A trend is occurring throughout our population that even spills over to dentistry. The trend is that people are living longer and longer. As this occurs, statistics also show that Americans are keeping their teeth longer.
This is borne out in two points that come to mind. The first is a study that was done by the American Dental Association. In the early 1960s, the average 65-year-old American had seven teeth left. In the early 2000s, that number was up to 20. The second is just observation. I have had the privilege of acting as the attending dentist for two nursing homes in the area. From my own observations, it can be seen that in the nursing home population there are more and more residents which have almost a full compliment of teeth.
Now that the trend is shifting toward people keeping their teeth longer, the onus falls upon us as oral health care providers to do the best we can to provide this population with quality care.
Recent research has well established the links between periodontal disease and heart disease. Making sure that the older population has healthy gums and helping the patient to understand why this is important is of the utmost importance.
I have had the misfortune to see a person steadfastly refuse periodontal treatment and choose to have an active infection in their mouth. The sad result of this particular patient was that his knee replacement got infected. When the bacteria were cultured, it was found that they were the same bacteria that caused his gum disease. Now not only did this patient need gum disease therapy, but he also needed a new knee replacement.
The number of people in my own practice that have prosthetic joint replacements is significant, and it is important that we as dentists make sure our patients understand the damage they can be doing to themselves by not having healthy gums.
One of the other common areas of concern with the aging population retaining their teeth is keeping decay off of these teeth. Receding gums is a commonly seen thing in people as they age. The issue with the receding gums, aside from weakening the support of the tooth, is that the softer root surface is exposed to the acid attacks of the bacteria in our mouths. This root surface can't stand up to the acid attack like the hard enamel can. In fact the root surface is seven times softer than the enamel. This can make root caries a difficult thing to keep up with for a dentist.
So what can be done to help? The first and foremost is education of the patient. Making sure that they understand that prevention lies with their own self care and that the dental team is there to help. We may see a patient three to four times a year for visits with the hygiene team, which leaves another 360 days that patients have to care for themselves. There are many aids which are effective to helping.
Many times my older patients just can't coordinate flossing. In those people, I have to help them come up with another way to keep the plaque off the in-between surfaces of the teeth. Perhaps a sonic action toothbrush or a water pick would be adequate to keep these surfaces debris free.
I have had patients not be able to grip the thin toothbrush handle. Something as simple as making two slits in a tennis ball and sliding the thin toothbrush handle through will make a world of difference to letting a patient clean their own teeth.
There are other preventive measures that we can take as well. Fluoride varnishes and rinses are very effective for preventing root caries. Anti bacterial rinses work great for killing the bacteria that make plaque sticky and also killing the bacteria that cause gingivitis, the precursor to bone destroying periodontal disease.
The most important idea that I could get across is that patients need to express their concerns to their dental team. If you are having a hard time with a certain method of cleaning your teeth, bring it up because I would bet that there may be an alternative that would fit your needs. We recognize and understand that different people are going to have different needs which is why in my office there are closets full of different oral hygiene aids.
Talk to your dentist to find out what will be the best for you.
Dr. Michael K. Keating, DDS, is a dentist in Auburn and can be reached at 252-7278 or e-mail him at DrMike@FingerLakesSmiles.com
Now that the trend is shifting toward people keeping their teeth longer, the onus falls upon us as oral health care providers to do the best we can to provide this population with quality care.
Recent research has well established the links between periodontal disease and heart disease. Making sure that the older population has healthy gums and helping the patient to understand why this is important is of the utmost importance.
I have had the misfortune to see a person steadfastly refuse periodontal treatment and choose to have an active infection in their mouth. The sad result of this particular patient was that his knee replacement got infected. When the bacteria were cultured, it was found that they were the same bacteria that caused his gum disease. Now not only did this patient need gum disease therapy, but he also needed a new knee replacement.
The number of people in my own practice that have prosthetic joint replacements is significant, and it is important that we as dentists make sure our patients understand the damage they can be doing to themselves by not having healthy gums.
One of the other common areas of concern with the aging population retaining their teeth is keeping decay off of these teeth. Receding gums is a commonly seen thing in people as they age. The issue with the receding gums, aside from weakening the support of the tooth, is that the softer root surface is exposed to the acid attacks of the bacteria in our mouths. This root surface can't stand up to the acid attack like the hard enamel can. In fact the root surface is seven times softer than the enamel. This can make root caries a difficult thing to keep up with for a dentist.
So what can be done to help? The first and foremost is education of the patient. Making sure that they understand that prevention lies with their own self care and that the dental team is there to help. We may see a patient three to four times a year for visits with the hygiene team, which leaves another 360 days that patients have to care for themselves. There are many aids which are effective to helping.
Many times my older patients just can't coordinate flossing. In those people, I have to help them come up with another way to keep the plaque off the in-between surfaces of the teeth. Perhaps a sonic action toothbrush or a water pick would be adequate to keep these surfaces debris free.
I have had patients not be able to grip the thin toothbrush handle. Something as simple as making two slits in a tennis ball and sliding the thin toothbrush handle through will make a world of difference to letting a patient clean their own teeth.
There are other preventive measures that we can take as well. Fluoride varnishes and rinses are very effective for preventing root caries. Anti bacterial rinses work great for killing the bacteria that make plaque sticky and also killing the bacteria that cause gingivitis, the precursor to bone destroying periodontal disease.
The most important idea that I could get across is that patients need to express their concerns to their dental team. If you are having a hard time with a certain method of cleaning your teeth, bring it up because I would bet that there may be an alternative that would fit your needs. We recognize and understand that different people are going to have different needs which is why in my office there are closets full of different oral hygiene aids.
Talk to your dentist to find out what will be the best for you.
Dr. Michael K. Keating, DDS, is a dentist in Auburn and can be reached at 252-7278 or e-mail him at DrMike@FingerLakesSmiles.com
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