Oral Healthcare Often Neglected in Older Adults | Vital Signs | UCLA Health

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De n t i s t ry Oral Healthcare Often Neglected in Older Adults As many as 60 percent of older adults do not receive regular dental-care services because they lack dental insurance or face other barriers to care. A major reason for this, experts say, is that most people lose employer-based healthcare when they retire, and programs such as Medicare and Medicaid rarely include dental coverage. Limited access to oral healthcare places these individuals at increased risk for a host of oral-health problems that affect their overall well-being. “We often see the direct effects of poor oral healthcare, such as dental caries, gum disease, dry mouth, pain or even oral cancer, but we then forget about equally important issues related to quality of life,” says UCLA geriatric- medicine specialist Patricia Harris, MD. “As people start to lose their teeth, chewing and swallowing may negatively impact their nutrition, and cosmetic issues may lower their self-esteem and reduce social interactions.” Poor oral healthcare is also associated with increased risk of respiratory disease, cardiovascular disease and diabetes, as well as inappropriate use of hospital emergency departments, according to an Institute of Medicine report. Although experts are not exactly sure why poor oral healthcare is linked to other serious health problems, the potential spread of infection from the tooth or gums to the jaw to the heart and other organs is considered a key suspect. “Unexplained fever, pain in the tooth or jaw and dry mouth should not be ignored because they may be symptoms of tooth infections that may become serious and spread if left undiagnosed and untreated,” Dr. Harris explains. “That’s when older patients end up in the emergency room.” Nearly one-third of older adults have untreated tooth decay that may lead to pain, dental abscess or more serious infections, such as bacteremia. According to Diana Messadi, DDS, DMSc, a specialist in geriatric dentistry and oral medicine in the UCLA School of Dentistry, many of these problems spiral out of control because elderly patients and their caregivers are inadequately trained in proper oral hygiene. “One of the big issues in elderly patients is that many are taking medications that cause dry mouth, which is associated with higher rates of yeast infections and dental caries,” she explains. “These types of infections are UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) more common among denture wearers and often develop when people don’t clean the dentures properly.” Dr. Messadi recommends that patients brush their natural teeth twice a day with a soft toothbrush and clean their dentures once a day with a denture brush, and that dentures should not be worn at night. She also recommends that patients rinse with non-alcoholic mouthwash to avoid dryness caused by alcohol, and she calls for better training of caregivers who work in nursing and assisted-living facilities. “Many of our elderly live in long-term-care institutions and must depend on others for their daily hygiene, yet the nursing staff in those facilities often receive little or no training in providing appropriate oral healthcare,” Dr. Messadi explains. “We need to do a better job at promoting oral health for older Americans, regardless of where they live.” De n t i s t ry Oral Healthcare Often Neglected in Older Adults As many as 60 percent of older adults do Poor oral healthcare is also associated more common among denture wearers and not receive regular dental-care services with increased risk of respiratory disease, often develop when people don’t clean the because they lack dental insurance or face cardiovascular disease and diabetes, as well dentures properly.” Dr. Messadi recommends other barriers to care. A major reason for as inappropriate use of hospital emergency that patients brush their natural teeth twice this, experts say, is that most people lose departments, according to an Institute of a day with a soft toothbrush and clean their employer-based healthcare when they Medicine report. Although experts are not dentures once a day with a denture brush, and retire, and programs such as Medicare and exactly sure why poor oral healthcare is linked that dentures should not be worn at night. She Medicaid rarely include dental coverage. to other serious health problems, the potential also recommends that patients rinse with Limited access to oral healthcare places these spread of infection from the tooth or gums non-alcoholic mouthwash to avoid dryness individuals at increased risk for a host of to the jaw to the heart and other organs is caused by alcohol, and she calls for better oral-health problems that affect their overall considered a key suspect. training of caregivers who work in nursing well-being. and assisted-living facilities. “Unexplained fever, pain in the tooth or jaw “We often see the direct effects of poor oral and dry mouth should not be ignored because “Many of our elderly live in long-term-care healthcare, such as dental caries, gum disease, they may be symptoms of tooth infections institutions and must depend on others for dry mouth, pain or even oral cancer, but we that may become serious and spread if left their daily hygiene, yet the nursing staff in then forget about equally important issues undiagnosed and untreated,” Dr. Harris those facilities often receive little or no training related to quality of life,” says UCLA geriatric- explains. “That’s when older patients end in providing appropriate oral healthcare,” medicine specialist Patricia Harris, MD. up in the emergency room.” Dr. Messadi explains. “We need to do a “As people start to lose their teeth, chewing better job at promoting oral health for older Nearly one-third of older adults have and swallowing may negatively impact their Americans, regardless of where they live.” untreated tooth decay that may lead to pain, nutrition, and cosmetic issues may lower their dental abscess or more serious infections, such self-esteem and reduce social interactions.” as bacteremia. According to Diana Messadi, DDS, DMSc, a specialist in geriatric dentistry and oral medicine in the UCLA School of Dentistry, many of these problems spiral out of control because elderly patients and their caregivers are inadequately trained in proper oral hygiene. “One of the big issues in elderly patients is that many are taking medications that cause dry mouth, which is associated with higher rates of yeast infections and dental caries,” she explains. “These types of infections are UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) De n t i s t ry Oral Healthcare Often Neglected in Older Adults As many as 60 percent of older adults do not receive regular dental-care services because they lack dental insurance or face other barriers to care. A major reason for this, experts say, is that most people lose employer-based healthcare when they retire, and programs such as Medicare and Medicaid rarely include dental coverage. Limited access to oral healthcare places these individuals at increased risk for a host of oral-health problems that affect their overall well-being. “We often see the direct effects of poor oral healthcare, such as dental caries, gum disease, dry mouth, pain or even oral cancer, but we then forget about equally important issues related to quality of life,” says UCLA geriatric- medicine specialist Patricia Harris, MD. “As people start to lose their teeth, chewing and swallowing may negatively impact their nutrition, and cosmetic issues may lower their self-esteem and reduce social interactions.” Poor oral healthcare is also associated with increased risk of respiratory disease, cardiovascular disease and diabetes, as well as inappropriate use of hospital emergency departments, according to an Institute of Medicine report. Although experts are not exactly sure why poor oral healthcare is linked to other serious health problems, the potential spread of infection from the tooth or gums to the jaw to the heart and other organs is considered a key suspect. “Unexplained fever, pain in the tooth or jaw and dry mouth should not be ignored because they may be symptoms of tooth infections that may become serious and spread if left undiagnosed and untreated,” Dr. Harris explains. “That’s when older patients end up in the emergency room.” Nearly one-third of older adults have untreated tooth decay that may lead to pain, dental abscess or more serious infections, such as bacteremia. According to Diana Messadi, DDS, DMSc, a specialist in geriatric dentistry and oral medicine in the UCLA School of Dentistry, many of these problems spiral out of control because elderly patients and their caregivers are inadequately trained in proper oral hygiene. “One of the big issues in elderly patients is that many are taking medications that cause dry mouth, which is associated with higher rates of yeast infections and dental caries,” she explains. “These types of infections are UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) more common among denture wearers and often develop when people don’t clean the dentures properly.” Dr. Messadi recommends that patients brush their natural teeth twice a day with a soft toothbrush and clean their dentures once a day with a denture brush, and that dentures should not be worn at night. She also recommends that patients rinse with non-alcoholic mouthwash to avoid dryness caused by alcohol, and she calls for better training of caregivers who work in nursing and assisted-living facilities. “Many of our elderly live in long-term-care institutions and must depend on others for their daily hygiene, yet the nursing staff in those facilities often receive little or no training in providing appropriate oral healthcare,” Dr. Messadi explains. “We need to do a better job at promoting oral health for older Americans, regardless of where they live.”