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Dentist urges campaign to tackle crisis in oral care for elderly

Dental News by Dental News
August 1, 2021
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Dentist urges campaign to tackle crisis in oral care for elderly
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Medicines and fortified drinks are contributing to sick elderly people rapidly losing their teeth, a leading dentist said.

r Anne Twomey said elderly people with a mouth full of healthy teeth can end up with rotted teeth in the space of a few years — or even months in severe cases — when oral care is neglected.

With Irish people tending to keep their teeth longer, they can end up with infections, abscesses, and loose teeth when mouth care deteriorates with ill health or dementia.

Dr Twomey said there is a combination of factors that can cause teeth to literally snap off due to medications, sweetened diet, and poor mouth care.

“It’s a terrible storm. It’s dry mouth from medication, fortified drinks, a sweetened tooth, and people giving them sweets as comfort,” the dentist, who has a master’s degree in gerontology, said.

“There’s the inability to administer their own oral care and lack of knowledge by people who are caring for them on how serious this is. It’s a combination of things.”

Conversely, as Irish people are keeping their teeth into old age, she is seeing an increasing number of mouth issues when she is called to treat elderly patients.

“When I trained first and I was going into nursing homes, by and large I was making dentures. It was unusual to have teeth. Now I see (cases) of a full mouthful of teeth which are rotting and filthy and have not been brushed for a long time, or inadequately brushed.”

In some cases patients suffer with decay in silence as they cannot reveal the pain is coming from their mouth. 

The former President of the Irish Dental Association is calling for a national campaign to get the message to healthcare workers, nursing staff and GPs about the importance of oral care.

“People who have their teeth are healthier and able to eat everything and are pain-free. There is a total lack of awareness of prevention right across the board,” she said.

“I see infections, abscesses, and loose teeth where there is a risk of swallowing them, or the teeth can be digging into the cheeks. If the teeth rot very fast they just snap off but what’s underneath are infected roots.

“They can cause pain but if somebody is not able to express themselves they won’t be able to tell you.

“This situation can happen very quickly. Some patients are highly resistant to personal care and won’t allow anyone to brush their teeth. So the situation is dire by the time I get to see them.

“High intake of sugar accelerates the decay no end. Some of these patients are put on high sugar supplements to boost them up. But in doing so their teeth simply rot.

“The other thing I found is families will bring in 7UP or jellies or sweets. There is the continual ingestion of sugar in these patients.”

She said these cases of severe decay are often quite preventable for older people.

“There is a special high-fluoride prescription-only toothpaste but it is not free, which is a bone of contention for me as it is a wonderful thing. There are also things you can use as lubricant to reduce the dry mouth sensation.

“I often recommend an electric toothbrush because it’s easier to do someone else’s teeth with an electric toothbrush, particularly someone resistant to care. People also need to be put on a low-sugar diet.

“Quality of life is definitely better with your own teeth but only if they are healthy.” 



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