Mouths, like people, are affected by years as well as by genes. If you’re over 60, your oral chemistry is changing—and thorough examinations of gums and salivary glands can be a lifesaving early detector of oral cancer or other disease. Older Americans are becoming a larger segment of our population and suffer disproportionately from oral diseases, with the problem being particularly acute for individuals in long term care facilities. They generally requiremultiple medications, and common side effects of the more than500 medications used to treat their overall health issues usually reduce salivary flow. Usually the reduction in saliva can adversely affect their quality of life, the ability to chew, and lead to significant problems of the teeth and their supporting structures.
The elderly may also have difficulty performing routine oralhygiene procedures because of physical limitations, such as Parkinson’s or rheumatoid arthritis. In addition,oral infection is now recognized as a risk factor for a number of systemic diseases, including cardiovascular diseases, cerebro vascular diseases,diabetes, mellitus, and respiratory disorders. Also,it is important to note that once people have lost their teeth and are using complete dentures, their oral healthneeds do not decrease. Our jaws are not static and may continue toresorb over time. Besides the continued resorption of bone, improperly fitted dentures can adversely affectchewing, leading to poor nutrition. In addition, those without teeth remain susceptible to oral cancer, mucosal diseases, and alterations in salivary gland function.
As early as 55, patients are developing twice as many cavities as children do. All these health issues and their medications that create reduced saliva and cause dry mouth have become an open invitation for tooth decay and periodontal disease. Does the patient have to make a choice between his or her general health verses their oral hygiene? They shouldn’t have to.
What should you expect from a visit to your dental hygienist? Along with your dental cleaning you may need professional scaling and root planing to remove harmful plaque and calculus deposits. Your hygienist should also record the depths of your periodontal pockets (that space between your teeth and gums where decay and periodontal disease flourish).
Keeping track of you is a key part of the hygienist’s job. It includes keeping your dental chart and health history current, making preliminary oral inspections, and creating tooth impressions.
Your hygienist is also an educator—someone who can teach you preventive dentistry skills—brushing and flossing techniques that make for healthy, trouble-free gums and teeth, regardless your age or your onset of other health issues. Together, you two can make an unbeatable team!
Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200A
Atlanta (Sandy Springs), GA 30328
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 Fox PC, Eversole LR. Diseases of the salivary glands. In: Silverman S, Eversole LR, Truelove EL, eds. Essentials of Oral Medicine. Ontario, Canada: BC Decker; 2002:260–276.