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Proper dental hygiene seems easy enough. Brush, floss, see your dentist regularly... and pop a mint after that garlic pizza if you care about those in breathing range of you.
As we age, however, oral health isn’t as easy to achieve. If you’ve noticed an elderly person with persistent bad breath, for instance, it might be a sign that something more serious is happening. Changes such as unusual bad breath, dry mouth or bleeding gums and new cavities may indicate a different kind of problem. Factors such as dementia, arthritis or other debilitating conditions such as poor eye sight, may be at the root of the problem. It is important for family and caregivers to note and address all oral health issues of elderly persons who may be unable to properly care for themselves.
“Years ago, I had an elderly woman patient who started losing her toothbrush every day. She remembered that she had a toothbrush, but she couldn’t find it. This frustrated her. Her husband found it every day and gave it to her to use. He was frustrated, too, and worried, and so he talked to me the next time his wife came in for a checkup,” recalls geriatric dentist June Sadowsky.
Sadowsky listened carefully and worked with her patient’s husband to find ways for his wife to maintain good oral health.
“I was often dentist and therapist, especially for those who were caregivers to elderly patients,” says Sadowsky, assistant professor of restorative dentistry and biomaterials at The University of Texas Dental Branch at Houston (UTHealth).
For readers of HealthLeader in the Houston area who need dental care, contact UT Dentists at 713-500-4444. UT Dentists is the faculty practice of The University of Texas Dental Branch at Houston. UT Dentists is committed to providing the best that dentistry has to offer with quality care that combines the latest dental treatments and innovations with the most up-to-date technology. Learn more at www.UTDentists.org.
The field of geriatric dentistry draws upon special knowledge and technical skills required when providing oral health care to older adults. Nearly 14 percent of the U.S. population is over 65, and this proportion will increase to more than 23 percent by the year 2040.
Oral health is crucial for older adults, who are more prone to systemic conditions, making them candidates for oral diseases, which can lead to malnutrition, altered or reduced communication, increased susceptibility to infectious diseases and diminished quality of life.
As we age, hand and finger dexterity declines. This makes it difficult to hold a toothbrush and nearly impossible to manipulate dental floss. Failing eyesight can thwart proper hygiene—patients don’t clean what they don’t see. Daily dental hygiene can become yet another thing of the past once dementia or other degenerative brain disorders develop.
“Self-neglect is one of the reasons we are focusing on training caregivers about how to help provide proper dental hygiene to the elderly,” says Sadowsky, a diplomate of the American Board of Special Care Dentistry. To boost these efforts, UTHealth Dental Branch has produced a training video titled, “Elder Loving Care™ Oral Hygiene Training.” Co-produced with UTHealth School of Nursing’s Center on Aging, this video not only teaches caregivers how to help the elderly maintain good oral health, but also teaches dental professionals how to train these caregivers.
“We must educate the caregivers as well as the next generation of dentists,” says Sadowsky, who is working to develop a geriatric dentistry curriculum for dental students. “We need them to be able to safeguard the good oral health of our aging population.”
One of the most challenging aspects of treating senior citizens is acquiring an accurate list of all prescription and over-the-counter (OTC) medications they are taking. Today, the average senior takes five prescription meds and two non-prescription meds daily. It is not unusual for a senior to be taking more than 10 prescription medications and five or more OTC medications, including herbal remedies, which are often under reported by the patient. For the dental and medical professionals, juggling medications is complex and requires extensive pharmaceutical knowledge. The chance of adverse drug interactions is high. That’s why Sadowsky is teaching young professionals to view the whole patient’s history, not just his or her dental histories.
“They can’t be treated the same as younger patients. We’ll need to use more of a medical model when taking a patient’s history,” says Sadowsky. “We must be quite skilled at understanding drug interactions and very good at recognizing the potential adverse interactions with any medications we might need to prescribe the patient.”
Seniors face many special oral health concerns, whether caring for their own teeth or dentures. Follow these tips for correct oral care between dentist visits:
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June Sadowsky, DDS, MPH, is an assistant professor in the Department of Restorative Dentistry and Biomaterials at UTHealth Dental Branch.
Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.
