The impact of poor oral health on general health and quality of life is enormous, especially for vulnerable older adults. Millions live with untreated cavities, tooth decay, gum disease, oral pain and tooth loss due to limited, or no, access to basic dental care.
Recent studies have shown oral health issues may be associated with serious medical conditions including heart disease, stroke, diabetes, cognitive decline and pneumonia. Aside from the physical toll, poor oral health reduces self-esteem and increases social isolation.
Lack of Access to Dental Care
Many older adults, however, are often on their own when caring for the teeth. Most don’t have dental insurance (Medicare, the largest health provider for those over 65, does not cover routine dental care) and high out-of-pocket costs keep them out of the dentist’s chair.
A new analysis of 2012 Medicare data by Johns Hopkins Bloomberg School of Public Health found that only 12 percent of people 65 and older have some form of dental insurance and fewer than half visited a dentist in the previous year. Dental visits are even less frequent among low-income and minority older adults.
That makes them particular hard hit by oral health issues, said Dr. Karen Becerra, dental director of the Gary and Mary West Senior Dental Center in San Diego. The center is one of the few geriatric dental clinics in the country focused on providing care for low-income elders — some of whom haven’t been to a dentist in more than 20 years.
Untreated oral disease can cause pain and make it difficult to chew, swallow and eat, which in turn, can have a major impact on nutrition.
“If you don’t have a healthy mouth, chances are, you don’t have a healthy body. It’s so important to pay attention to what your teeth may be telling you,” Becerra said. “It’s especially important as we get older, since seniors actually experience tooth decay at higher rates than children and tend to have chronic conditions that can be related to their oral health.”
5 Signs of Trouble
Becerra offered these five signs older adults may experience that should not be ignored:
1. Dry mouth Dry mouth is not a normal part of aging. It is, however, a side effect of more than 400 medications, including those for high blood pressure, high cholesterol, pain, anxiety and depression, Parkinson’s and Alzheimer’s disease.
If you are always feeling parched, consult with your doctor to see if it’s connected to one of your medicines. If so, your doctor may be able to change the dose or provide an alternative. Over-the-counter sprays, rinses or mouthwash and drinking more water can also help stimulate saliva flow and restore moisture in your mouth.
Your dentist can apply a fluoride varnish to protect the teeth from new cavities, since the mouth acidity may have changed. This will help reduce the risk for cavities, gum disease and infection.
2. Pain in the mouth Untreated oral disease can cause pain and make it difficult to chew, swallow and eat, which in turn, can have a major impact on nutrition. People start to avoid certain foods, like healthy fruits, vegetables, and chicken and fish and replace them with softer foods like pastas and rice, or reduce consumption altogether.
Also, a poor diet can contribute to painful cavities and gum disease, so it works both ways. If you’re a caregiver, and you notice that a loved one is having trouble eating, it may not be their appetite, it may be their teeth. Encourage them to seek treatment and find out their options for fixing their teeth and eating right.
3. Covering your mouth or avoiding social interaction Missing teeth or oral pain can lead to social isolation and embarrassment. Research shows older adults who describe themselves as lonely have a 59 percent greater risk of functional decline and a 45 percent greater risk of death.
If you or a loved one are shying away from social interactions because of your teeth, talk to a dental professional about your options. Having a conversation, smiling, laughing and showing emotion are a lot easier when your mouth is healthy. If you have oral health problems, you are not alone and you can get help.
4. Loose teeth or bleeding gums Unhealthy teeth and gums have been associated with several chronic conditions including diabetes, heart disease, stroke and cognitive decline or dementia. In fact, the state of your teeth may be a sign you have one of these conditions or could make them worse.
For example, gum disease, bleeding gums and loose teeth could be signs of diabetes. At the same time, research suggests that treating gum disease can help improve blood sugar control in people with diabetes and may slow the progression of the disease.
5. Open sores or areas of irritation in the mouth that last more than two weeks The American Cancer Society estimates that about 48,330 Americans will be diagnosed with oral and throat cancers this year. The average age of those diagnosed will be 62.
Symptoms include a sore or irritation in the mouth or throat that persists, red or white patches or a pain, tenderness or numbness in the mouth or lips. During check-ups, dentists look for any abnormalities or suspicious changes that could indicate disease.
Oral health cannot be separated from general health. Maintain a good oral health regimen every day to stay healthy and seek out professional dental care. For resources in your area, visit the Area Agencies on Aging (AAA) locator. For more information about oral health for older adults, visit the Oral Healthcare and Care Coordination area of the WestHealth site.
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