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Geriatric Dental Care

As age progresses, a lot of changes occur in the human body from skeletal to dental, physiological to psychological.
Their need for health care is very different from others as they have had many experiences of varied treatments through out there life. Their expectations and their level of endurance is different too. Their treatment needs have to be carefully planed. They need to be handled with lot of care, patience and a good ear.

Most geriatric patients suffer from other ailments and may be under medication or treatment for various ailments like diabetes, hypertension, cardiovascular diseases, gastric problems, depression, alzheimers, neurological disorders etc. The medication they take for such condition may also have certain side effects on the teeth, gums and other tissues in the mouth.

As age increases oral health needs are also increased as teeth starts to wear and develop caries in the roots. The gums become weak and start to recede, the tissues of the cheek become dry or rough and looses its consistency. This causes related dental problems like altered oral hygiene and speech problems. In few countries senior citizens do not bother much about their dental problems and are content with their situation as long as there is no pain.

Some alterations are observed in the oral function:
1. The posture of the lip sometimes causes drooling and angular cheilosis
2. Any alternation in the muscles which help in chewing would cause the efficiency of chewing going down.
3. As body slows down and changes in metabolism are observed, with medication for ailments it causes changes in taste perception too.
4. Salivation gets affected by certain medication causing dry mouth.
5. There are changes in the functions of the tongue. Any alteration due to age would cause change in speech, swallowing, snoring, bite injury to tongue, etc.
6. Swallowing when affected would cause in choking, nausea or vomiting.

Keeping all these in mind an elderly patient’s attitude towards dental treatment decides the out come.

Some commonly occurring dental problems in senior citizens are:
1. Decay of teeth
2. Caries in the root surface
3. Diseases of the gums
4. Dry mouth
5. Certain fungal infection in the mouth
6. Missing teeth
7. Denture related problems etc.

As age progresses the most commonly affected portion of tooth is the root. This kind of decay is known as root surface caries. As it progresses at a slow rate the condition is generally painless.

To avoid such a condition:
1. Brush daily with a fluoride tooth paste.
2. Use fluoride containing mouth washes.

These measures have shown to greatly reduce the incidence of root surface caries.

Recession of gums, attrition of teeth, loss of bone supporting the teeth is seen mainly due to poor oral hygiene.

Dry mouth or xerostomia means less saliva or absence of saliva. Saliva is necessary for keeping the mouth clean, helps in digestion, acts like a lubricant.

Signs and symptoms are burning in the mouth, dryness, changes in taste perception, difficulty in swallowing and caries of the root surface.

Approximately 80% of elderly patients receive some kind of medication and 90% of their medications cause dry mouth. Other factors which cause this condition are radiation/chemotherapy, endocrine disorders, nutritional disorders and psychological conditions.

1. Fluoride mouth wash and tooth paste.
2. Very good oral hygiene.
3. Keeping self well hydrated.
4. Artificial saliva to be given if needed.
5. Consumption of alcohol, tobacco, spicy food should be regulated.
6. Certain mouth washes with high alcohol content should be avoided.

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