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Dental Health in Old Age

4 January 2024

Oral and dental health have tremendous effects on daily function and the quality of life in several areas: eating, speaking, social connections, reduced risk for diseases and promoting overall emotional well-being and health.

Conditions such as increasing difficulty in maintaining oral hygiene, as well as gum diseases, caries, fungus in the oral cavity, cancer of the oral cavity and lips, may develop in older adults.

The following recommendations are intended to reduce such problems and improve and maintain oral and dental health throughout our lifetime:

  • Teeth brushing and maintaining oral hygiene.
  • Thorough cleaning of dentures.
  • Periodic oral exam at the dentist.
  • Smoking cessation.
  • Reduced intake of alcoholic drinks.
  • Healthy nutrition, rich in fresh fruits and vegetables, with low sugar.
  • Treating of conditions such as lesions and oral fungus.

Older adults who are 72 years or older are eligible for dental care services covered by the health basket, which includes an examination and descaling without any required copayment. However, other dental treatments may require copayment as detailed in the health basket guidelines.

Oral and dental health have tremendous effects on daily function and the quality of life in several areas: eating, speaking, social connections and promoting overall emotional wellbeing and health. Oral and dental health can be typically maintained throughout our lifetime, and in old age specifically, in several ways: adopting healthy habits such as maintaining oral hygiene habits, eating a balanced diet and medical follow-up. Receiving dental care is possible through the health basket services.

Dental care for senior citizens according to the healthcare basket

As part of the health basket services, patients who are 72 years old and over are eligible for dental care. This includes an annual examination, bitewing x-ray, and descaling, which do not require any copayment. Other treatments require low copayment according to the type of treatment.

Exercise of eligibility: contact your HMO to exercise your eligibility for the dental clinic according to the agreement with the HMO.

For further details: dental care for old age included in the healthcare basket

Common dental problems among older adults

Regardless of whether you are active, independent and maintain a healthy lifestyle, if you are aged 65 and over, you probably feel the effects of aging in your body. Oral and dental problems typical of this age also appear:

  • Poor oral hygiene: Health issues, mobility limitations, or function problems may appear in old age, and as a result it can be challenging to brush teeth or keep up with oral hygiene.
  • Gum diseases: Infection-driven inflammatory disease in tooth-supporting tissues may cause gum bleeding, bad breath, gum recession, and tooth shifting which may lead to tooth loss. Gum disease may also influence other diseases, including heart disease, stroke, and diabetes.
  • Caries: The risk of developing caries (a disease that causes cavities in the teeth) increases with age, due to exposed tooth roots caused by receding gums, multiplicity of old restorations (fillings) and mouth dryness, sometimes caused by medication side effects.
  • Oral fungus: If you wear dentures, take antibiotics or steroids for a long period of time, you have diabetes, a suppressed immune system, mouth dryness or poor nutrition, it is important to know you are at risk for oral fungus.
  • Soft tissue lesions: If you wear dentures, it is important to be aware that you may suffer from legions under the dentures. Usually, a lesion is formed due to the dentures rubbing against the oral cavity.
  • Lip and oral cavity cancer: The risk of getting lip and oral cavity cancer is higher over the age of 60. If you smoke, consume alcohol, or frequently expose yourself to the sun, you are at a higher risk.

Recommendations for maintaining oral and dental health

  • It is recommended to brush your teeth twice a day with a soft toothbrush and toothpaste containing fluoride. You can consult your pharmacist or your dentist about a recommended toothpaste.
  • If you have limited mobility, you should check the possibility of an electric toothbrush, which can help brush your teeth thoroughly all over the mouth.
  • Cleaning your mouth can be complemented by using teeth cleaning aids (dental floss, etc.), and you can consult your dental hygienist or your dentist about tooth cleaning suitable for your oral condition.

Dentures are commonly used among older adults because they replace natural teeth that have been lost over the years. It is important to be aware that bacteria adhere to dentures in the same manner they adhere to natural teeth, therefore it is essential to maintain regular cleaning of the dentures.

  • Daily cleaning: clean the dentures daily and remove them from your mouth during the night.
  • Brushing: it is recommended to brush your dentures with a designated toothbrush.
  • Washing: after brushing, you can thoroughly wash and dry your dentures.
  • Maintenance: when the dentures are not in your mouth, it is important to soak them in an antiseptic solution designated for dentures, according to the instructions.

During a visit at the dentist, it is important to update them of any medical change, including medication intake change.

Patients over the age of 72 are eligible for dental care as part of the health basket services. Annual checkup, bitewing x-ray, and descaling do not require any copayment. Other treatments require low copayment according to the type of treatment.

If a lesion persists in your oral cavity for more than two weeks, it is recommended to consult a dentist for evaluation.

It is important to know: Early stages of oral cancer do not necessarily cause pain or any oral changes, but occasionally the disease can be diagnosed through a routine dental checkup.

There are many good reasons to quit smoking and when it comes to oral health, there are three main reasons:

  • Smoking is a risk factor for oral cancer.
  • Smoking may aggravate gum inflammation and diseases.
  • Smoking has a bad effect on recovery after dental treatments and on integration of dental implants.

For further information on smoking cessation

Alcohol is a risk factor for oral cancer, and therefore it is recommended to reduce consumption of alcoholic drinks.

Healthy nutrition, rich with fresh fruits and vegetables, is essential for maintaining overall health and particularly oral health. Reducing high-sugar foods will protect the teeth from caries and help prevent tooth cavities.

Further information on healthy nutrition among older adults

If you experience dryness in your mouth, it is advisable to consult your regular family doctor and dentist to determine the underlying cause. The treatment you receive will be according to the reason of dryness.

To help ease mouth dryness, it is recommended to drink plenty of water throughout the day and chew sugar free gum or suck sugar-free candy.

  • Maintaining oral hygiene and cleaning dentures daily is very helpful in preventing fungus.
  • It is recommended to visit a dentist for a checkup if a fungal lesion appears in the mouth.

If you have had tooth extraction or some of your teeth have fallen or were broken, your dentist will consider a rehabilitation of the gap though dentures or implants. Two options of rehabilitative treatment may be suggested: removable dentures that simulate the natural dental system and replace the missing teeth aesthetically as well functionally.

  • Full dentures designated to replace all the teeth in one of the jaws or in both.
  • Partial dentures designated to replace a few missing teeth.

Wearing dentures over implants: a denture supported by dental implants.

Another option is a bridge or an implant-supported bridge rehabilitation. This way, the gap left by the missing teeth is filled by a bridge supported by the natural teeth or by implants.