make a Lasting Impression on everyone.

For information on dental professionals who conduct nursing home visits, contact the MDS at (800) 342-8747.