Oral Health Plays Greater Role in Overall Health As We Age

Dentistry Today
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While oral health is vital to overall health for people of all ages, it is especially critical for older adults, report experts at UConn Health, who note the potential complications that can arise from poor oral hygiene and the role of all healthcare professionals in working to promote good oral hygiene in this population.

“All healthcare professionals should work to promote good oral hygiene for their older patients,” said Patrick Coll, MD, professor of family medicine and medicine at the UConn School of Medicine and lead author of the story, adding that they “should consider an oral examination during an annual wellness visit, especially for those patients who are not receiving regular dental care.”

The need is evident, the researchers report. Data from the National Center for Health Statistics indicates that the prevalence of cavities is more than twice as high in older adults than younger adults. The prevalence of periodontitis also increases with age, with as many as 64% of older adults in the United States suffering from it, the researchers note.

Periodontitis is associated with a variety of medical conditions include cardiovascular disease and diabetes. Patients with replacement heart valves and prosthetic joints should be particularly careful regarding their oral hygiene, the researchers caution. Also, the manipulation of teeth and their support structures can result in oral bacteria entering the bloodstream, leading to infections in parts of the body far removed from the oral cavity.

“Even toothbrushing for those who have poor oral hygiene can cause bacteria to be released into the bloodstream, and these bacteria can potentially cause joint infections and heart valve infections,” said Coll.

Without good oral hygiene, the use of fluoride, and regular dental care, older adults are more prone to damage to the oral cavity and the extension of infection into surrounding tissues. For example, tooth lost can affect the ability to chew, leading to malnutrition. Chronic oral infection is a risk factor for heart disease and can lead to infection in artificial joints and endocardia implants. 

Several populations of older adults who are at increased risk for oral health problems including patients with diabetes, patients with dementia, and those in long-term care settings. Patients with dementia, particularly those with advanced dementia, may neglect their oral health and may be reluctant to see a dental hygienist.

Also, many residents in nursing homes do not receive adequate dental care, despite federal requirements for these facilities to provide both routine and emergency dental care. Nursing homes, the researchers said, should adopt risk assessment tools to identify patients at high risk for poor oral hygiene and educate staff on the importance of good oral hygiene and how to provide it.

The researchers recommend that all older adults should have biannual dental cleanings performed by a hygienist and a biannual oral health assessment by their dentist.

“Your mouth is a mirror to your body,” said Sree Raghavendra, DMD, coauthor of the study and assistant professor in the Department of Craniofacial Sciences at the UConn School of Dental Medicine. “This article is a prime example of true interprofessional collaboration that emphasizes the importance of the entire healthcare team coming together to take care of all of our patients and especially our geriatric population.” 

The study, “The Prevention of Infections in Older Adults: Oral Health,” was published by the Journal of the American Geriatrics Society.

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