Helping an Older Loved One Maintain Good Oral Health

When caring for an older loved one with a chronic health condition or serious health concern, you most likely take them to regular appointments with doctors or specialists to assure that they are healthy and in the best possible condition. But with all these important appointments to manage, do you remember to bring your loved one in for a biannual appointment with their dentist? Though oral health may seem like a smaller concern compared to taking care of a loved one’s chronic health condition or other health issues, a healthy mouth can play an important role in their overall wellbeing, self-image and nutrition.     

Why is oral health important for older adults?

Though there have been many advancements in oral health care over the recent decades such as fluoride, teeth aligners and improved detection and treatment of cavities and gum diseases, most older adults did not benefit from these relatively new innovations in their childhood. As a result, many older adults experience cavities, gum disease and decay, and may have also lost teeth and require the use of dentures.

Studies show that not only can poor oral health result in additional health complications, but certain health conditions can also in turn have a negative impact on your loved one’s oral health and cause them additional pain and discomfort. For example, adults with diabetes and respiratory diseases have a greater risk of gum disease, and adults with osteoporosis have an increased risk of severe jaw pain. Gum disease is also a risk factor in cardiovascular disease and strokes (Dolan TA, Berkey D. Planning for the future. In: Friedman PK, ed. Geriatric Denistry: Caring for Our Aging Population. Ames, IA: John Wiley & Sons; 2014:303).

Oral health also plays an important role in appearance, socializing and nutrition. A loved one with poor oral health may feel less confident in their self-image and have a lower desire to interact with others. Poor oral health can also lead to difficulties in chewing, eating and swallowing, which can in turn lead your loved one to cut back on their food and beverage intake, putting them at risk of malnutrition (Polser I, Schimmel N, Müller F, Biffar R. Edentulism as part of the general health problems of elderly adults. Int Dent J. 2010;60[3]:143-155).

What are some barriers older adults may face in maintaining their oral health?

Though oral health is an important part of a loved one’s care, there may be barriers that prevent them from getting the dental care they need, such as:

• Difficulty covering costs. Dental care is not currently covered by Medicare, and a loved one may no longer have access to dental insurance if they are retired.
• Low prioritization. Both older adults and their caregivers may view routine or specialized oral health care as a lower priority to receiving care for a chronic health condition, or treatment for another disease. Oral health is also typically held as a lower priority in long-term care facilities, with residents generally having very limited access to dental care (Dirks SJ. Nursing facility dentistry. Generations. 2016;40[3]:52-59).
• Perception. A study on perceptions of oral health showed that adults with lower levels of education were less likely to understand the ins and outs of oral health, and very likely to fail to recognize their own oral health symptoms.
• Health conditions. Certain health problems may affect a loved one’s ability to manipulate toothbrushes and dental floss, or to remember to regularly brush their teeth.
• Transportation. Many older adults with mobility issues may have difficulties traveling to a dental clinic, especially in rural areas where these clinics may not be widespread.

How can you help your loved one maintain good oral health?

To make a loved one’s oral health a priority, consider: 

• Scheduling your loved one for biannual dentist appointments
• Making sure they are brushing and flossing regularly
• Asking them if they are experiencing any mouth pain
• Assessing whether they can use a toothbrush and dental floss without difficulties
• Providing them with assistance if they need help brushing or flossing, or asking another trusted family member or friend for help

If your loved one is struggling to manage the cost of dental care, discuss payment plans for non-emergency procedures with your loved one’s dentist and request estimates in advance, so you can plan a budget. You may also want to consider exploring low-cost dental schools, public dental clinics or the Donated Dental Services Program, which provides free dental care to adults over the age of 65 with permanent disabilities or severe health conditions. 

If transportation is an issue, talk to your loved one’s family and friends to see if anyone is available to drive them to appointments, or look into ridesharing companies that offer special services for those traveling to health appointments, such as Uber Health. If your loved one receives Medical Assistance, they can also use the Medical Assistance Transportation Program.

There are also certain tools we can use to make our loved one’s oral care simpler. A team from Benjamin Rose Institute on Aging, led by Dr. Farida Ejaz, assessed the effectiveness of Daily Dental Care oral lozenges, a supplemental oral care product which promotes strong teeth and healthy gums, on the dental health of older adults. Introducing oral health supplements such as lozenges and mouthwashes into your loved one’s routine can help eliminate bacteria in tandem with their daily brushing routine.

If your loved one has difficulties using dental floss or toothbrushes, water flossers and electric toothbrushes may be simpler for them to manipulate. If you are unfamiliar with these products, ask your loved one’s doctor for recommendations and more information.

By helping your loved one maintain a healthy mouth, you can support their overall wellbeing and keep their smile looking as bright and confident as it can be.