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Dental health can change with age

More people are keeping their teeth, but illness and medication can cause problems, affecting quality of life.

March 29, 2004|Korky Vann | Hartford Courant

While today's older adults are more likely to keep their teeth for a lifetime, they often have unique conditions that can affect their dental health. And as the numbers of seniors increase, so does the need for dentists skilled in the treatment of geriatric patients.

"The reality is, there are going to be more and more older patients," said Dr. James W. Little, spokesman for the Academy of General Dentistry.

Currently, though, there is no formal geriatric dentistry specialty, says Dr. Ruth Goldblatt, an assistant professor in the Department of Behavioral Sciences and Community Health at the University of Connecticut School of Dental Medicine.

"Will there be someday? I sure hope so," said Goldblatt, who is also the director of dental services at the Hebrew Home, a long-term-care facility in Bloomfield, Conn. "Older patients come with a myriad of issues that go far beyond what's going on in their mouths, and we need dentists who are able to effectively treat them."

It's a challenging task. Currently, about 85% of people 85 and older have one or more chronic illness, and 30% have three or more. Older adults take an average of six to eight medications, some of which can cause side effects detrimental to oral health. In many cases, elderly patients' immune systems are weak, making periodontal disease and other dental problems harder to manage, and recent studies have linked periodontal disease to heart disease, respiratory disease and diabetes.

Arthritis, stroke, Parkinson's, Alzheimer's and other conditions can make brushing and flossing difficult. As people age, saliva output is reduced, making them more susceptible to cavities and periodontal disease. Missing teeth, ill-fitting dentures, cavities, gum disease or infection can cause difficulty eating as well as a range of physical and emotional problems.

"Dental health problems can lead to a change in quality of life very quickly," Goldblatt said. "One or two small issues can trigger more problems. Older adults don't have the bounce-back factor of younger patients. And money is often an issue. Routine dental care is not covered under Medicare or most health insurance plans."

Dental treatment should be tailored to the needs and preferences of the individual, regardless of age. To help ensure older patients receive the best possible dental care, Goldblatt suggests the following:

* Be sure to present your dentist with a list of your medications and dosages -- including vitamins, over-the-counter remedies and herbal supplements.

* Alert your dentist any time medications or dosages change.

* Provide your dentist with a list of all your healthcare providers, and be sure he or she is aware of all your health issues.

"Dentists need to be sure there is good communication between the patient, family members and healthcare providers," Goldblatt said. "Patients need to be informed advocates and active participants in any dental treatment decisions."

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