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“Elderly suffer a disproportionate & debilitating amount of oral disease.” - Alliance for Aging Research TRUE or FALSE? People with Diabetes are at a greater risk of developing gum disease. Healthy eating can contribute to the condition of a an individuals mouth. Hypertension (High Blood Pressure) medications can affect your mouth. Among new military recruits in 2010, what percentage were not deployed because of significant dental issues? A. 0-40% B. 40-60% C. 60% + Heart Disease Stroke Pneumonia Diabetes “… providing mechanical oral hygiene may prevent 1 in 10 deaths from pneumonia in dependent elderly people and show similar pneumonia prevention effect.” (Sjogren, P., et al: JAGS 2008 (56); 2124-30) 35% of all Americans have some form of PD 13% have severe periodontal disease 75% of all Americans have inflammation of the gums (gingivitis) Progression of gingivitis to bone loss: Pockets form around the teeth Pockets gradually deepen, ulcerate Bone loss visible on x-rays Nearly 1/3 of people with diabetes have severe bone loss (CDC) Diabetics are 3 - 4 times more likely to develop periodontal disease (gum disease) Develop infections easier Can contribute to heart disease Can contribute to pneumonia (http://www.perio.org/consumer/mbc.diabetes.htm) Xerostomia: Dry Mouth “A feeling that there is not enough saliva in the mouth, all or most of the time.” (NIH Senior Health, 2003) A side effect of certain diseases and infections: Sjögren's syndrome HIV/AIDS Alzheimer's disease Diabetes Anemia Cystic fibrosis Crohn’s disease Systemic Lupus Erythematosis Rheumatoid arthritis Hypertension Parkinson's disease Stroke Scleroderma Hepatitis A side effect of over 500 medications: Antidepressants Antihypertensives Narcotics Anticholinergics Antipsychotics Anti-Parkinson Antiasthmatics Anorexiants Anticonvulsants Antacids Hormone replacements Diuretics Sedatives Inhalants Decongestants Glaucoma eye drops Antihistamines Pseudoephedrine (USDHHS, 2008) Dry, sticky oral tissues Thick saliva Ulcers in mouth Cracking of the corners of the mouth or tongue Bad breath Frequent yeast infections Red gums that bleed easily Increased tartar build up Increased dental decay o o o Sore or burning mouth, lips or tongue Sleep interruptions due to thirst or oral discomfort Difficulty chewing, speaking, swallowing and wearing dentures o Difficulty clearing leftover food in the mouth o Patient may avoid eating dry foods Dry mouth may contribute to: Inflammation Yeast infections Tooth decay Gum disease …the longer one waits Over the counter products might be sufficient Talk with doctor/ dentist for prescriptions AVOID SUGAR CANDY Sugar-Free Candies Okay! Handle with great care – very expensive Brush & rinse dentures daily – soft bristles designed for dentures Clean with denture cleanser – NOT toothpaste Dentures need to be kept moist when not worn Important to remove to allow oxygen to get to tissues Put in denture case NOT a Kleenex/paper towel! Remember to still brush gums and palate ONLY a dentist/ prosthodontist should adjust dentures Conditions with a high risk of infection antibiotics are recommended prior to some dental procedures Most conditions of the heart, pace makers, heart valves etc. Check with doctor/dentist (http://www.mouthhealthy.org/en/az-topics/p/Premedication-or-Antibiotics) Aging in general increases the risk of oral cancer Dry mouth from RX’s Eventually dependant on care giver Early stages help remind about daily brushing Increase fluoride treatments Use alcohol-based pen to write name on dentures Be SMART brushers ◦ 2x day for 2 minutes Floss daily Prevent dry mouth ◦ Biotene or generic brand ◦ Keep mouth moist! Eat healthy fruits & vegetables Use floss holders Arthritis or other conditions that limit movement… • • Electric toothbrush Duck tape a golf ball securely to handle of regular toothbrush NEVER put your fingers between teeth Studies show professional teeth cleaning lowers inflammation and pain in Arthritis patients… (http://www.arthritistoday.org/news/gum-disease.php) (South Australian Dental Service, 2009) Fear if being touched Not opening mouth Not understanding or responding to directions Biting the toothbrush Grabbing or hitting out (South Australian Dental Service, 2009) Talk clearly, mime Allow resident to inspect the items Right environment Body language Overcoming fear of being touched ◦ ◦ ◦ ◦ ◦ Bridging Chaining Hand over hand Distraction Rescuing (South Australian Dental Service, 2009) Bleeding gums Sore mouth or tongue Sore corners of mouth, tongue Thrush (candidiasis) Gum disease (gingivitis) or severe gum disease (periodontitis) Ulcers and sore spots Dry mouth Tooth decay, root decay, retained tooth roots Dentures that are illfitting or require attention Maintain a healthy diet in order to maintain good: • Physical condition • Memory • Bone health • Eye health • Blood circulation • Immune system • ORAL HEALTH Half of plate = fruits and vegetables At least half of grains = whole grains Vary protein choices Cut back on foods that are high in sodium or fat Drink plenty of fluids ◦ As we age, we start loosing our sense of thirst. Exercise! (USDA MyPlate, 2013) Any Questions??? http://www.mouthhealthy.org/en/adults-over-60/healthy-habits.aspx