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ORAL HEALTH CARE

AMONG OLDER PERSONS

ALBERT CANTOS D.D.S, CLINICAL ASSISTANT

PROFESSOR, FELLOW AMERICAN ACADEMY OF ORAL

MEDICINE, FELLOW SPECIAL CARE DENTAL

ASSOCIATION

ORAL HEALTH CARE AMONG

OLDER PERSONS

NEW YORK STATEWIDE SENIOR ACTION COUNCIL

PRESENTATION

WWW.NYSENIOR.ORG

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Dr. Albert Cantos , DDS

•Fellowships in Oral Medicine and Special Care Dentistry

•Practicing Dentistry over 37 years

•Treated SNF patients over 20 years

•Educator in Geriatric Dentistry and Oral Medicine more then 15 years

•Treated homebound patients for many years

acantos@buffalo.edu

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Why is Oral Heath(care) Important

• Relationship to systemic health

• Cardiovascular disease…correlations

• Diabetes….bidirectional relationship

• Pneumonia….inhalation of bacteria , debris…more common in older adults

• Infection….local and systemic

• Choking….due to diminished chewing ability

• Reliable predictor of physical frailty

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Why is Oral Heath(care) Important

•Poor Nutrition when function is poor•Fat, sugar ↑•vitamins, leafy and fibrous foods ↓

•Psycho-social impacts of poor oral health•Psychosocial-embarrassment eating/talking

•Accelerated dementia due to withdrawal•Depression/ low self esteem

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Older Adults-what’s different

•Multiple medications leading to dry mouth or side effects

•Dry mouth due to damaged salivary glands-radiotherapy

•Decreased immune defenses

•Frailty, cognitive deficit or physical disability leading to poor oral hygiene

•Access issues (economic or mobility)

•Use of prosthesis

•Sometimes see acclamation to discomfort

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Medical Therapies which require an infection free mouth to minimize adverse outcomes

•Joint replacement surgery

•Cardiac surgery

•Chemotherapy

•Radiation therapy to head and neck

•I.V. bisphosphonate therapy

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Recognizing problems in yourself or others

• Infections of the gums-gingivitis

• Infections of the tooth supporting bone-periodontitis (Pyorrhea)

• Infections of the teeth- dental caries (cavities)

• Infections of the palate , tongue , lips- Fungal infection

• Loss of function –missing teeth, poor fitting appliances

• Sores and ulcers

• Dry mouth

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Gingivitis

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Periodontitis

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Calculus

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Dental Caries (Tooth Decay)

Extensive Dental Caries

Common Dental Abscess

Fungal (Yeast) infections

Fungal (Yeast) infections

Fungal (Yeast) infections

Fungal (Yeast) infections

Dry Mouth

Oral Cancer

Oral Cancer

Oral Cancer

Denture sores

Denture sores

Toothbrush at 45 degree angle

All surfaces

Spit and rinse

After Brushing

Thoroughly rinse toothbrush

Remove excess water

Store so it can dry

Replace

quarterly

after illness

evident wear

If grip used clean and dry separately

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Flossing

Credit:Colgate Professional

https://www.colgateprofessional.com/education/patient-education/video-library/daily-flossing-technique

Credit:SA Dental Service

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Daily Denture Care• Remove dentures after each meal and rinse mouth and dentures

• Brush dentures morning and night

• Encourage pt to remove dentures at night (if caregiver)

• Soak cleaned dentures in cold water w/tablets or Listerine

• Don’t let dentures dry out

• Denture baths should be washed and dried daily

Credit:SA Dental Service

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Hold in a stable grip between fingers

Rinse well to remove saliva-very slippery

Brush all surfaces

If inner surface has been relined- brush carefully

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Never hold a lower denture like this

Credit:SA Dental Service

Squeezing too hard will break the denture

Credit:SA Dental Service

Use soft toothbrush to clean clasps

Gently brush around clasps

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36Credit:SA Dental Service

Some poorly fitting dentures can be made

comfortable and stable with adhesive

Paste powder and sticky strips

Follow directions on package

Remove all adhesive from denture and mouth

morning and night

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37Credit:SA Dental Service

Calculus is calcified plaque

Well cleaned dentures will not form much calculus

For a complete denture (all plastic) Ok to soak in vinegar or lemon juice

this will soften it and allow removal

Don’t soak partial dentures in such solutions

Heavy calculus or calculus on partials should be removed by a professional

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Resources

•Information about oral health from ADA

https://www.mouthhealthy.org/en/az-topics/o/oral-health

•A way to find a dentist from The American Dental Association

https://findadentist.ada.org

•Oral Health Guide from WEBMD

https://www.webmd.com/oral-health/default.htm

•Colgate Oral health Info

https://www.colgate.com/en-us/oral-health/life-stages/adult-oral-care/what-is-good-oral-hygiene

•Info on Oral Health for Seniors and Finding Care

https://www.toothwisdom.org•Guides to Self-care

https://www.colgateprofessional.com/education/patient-education/video-library/daily-flossing-technique

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Geriatric Oral Health Resource For Caregivers/Professionals

❖Oral Health Delivery Frameworkwww.QualisHealth.org/white-paper

❖Oral Health Nursing Education and Practice Programwww.OHNEP.org

❖Smiles for Life: A National Oral Health Curriculumhttp://www.smilesforlifeoralhealth.org/

❖Adult-Geri Interprofessional Faculty Oral Health Toolkit http://www.ohnep.org/faculty-toolkit

❖HEENOT Articlehttp://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302495

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Resources…finding help

• https://www.colgateprofessional.com/education/patient-education/video-library/daily-flossing-technique