While some aspects of regular dental visits are much the same for everyone, they can be more involved for an older adult. That’s because people later in life face an increased risk of dental disease and other age-related issues.
If you’re a caregiver for an older adult, you’ll want to be aware of these heightened risks. Here are 4 areas of concern we may check during their next regular dental visit.
Oral cancer. While it can occur at any age, cancer is more prevalent among older adults. Although rarer than other cancers, oral cancer’s survival rate is a dismal 50% after five years. This is because the disease is difficult to detect early or is misidentified as other conditions. To increase the odds of early detection (and better survival chances) we may perform a cancer screening during the visit.
Dental disease. The risks for tooth decay and periodontal (gum) disease also increase with age. A primary risk factor for older people is a lack of adequate saliva (the mouth’s natural disease fighter) often caused by medications or systemic conditions. We’ll watch carefully for any signs of disease, as well as assess their individual risk factors (including medications) for decreased oral health.
Dentures. If they wear dentures, we’ll check the appliance’s fit. While dentures can wear with use, the fit may also grow loose due to continuing bone loss in the jaw, a downside of denture wearing. We’ll make sure they still fit comfortably and aren’t stressing the gums or supporting teeth. It may be necessary to reline them or consider replacing them with a new set.
Oral hygiene. Brushing and flossing are just as important for older adults as for younger people for preventing dental disease, but often more difficult due to mental or physical impairment. We can note areas of bacterial plaque buildup and recommend ways to improve their hygiene efforts.
Depending on how well your older adult can care for themselves, it may be advisable for you to come with them when they visit us. Our dental team can provide valuable information and advice to help you help them have a healthier mouth.
If you would like more information on dental care for older adults, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Aging & Dental Health.”
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
If you have periodontal (gum) disease, you’ve no doubt experienced red and swollen gums. If, however, you notice an especially inflamed area next to a tooth, you may have developed a gum abscess.
An abscess is a pus-filled sac that develops as a result of chronic (long-standing) gum disease, an infection caused by bacterial plaque that’s built up on tooth surfaces from inadequate oral hygiene or from a foreign body (food debris) getting stuck below the gums. The abscess, which typically develops between the tooth and gums, may be accompanied by pain but not always (the affected tooth may also be tender to bite on). Abscesses may grow larger, precipitated by stress or by a general infection like a common cold, and then abate for a time.
As with other abscesses in the body, a gum abscess is treated by relieving the pressure (after numbing the area with local anesthesia) and allowing it to drain. This is often followed by cleaning any infected root surfaces of bacterial plaque and then irrigating the area with a saline and/or antibacterial solution. We may also prescribe antibiotics afterward and some form of pain control (usually a non-steroidal anti-inflammatory drug like ibuprofen) to help with discomfort.
Although the results of this procedure can be dramatic, it’s just the first step in treating the overall gum disease. After a few days of healing, we continue with a complete examination and recommend further treatment, usually starting with removing bacterial plaque and calculus (hardened plaque deposits), the underlying cause for the infection and inflammation, from all tooth and gum surfaces. This may take several sessions before we begin seeing the gum tissues return to a healthier state.
The key to preventing an abscess recurrence (or any symptom of gum disease) is to remove plaque everyday through proper brushing and flossing, and visiting us twice a year (or more if you’ve developed chronic gum disease) for cleanings and checkups. Doing so will raise your chances of avoiding an uncomfortable and often painful gum abscess in the future.
If you would like more information on gum abscesses, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal (Gum) Abscesses.”
The human body’s immune system has amazing defensive capabilities. Without it a common cold or small wound could turn deadly.
One of the more important processes of the immune system is inflammation, the body’s ability to isolate diseased or injured tissue from unaffected tissue. Ironically, though, this vital component of the healing process could actually cause harm if it becomes chronic.
This often happens with periodontal (gum) disease, an infection of the gums caused by bacterial plaque built up on teeth due to inadequate hygiene, which in turn triggers inflammation. The infection is often fueled by plaque, however, and can become difficult for the body to overcome on its own. A kind of trench warfare sets in between the body and the infection, resulting in continuing inflammation that can damage gum tissues. Untreated, the damage may eventually lead to tooth and bone loss.
In treating gum disease, our main goal is to stop the infection (and hence the inflammation) by aggressively removing plaque and calculus (tartar). Without plaque the infection diminishes, the inflammation subsides and the gums can begin to heal. This reduces the danger to teeth and bone and hopefully averts their loss.
But there’s another benefit of this treatment that could impact other inflammatory conditions in the body. Because all the body’s organic systems are interrelated, what occurs in one part affects another especially if it involves inflammation.
It’s now theorized that reducing gum inflammation could lessen inflammation in other parts of the body. Likewise, treating other conditions like high blood pressure and other risk factors for inflammatory diseases could lower your risk of gum disease and boost the effectiveness of treatment.
The real key is to improve and maintain your overall health, including your teeth and gums. Practice daily brushing and flossing to remove plaque, and visit your dentist regularly for more thorough cleanings. And see your dentist at the first sign of possible gum problems like bleeding, redness or swelling. You’ll not only be helping your mouth you could also be helping the rest of your body enjoy better health.
If you would like more information on the relationship between gum disease and other systemic conditions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Link between Heart & Gum Diseases.”
We all experience the occasional bout of bad breath from dry mouth or after eating certain foods. Chronic halitosis, on the other hand, could have an underlying health cause like periodontal (gum) disease, sinus infections or even systemic illnesses like diabetes. Anyone with persistent halitosis should undergo a thorough examination to determine the root cause.
If such an examination rules out a more serious cause, it’s then possible the particular population of bacteria that inhabit your mouth (out of a possible 600 or more strains) and your body’s response makes you more susceptible to halitosis. After feeding on food remnants, dead skin cells or post-nasal drip, certain types of bacteria excrete volatile sulfur compounds (VSCs) that give off an odor similar to “rotten eggs.”
In this case, we want to reduce the bacterial population through plaque removal, which in turn reduces the levels of VSCs. Our approach then is effective oral hygiene and perhaps a few cleanings — the basics every person should practice for good oral health — along with a few extra measures specific to chronic halitosis.
This calls for brushing and flossing your teeth daily. This will remove much of the plaque, the main breeding and feeding ground for bacteria, that has accumulated over the preceding twenty-four hours. In some cases, we may also recommend the use of an interproximal brush that is more adept in removing plaque clinging to areas between the teeth.
You may also need to pay special attention in cleaning another oral structure contributing to your bad breath — your tongue. The back of the tongue in particular is a “hideout” for bacteria: relatively dry and poorly cleansed because of its convoluted microscopic structure, bacteria often thrive undisturbed under a continually-forming tongue coating. Simply brushing the tongue may not be enough — you may also need to use a tongue scraper, a dental device that removes this coating. (For more information, see the Dear Doctor article, “Tongue Scraping.”)
Last but not least, visit our office for cleanings and checkups at least twice a year. Professional cleanings remove bacterial plaque and calculus (hardened plaque deposits) you’re unable to reach and remove with daily hygiene measures. Following this and the other steps described above will go a long way toward eliminating your bad breath, as well as enhancing your total oral health.
If you would like more information on treating chronic bad breath, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”
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