The ‘golden’ period of life is the stage reached by those in the over 65-year old generation. The expectation of every nation is an increase in proportion of the elderly in the population due to improved health care. The population of the elderly people is expected to keep rising further in the nearest future. This increase will necessitate an increased sensitivity to, and a heightened awareness of the uniqueness of the elderly patients by the dental profession. Longevity varies considerably with gender as there are more elderly women than men.
Aging process is an interesting gift to whoever experience it .Aging is multifactorial. Starts from birth. Aging is a normal process that take place at different rates in different people and sex, and within different systems of the body. From person to person, the rate of this progression really differ. As we age, our bodies change in many ways that affect the functions and forms of our cells. These changes occur little by little and progress over time.
The major results of the aging process are: reduction in the functions of the kidney, heart, lungs, heart, brain, eyes etc.; a decline in quickness of response; a changed motor and visual coordination; a decreased interest; a lowered oxygen consumption;a decreased capability of adapting to altering conditions; a decreased immune response; a decrease in gastric juice production; a reduced feeling of thirst; a reduced muscle mass; an increased fat content; hardening of soft tissues; as well as related increased incidence of cancer and age related immune conditions; sensory loss such as reduced smell perception, visual impairment, hearing defect, and tastelessness of food; digestion problems since constipation is more common in older adults due to slowed circulation, reduced sense of thirst and lessened activity level.
Apart from what we see in the general health, there are also changes in dental health, however, there could be some problems associated with these changes.
ORAL HEALTH PROBLEMS AMONG ELDERLY PEOPLE
These health problems have strong association with the socioeconomic status of individuals, with past medical and dental records of individuals, and accessibility of oral healthcare
- POOR ORAL HYGIENE- In elderly people, due to poor manual dexterity which will affect the technicality of tooth brushing and accumulated effects of lack of dental care probably due to unavailability and inaccessibility of dental clinics or unaffordability of dental services with ; the sticky stuffy substances on the teeth will lead to general poor oral hygiene
SOLUTION – oral hygiene instructions on tooth brushing and flossing, scaling and polishing and curettage
2. GUM DISEASE LEADING TO TOOTH LOSS– In elderly people, the overall effect of the poor oral hygiene will lead to the infection of the gum and the gum will become swollen, red, itchy and bleeds on tooth brushing .The attachment of the teeth to the bone becomes compromised due to lack of bone support and subsequently tooth loss is inevitable.
SOLUTION – oral hygiene instructions on tooth brushing and flossing scaling and polishing and curettag
3. TOOTH WEAR LESIONS – In elderly people, cumulative effect of wrong brushing technique, use of wrong tooth brush and effect of long term use of the teeth will cause wearing away of the teeth surface in the form of attrition, abrasion, erosion. Thus teeth becomes sensitive and appears longer, chipped-off and the gum coverage become smaller.
SOLUTION- restorative treatment which includes filling of holes, root canal treatment and crowns fabrication
4. CONSEQUENCE OF UNTREATED HOLES –Once there is a cavity/hole on any part of the teeth, be it the root or the crown, it is an irreversible process that would progress if not treated or stopped. Most adults have deep and big holes on the teeth, fractured or broken teeth that they have been nursing over time. If left untreated, there would be sensitivity , pain on chewing , swelling, headache, pus discharge, shaking teeth, jaw swelling, jaw infection , etc.
SOLUTION- restorative treatment which includes filling of holes, root canal treatment and crowns fabrication
5. TOOTH DISCOLOURATION – In the elderly people, the pulp canal (inner part of a tooth) is calcified and the tooth appears yellow. Also, the cumulative effect of plaques and calculus can also be seeing as a source of tooth discoloration with other herbs consumption and inefficient tooth brushing. Old age doesn’t mean one shouldn’t have sparkling dentition that is pleasant to the eyes
SOLUTION – at least scaling and polishing
- DRY MOUTH (Xerostomia) – Xerostomia means dry mouth resulting from reduction in or absent of saliva flow. It is not a disease, but it may be a symptom of various medical conditions and old age, a side effect of a radiation to the head and neck, or a side effect of a wide variety of medications. Among Nigerian adults, it is a common complaint. Individuals with xerostomia often complain of problems with eating, speaking, swallowing and wearing dentures. Dry, crumbly foods, such as cereals and crackers, may be particularly difficult to chew and swallow. Denture wearers may have problems with denture retention, denture sores and the tongue sticking to the palate. It can lead to markedly increased dental caries, parotid gland enlargement, of the lips ,inflammation or ulcers of the tongue and mouth soft tissues, salivary gland infection ,halitosis
SOLUTION – removal of the cause, review of medications, saliva stimulant etc.
4. ORAL CANCER – People whose diet are deficient in Vitamin A [its precursor B carotene] and in Vitamin C are associated with a higher risk of oral cancer. It is also thought that nutritional deficiency causes atrophy of the oral and other mucous membranes which render them susceptible to carcinogens. The chewing of tobacco and smoking; also Alcohol, UV-light, Chronic irritation from dental calculus, repeated trauma and ill-fitting dentures and jagged edges of restoration may play a role in localising the site of tumour development in adult.
SOLUTION– quitting tobacco consumption in any form and taking diets high in fruits and vegetables appear to confer some protection against cancer. Go to dental clinics for screening.
5. MISALIGNED TEETH – Although malocclusion/misaligned teeth as classically described is not necessarily an unhealthy/disease condition, some tooth positions are not conducive to long-term oral health.
SOLUTION- ADJUNCT TREATMENT to facilitate restorative treatment by positioning the teeth so that more ideal and conservative techniques (including implants) can be used and Improve periodontal health by eliminating plaque harbouring areas and improving the alveolar ridge contour adjacent to the teeth
6. PROBLEMS WITH WEARING PROSTHESIS such as denture
In elderly people,, dry mouth may interfere with the retention and stability of dentures in the mouth. Denture wearers may have problems with denture retention, denture sores and the tongue sticking to the palate one
SOLUTION- Dentures (artificial teeth) should not be worn by users during sleep. Acrylic type should be kept clean by overnight soaking in water or sodium hypochlorite solution, and metal dentures should be soaked in chlorhexidine. Patient may want to consider visiting their dentist more frequently and should take advantage of the opportunity to discuss their xerostomia (dry mouth).
7. MOUTH ODOUR– In elderly people, mouth odour/Halitosis is also called bad breath, malodor, offensive or foul odour. This is a common complaint in adults; it is an unpleasant smell on one’s breath that other people notice when one speaks or breaths out. In most cases of persistent bad breath, the smell comes from a buildup of bacteria within the mouth- in food debris, due to plaque and gum disease, or in a ‘coating’ on the back of the tongue.
SOLUTION- Once the cause of the condition is discovered the patient is already treated half way. Treatment modalities includes the following; scaling and polishing, flossing, tongue cleaning, oral hygiene instructions, mouth rinses etc.
The elderly are a group of people who are with us- they are special and have peculiar needs. They should thus be helped, encouraged and taught to take good care of their teeth to prevent dental diseases and to prolong their life so that they can live the rest of their lives in good general health.
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