This podcast discusses the importance of older adults maintaing good oral health habits. It is primarily targeted to public health and aging services professionals. Created: 10/27/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).
Date Released: 10/27/2008. Series Name: Healthy Aging.
This podcast is presented by the Centers for Disease Control and Prevention. CDC – safer, healthier people.
The CDC wants you to know about the importance of preventing oral diseases among older Americans. Oral diseases and conditions can affect a person’s general health and well-being. Besides affecting speech, laughter, and social expression, oral problems can lead to needless pain and suffering, difficulty chewing and swallowing, loss of self-esteem, and higher health care costs. There also are several serious health conditions that can affect one’s oral health. Therefore, experts agree, oral health and general health are inseparable.
Many people mistakenly believe that losing one’s teeth is an inevitable part of aging and that there is nothing they can do about it. In the 1950s, just over half of older adults kept their teeth. But now, almost three-fourths of the nation’s 37 million adults age 65 and older keep their teeth into old age. This means, however, that older adults need to keep up good oral health practices to maintain healthy teeth and gums - that is, brush daily with a fluoride toothpaste, floss, drink fluoridated water, and get regular professional dental care.
The risk for oral problems may also increase with age for a variety of reasons, including dry mouth and receding gums that expose softer root surfaces to decay-causing bacteria. Older adults often have difficulties with flossing and brushing due to poor vision, impaired ability to process information, chronic diseases, such as arthritis, physical disabilities, and financial limitations.
Dry mouth can be a particularly harmful problem for older adults. Saliva is needed to lubricate the mouth and gums, reduce bacterial growth, and provide important minerals to heal tooth surfaces where tooth decay is just beginning. More than 400 commonly used medications, including antihistamines, diuretics, and antidepressants, can cause dry mouth. In addition, many medical treatments, such as head and neck radiation or chemotherapy, can reduce or stop the flow of saliva and cause oral tissues to become red, swollen, and painful. Dry mouth can also be a sign of certain diseases and conditions, such as diabetes, Parkinson’s disease, and Sjögren’s syndrome. Sjögren’s syndrome is a disorder in which immune cells attack and destroy the glands that produce tears and saliva.
To relieve the symptoms of dry mouth and prevent oral problems, dentists and other health professionals recommend drinking extra water and reducing consumption of sugar, caffeine, alcohol, and tobacco. They may also suggest buying artificial saliva, which is available at most drug stores, or sucking on sugar-free hard candy to stimulate saliva.
Older individuals are also at risk for serious, life threatening oral diseases. Each year, about 34,000 Americans are diagnosed with mouth and throat cancers, which can result in disfigurement and death. There are about 7500 deaths annually from oral cancers. The average age of people diagnosed with oral cancer is 60; these cancers occur twice as often in men than in women and more frequently in African American men. The primary risk factors for oral cancers are tobacco use and heavy alcohol consumption. Approximately 10 percent of Americans over age 65 are smokers. The prognosis for oral cancers is generally poor, partly because, in the early stages, they can be painless and difficult to identify, so they’re often diagnosed during later stages.
Periodontal, or gum, diseases are also associated with diabetes, and there is emerging evidence of a relationship between severe periodontal disease and heart disease and stroke.
Older adults should avoid smoking or other tobacco products, use alcohol only in moderation, and be conscious of maintaining a healthy and nutritious diet. Dedication to these habits can help ensure healthy teeth and good oral health for a lifetime.
Seniors who are homebound or in nursing homes - even those who no longer have their teeth or wear dentures - should receive regular oral examinations and dental care. Many of these seniors need daily assistance with oral hygiene, which is critical to maintain a healthy, comfortable mouth. The use of fluoride products - especially brushing with fluoride toothpaste - is important. Fluoride mouth rinses, varnishes, or supplements may also be recommended.
CDC currently is supporting state-based programs to promote oral health across the lifespan. Key activities focus on monitoring oral health status and implementing effective prevention programs, such as water fluoridation. CDC works with the states to track oral diseases and target prevention programs to populations at greatest risk. It supports Web-based information systems, such as the National Oral Health Surveillance System at www.cdc.gov/nohss that link oral health data from various state-based systems, such as the adult-focused Behavioral Risk Factor Surveillance System. CDC also works with states to expand proven prevention strategies, such as water fluoridation and tobacco cessation programs that can improve health and reduce health care costs. Currently, 100 million Americans still do not have access to water that contains enough fluoride to protect their teeth.
CDC also has provided resources to expand partnerships among the aging services network, such as local Offices on Aging, and other key stakeholders, such as state dental directors, dental and other health professionals, such as nurses and home health aides; and schools of dentistry and dental hygiene.
For Fiscal Years 2008 and 2009, CDC is partnering with the National Association of Chronic Disease Directors in a program called Opportunity Grants for Healthy Aging. These grants will help state health departments develop their readiness related to aging. Two awards of approximately $25,000 were made specifically for projects to address oral health needs of seniors in Alaska and Connecticut. A third project funded in North Carolina also includes an oral health component.
For many older adults, their need for dental preventive and treatment services may increase at a time when their annual income is shrinking or fixed at a minimal amount. Most older adults pay for dental services out-of-pocket because dental insurance coverage usually ends when they retire. Furthermore, Medicare does not cover routine dental services, and Medicaid coverage, which is for low-income people, has limited routine dental services which are available in less than half the states.
More resources are needed to expand the focus of state oral health programs to older adults. The primary barrier to the provision of prevention services to older adults is a lack of funding for such programs.