Teeth Are Forever: Oral Teeth Are Forever: Oral Health and the Older AdultHealth and the Older Adult

Saskatchewan Dental Assistants’ AssociationSaskatchewan Dental Assistants’ Association

20122012

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REALITIES OF 2012REALITIES OF 2012

The paradigm shift relative to dental The paradigm shift relative to dental treatment…treatment…

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Societal ShiftsSocietal Shifts

Our population Our population is living longeris living longer

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In The PastIn The Past

Twenty years ago…Twenty years ago…

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Cosmetic DentistryCosmetic Dentistry

Baby Boomers have Baby Boomers have had access dental had access dental insurance programs insurance programs and extensive oral and extensive oral carecare

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Prepared Teeth forPrepared Teeth forCrown and BridgeCrown and Bridge

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Dental ImplantsDental Implants

Everybody is getting implants these days!Everybody is getting implants these days!

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Implant ProcedureImplant Procedure

Actual screws Actual screws are placed into are placed into the bone the bone structure and structure and serve as an serve as an attachment for a attachment for a replacement replacement tooth. tooth.

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A Type of Removable A Type of Removable Over-dentureOver-denture

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Actual view of implants and denture in Actual view of implants and denture in placeplaceYou need to know what you are working with and the incredible You need to know what you are working with and the incredible expense involved in these types of treatments. Caregivers need to expense involved in these types of treatments. Caregivers need to know!know!

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Implant Care ImplicationsImplant Care Implications

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Caregivers need to be aware that this type of Caregivers need to be aware that this type of dental treatment is becoming more common. dental treatment is becoming more common.

The attachments need to be cleaned on a The attachments need to be cleaned on a daily basis. daily basis.

The client will need regular dental hygiene The client will need regular dental hygiene care. care.

These attachments can break or need to be These attachments can break or need to be tightened in a dental office…tightened in a dental office…

AccessAccess

Everyone Everyone has has different different issues!issues!

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Access to CareAccess to Care

95% of the population over 65 live at home95% of the population over 65 live at home

5% are homebound5% are homebound

17% have mobility limitations17% have mobility limitations

THEREFORE over 70% can still travel to THEREFORE over 70% can still travel to the dentist.the dentist.

Majority of older adults are healthy and Majority of older adults are healthy and dependent!dependent!

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Access to CareAccess to Care

Access to care can be Access to care can be physical, geographic, physical, geographic, medical, cognitive medical, cognitive and financial…and financial…

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ORAL CARE ISSUESORAL CARE ISSUESSeniorsSeniors

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ConsiderationsConsiderations

Oral health is linked to general healthOral health is linked to general health– Chewing, swallowing & nutritionChewing, swallowing & nutrition– PainPain– Affect quality of life issues such as self image, Affect quality of life issues such as self image,

communication & social interactioncommunication & social interaction– Increased susceptibility to systemic infectious Increased susceptibility to systemic infectious

diseases, especially pneumonia…diseases, especially pneumonia…

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Dexterity IssuesDexterity Issues

Frailty: Frailty: increases the increases the need for need for regular oral regular oral assessmentassessment

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Mobility IssuesMobility Issues

Homebound: may be Homebound: may be unable to attend the unable to attend the dental office and may dental office and may have increased need have increased need for assistancefor assistance

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Considerations for Dental CareConsiderations for Dental Care

Transportation to Transportation to dental clinicdental clinic

Accompanied by a Accompanied by a caregivercaregiver

Shorter appointmentsShorter appointments

Bring a printed list of Bring a printed list of medicationsmedications

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PREVENTION & MANAGEMENTPREVENTION & MANAGEMENT

As people live longer and retain more As people live longer and retain more teeth that are often more heavily restored teeth that are often more heavily restored they will require significantly more they will require significantly more complex treatment, therefore complex treatment, therefore considerable emphasis should be placed considerable emphasis should be placed on caries prevention and education.on caries prevention and education.

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Dental ServicesDental Services

Regular check-ups with your dentistRegular check-ups with your dentist

Regularly cleaningsRegularly cleanings– May need to be as often as 4 times a yearMay need to be as often as 4 times a year– Reduces bacterial invasion of the lungsReduces bacterial invasion of the lungs

Edentulous?Edentulous?– All dental prosthesis require reassessment All dental prosthesis require reassessment

and maintenance over timeand maintenance over time– Your mouth still needs to be examinedYour mouth still needs to be examined

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PreventionPreventionBefore problems develop sound preventive Before problems develop sound preventive habits need to be adopted habits need to be adopted

Brushing twice a dayBrushing twice a day– Consider an electric toothbrushConsider an electric toothbrush

FlossingFlossing– Floss aids are available to assist an individual Floss aids are available to assist an individual

with manual dexterity issueswith manual dexterity issues

Mouth rinsesMouth rinses– Anticariogenic products (chlorhexadine rinse)Anticariogenic products (chlorhexadine rinse)

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DietDietDietary CounsellingDietary Counselling

Minimal consumption of fermentable dietary Minimal consumption of fermentable dietary sugars and carbohydratessugars and carbohydrates

Healthy betweenHealthy between meal snacksmeal snacks

Boost and Ensure are sticky and high in Boost and Ensure are sticky and high in sugar (unless sugar free)sugar (unless sugar free)

Read labels!Read labels!

Choose items with less fat, trans fat, Choose items with less fat, trans fat, saturated fat, sugar and sodiumsaturated fat, sugar and sodium

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TOOTH CLEANINGTOOTH CLEANINGRinse the Rinse the brush with brush with warm water warm water and place a and place a small amount small amount of toothpaste of toothpaste on the bristleson the bristles

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TOOTH CLEANINGTOOTH CLEANINGPlace bristles Place bristles of the brush of the brush on the tooth on the tooth and massage and massage back and forth back and forth to remove the to remove the plaque from plaque from all the all the surfaces.surfaces.

It is important It is important to brush the to brush the teeth and teeth and gums.gums.

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TOOTH CLEANINGTOOTH CLEANINGMove Move around the around the mouth in mouth in sequence, sequence, to contact to contact all of the all of the teethteeth

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TOOTH CLEANINGTOOTH CLEANING

Finally, Finally, rinse the rinse the mouth with mouth with water. water.

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FLOSSINGFLOSSINGFloss Floss comes in comes in may forms may forms (unwaxed, (unwaxed, waxed and waxed and yarn)yarn)

Select the Select the one that one that works the works the best for you.best for you.

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FLOSSINGFLOSSINGTake a 40-50 cm Take a 40-50 cm piece of floss, wind piece of floss, wind it around the middle it around the middle fingers of each fingers of each hand. Control with hand. Control with index fingers or index fingers or thumbs 5 cm of thumbs 5 cm of floss so that it can floss so that it can pass comfortable pass comfortable and flexibly and flexibly between the teeth.between the teeth.

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FLOSSINGFLOSSING

The plaque The plaque is removed is removed by moving by moving the floss up the floss up and down and down against the against the surfaces of surfaces of each tootheach tooth

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FLOSSINGFLOSSING

Make sure each Make sure each “in-between” “in-between” surface of the surface of the teeth is floss, teeth is floss, and the floss and the floss passes up and passes up and down cleaning down cleaning the tooth’s the tooth’s surface. surface. Discard the Discard the floss after use.floss after use.

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INTERPROXIMAL BRUSHESINTERPROXIMAL BRUSHES

Interproximal Interproximal brushes are brushes are brushes brushes used to clean used to clean the surfaces the surfaces between the between the teeth.teeth.

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BRUSH TECHNIQUEBRUSH TECHNIQUE

Insert the brush Insert the brush between the teeth, between the teeth, and clean with an and clean with an in-and-out motion. in-and-out motion. The brushes do The brushes do wear our so they wear our so they must be replaced, must be replaced, but can be rinsed but can be rinsed off and reused off and reused while still in good while still in good shape.shape.

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FLOSS HOLDERSFLOSS HOLDERS

The The addition of addition of a handle a handle may make may make it easier to it easier to floss. floss. There are There are several several designs.designs.

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USING A FLOSS HOLDERUSING A FLOSS HOLDER

Use the Use the floss floss holder in holder in a similar a similar manner manner to finger to finger flossing.flossing.

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GUM CLEANINGGUM CLEANING

The gum The gum around around teeth or teeth or under under dentures dentures should be should be cleaned cleaned with a brush with a brush every day.every day.

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MASSAGE GUMS & ROOF OF MOUTHMASSAGE GUMS & ROOF OF MOUTH

A toothbrush A toothbrush moistened with moistened with water can be used water can be used to massage the to massage the gums, the roof of gums, the roof of the mouth and the the mouth and the tongue. This tongue. This removes food removes food debris, improves debris, improves circulation and circulation and prevents bad prevents bad breath.breath.

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BRUSH TONGUEBRUSH TONGUE

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DENTURE CLEANINGDENTURE CLEANING

Dentures should Dentures should be removed be removed from the mouth from the mouth and brushed and brushed thoroughly at thoroughly at least once a least once a day. Clean the day. Clean the inside service. inside service. Clean over a Clean over a sink filled with sink filled with water in case water in case you drop it.you drop it.

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DENTURE CLEANINGDENTURE CLEANING

A A toothbrush toothbrush will remove will remove plaque and plaque and food food remnants remnants effectively. effectively. Avoid Avoid abrasive abrasive cleansers cleansers including including toothpaste.toothpaste.

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DENTURE CLEANINGDENTURE CLEANING

It is usually best to It is usually best to remove your dentures remove your dentures while sleeping. If you while sleeping. If you prefer to wear them prefer to wear them continuously, the continuously, the area under and area under and around the denture around the denture must be kept very must be kept very clean. clean.

Dentures should be Dentures should be dry when not in your dry when not in your mouth and should be mouth and should be stored in a marked stored in a marked container.container.

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Medical FactorsMedical Factors

Dry Mouth (Xerostomia) is caused by the Dry Mouth (Xerostomia) is caused by the natural aging process and certain natural aging process and certain medications; (blood pressure medication, medications; (blood pressure medication, antihistamines, Parkinson Disease antihistamines, Parkinson Disease medication, incontinence medications etc.)medication, incontinence medications etc.)

Stroke, arthritis & multiple sclerosis etc.Stroke, arthritis & multiple sclerosis etc.

Diabetes: bone loss, increased gingivitis, Diabetes: bone loss, increased gingivitis, slower healing times….slower healing times….

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Medical Factors (cont’)Medical Factors (cont’)

Denture sores that impair eatingDenture sores that impair eating

Candida yeast in the mouth (treat denture Candida yeast in the mouth (treat denture as well as mouth)as well as mouth)

Cancer treatment and post cancer Cancer treatment and post cancer medicationsmedications

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Zero Oral CareZero Oral Care

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Progression of Zero CareProgression of Zero Care

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Just Zero!Just Zero!

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Caries Prevention Can Include:Caries Prevention Can Include:

Xylitol sweetenerXylitol sweetener

Fluoride Products: mouthwashes, fluoride Fluoride Products: mouthwashes, fluoride varnish etc.varnish etc.

MI Paste (available at dental offices)MI Paste (available at dental offices)

Cheddar cheeseCheddar cheese

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Dry Mouth & TreatmentDry Mouth & Treatment

Dry mouth is a serious side effect of Dry mouth is a serious side effect of diseases, medication and conditionsdiseases, medication and conditions

A dry mouth can cause rampant decay, A dry mouth can cause rampant decay, difficulty swallowing, denture retention, difficulty swallowing, denture retention, bad breath, speaking difficulty and mouth bad breath, speaking difficulty and mouth sensitivitysensitivity

There are a variety of products on the There are a variety of products on the market that can lessen the effects of the market that can lessen the effects of the conditioncondition

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Long Term CareLong Term Care

Bedridden: a Bedridden: a client will client will require an require an individual care individual care plan based on plan based on accepted best accepted best care practicescare practices

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Alzheimer DiseaseAlzheimer Disease

With the progression With the progression of Alzheimer Disease of Alzheimer Disease this individual will this individual will require daily, require daily, consistent care…consistent care…

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Dental IssuesDental Issues

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Together, making a differenceTogether, making a difference

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THANK YOU!THANK YOU!

Early identification and rational management of Early identification and rational management of potential dental problems will support better health, potential dental problems will support better health, sustained function and a fun and graceful old age!sustained function and a fun and graceful old age!

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Teeth are Teeth are forever!forever!

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