Dental Health Concerns - Adults Over 60 | MouthHealthy - Oral Health Information from the ADA

Concerns

An older couple brushing their teeth together.

The Link Between Medications and Cavities

You may wonder why you’re suddenly getting cavities when you haven’t had them in years. As we get older, we enter a second round of cavity prone years. One common cause of cavities in older adults is dry mouth. Dry mouth is not a normal part of aging. However, it is a side-effect in more than 500 medications, including those for allergies or asthma, high blood pressure, high cholesterol, pain, anxiety or depression, Parkinson’s and Alzheimer’s diseases. This is just one reason why it’s so important to tell your dentist about any medications that you’re taking. Your dentist can make recommendations to help relieve your dry mouth symptoms and prevent cavities. Here are some common recommendations:

  • Use over-the-counter oral moisturizers, such as a spray or mouthwash.
  • Consult with your physician on whether to change the medication or dosage.
  • Drink more water. Carry a water bottle with you, and don’t wait until you’re thirsty to drink. Your mouth needs constant lubrication.
  • Use sugar-free gum or lozenges to stimulate saliva production.
  • Get a humidifier to help keep moisture in the air.
  • Avoid foods and beverages that irritate dry mouths, like coffee, alcohol, carbonated soft drinks, and acidic fruit juices.
  • Your dentist may apply a fluoride gel or varnish to protect your teeth from cavities.

Gum Disease

Many older adults have gum, or periodontal disease, caused by the bacteria in plaque, which irritate the gums, making them swollen, red and more likely to bleed. One reason gum disease is so widespread among adults is that it’s often a painless condition until the advanced stage. If left untreated, gums can begin to pull away from the teeth and form deepened spaces called pockets where food particles and more plaque may collect. Advanced gum disease can eventually destroy the gums, bone and ligaments supporting the teeth leading to tooth loss. The good news is that with regular dental visits gum disease can be treated or prevented entirely.

Mouth Cancer

According to the American Cancer Society, there are about 35,000 cases of mouth, throat and tongue cancer diagnosed each year. The average age of most people diagnosed with these cancers is 62. During dental visits, your dentist will check for any signs of oral cancer. Regular dental visits are important because in the early stages oral cancer typically does not cause pain and early detection saves lives. Some symptoms you may see include open sores, white or reddish patches, and changes in the lips, tongue and lining of the mouth that lasts for more than two weeks.

Paying for Dental Care after Retirement

Many retirees don’t realize that Medicare does not cover routine dental care. Begin to plan for your dental expenses in advance of retirement so you don’t have to let your dental health suffer once you’re on a fixed income. Organizations like AARP offer supplemental dental insurance plans for their members.

Discount dental plans are another option that typically have a lower monthly fee than traditional dental insurance. You select a dentist within the plan network who has agreed to provide certain services for 10 to 60 percent less than the typical fee. You pay the reduced fee out-of-pocket, and there is no claim paperwork to fill out. You can search for a dental plan at the National Association of Dental Plans website. Many dentists offer no interest or low interest financing plans that may be a better option than paying for your dental work on a household credit card with a higher interest rate. If you have concerns about continuing your dental care due to a limited income, talk to your dentist. He or she may be able to offer solutions.

Do I Need to Take an Antibiotic Before a Dental Procedure?

At times physicians and dentists recommend that a patient take antibiotics before certain dental procedures. This is called “antibiotic prophylaxis.” But why do healthcare providers suggest this extra step?

We all have bacteria in our mouths, and a number of dental treatments—and even daily routines like chewing, brushing or flossing—can allow bacteria to enter the bloodstream (bacteremia). For most of us, this isn’t a problem. A healthy immune system prevents these bacteria from causing any harm. There is concern, however, that for some people bacteremia can cause an infection elsewhere in the body.

Antibiotic prophylaxis is recommended for a small number of people who have specific heart conditions. The American Heart Association has guidelines identifying people who should take antibiotics prior to dental care. Learn more about them here.

Antibiotic prophylaxis guidelines have also been revised for people with orthopedic implants such as artificial joints. Learn more about why the ADA and American Association of Orthopedic Surgeons updated the recommendations and no longer recommend antibiotics for everyone with artificial joints.

Talk to your dentist if you have any questions about antibiotic prophylaxis.

Caregiving for a Disabled or Elderly Loved One

You may have a parent, spouse or friend who has difficulty maintaining a healthy mouth on their own. How can you help? Two things are critical:

  • Help them keep their mouth clean with reminders to brush and floss daily.
  • Make sure they get to a dentist regularly.

These steps can prevent many problems, but tasks that once seemed so simple can become very challenging. If your loved one is having difficulty with brushing and flossing, talk to a dentist or hygienist who can provide helpful tips or a different approach. There are dentists who specialize in caring for the elderly and disabled. You can locate a specialist through the Special Care Dentistry Association’s referral directory. For those who wear dentures, pay close attention to their eating habits. If they’re having difficulty eating or are not eating as much as usual, denture problems could be the cause.

When you’re caring for someone who is confined to bed, they may have so many health problems that it’s easy to forget about oral health. However, it’s still very important because bacteria from the mouth can be inhaled into the lungs and cause pneumonia.

If you are a representative for a nursing home resident who needs dental care and is enrolled in Medicaid, there is a regulation, called an Incurred Medical Expense, that may help pay for medically necessary care as determined by a dentist. The Medicaid caseworker at the nursing facility and the dentist providing care can work together to apply the Incurred Medical Expense to pay for needed dental benefits.