Oral and Dental Problems Associated with Aging
The deterioration of oral health is not a natural consequence of aging. This condition develops due to insufficient preventive dentistry services, systemic diseases, medication use, inadequate nutrition, and improperly performed oral care.
In general, intraoral changes thought to be related to aging include tooth loss, darkening of tooth color, gingival recession, decreased saliva volume, weakening of oral tissues and muscles, and a decrease in the sense of taste. Parallel to aging, structural changes occur in the teeth as a result of enamel wear. This condition can progress from simple superficial abrasions to significant substance loss. A significant portion of the elderly population uses removable dentures. These dentures can lead to changes that affect both the appearance and the integrity of the intraoral tissues. This situation leads to differences in chewing function and eating habits. With aging, bone loss (osteoporosis) is observed in all bones, frequently in women. In elderly patients who do not use dentures, this condition causes depression in the face and lips, constriction in the mouth, and wrinkles starting from the corners of the lips. When bone resorption in the mandible reaches advanced stages, the jawbones become thin and sharp like a knife, which makes the use of dentures difficult. To preserve the natural structure of the jawbones, functional teeth or tooth roots should be retained in the mouth. Saliva flow decreases with age. Due to this condition, bacterial plaque accumulation occurs, thus increasing the risk of caries and gum diseases, and fungal infections may be seen. Dry mouth also reduces the resistance of intraoral tissues to trauma, so wounds are frequently encountered in the mouth. In addition, dryness causes a layer of food debris to accumulate on the tongue, which leads to a decrease in the sense of taste. There is burning, itching, and pain in the tongue. The retention of dentures is reduced, so the chewing, swallowing, and speaking functions of patients are negatively affected. Removable dentures also prevent taste perception by covering large intraoral surfaces. Due to the decrease in taste sensitivity, salt and sugar consumption increases in the elderly, and this leads to the development of systemic problems. As a result of joint deformities, sounds ranging from mild to severe are heard during mouth opening. In addition, factors such as improperly made fillings and teeth grinding can cause changes in the chewing surfaces of the teeth, leading to the deterioration of the occlusal relationships between the upper and lower jaw teeth. This condition creates pain and limited movement in the temporomandibular joint. In the elderly, in addition to physical factors such as chronic diseases, medication use, chewing and swallowing disorders, decreased sense of taste, physical impairments, and reduced mobility leading to decreased food intake, various psychological and social factors also lead to nutritional disorders.
How should oral and denture care be in the elderly?
Elderly individuals should be checked every six months in terms of oral care. However, those with poor oral hygiene and systemic diseases affecting oral tissues should be seen at shorter intervals, such as 1-3 months. Since the gums of the elderly are not resistant to mechanical forces, toothbrushes with soft bristles are recommended for these patients. Fluoridated toothpastes and mouthwashes are recommended. With fluoride applications to the teeth, the formation of root caries or the progression of initial caries can be prevented. Since the interdental spaces resulting from the loss of gum tissue will cause food accumulation, these areas should be cleaned with interdental brushes and dental floss. In bedridden patients who cannot perform oral care, this procedure is performed by family members and assistant healthcare personnel. Since tooth loss is high in the elderly, the remaining teeth play an important role in the retention of fixed or removable prostheses. Therefore, the treatment of decayed teeth is necessary. Some medications taken continuously can cause dry mouth. Saliva is a natural secretion that protects teeth against decay, so consult your dentist if there is a decrease in saliva secretion. Dentures should be cleaned with a denture brush after meals and must be removed at night. Your gums also need to rest and air out. Removed dentures should be kept in cold water. In addition, denture cleaning tablets help to rid dentures of microbes.