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Don't neglect oral healthcare in frail, elderly: study

By Shereen Jegtvig

NEW YORK (Reuters Health) - Advancements in dentistry make it more likely that older adults will keep their teeth longer, which means ongoing oral healthcare is essential, a new study says. Unfortunately, it's not unusual for the frail and elderly to have poor oral hygiene.

"Although during recent years increasing attention has been given to improving oral health care for frail old people, there is ample evidence showing that the oral health of elderly people, in particular of care home residents is (still) poor," researchers wrote in the journal European Geriatric Medicine.

Dr. Gert-Jan van der Putten and colleagues reviewed the consequences of poor oral health and its impact on the general health of frail, elderly people. Van der Putten is with the Flemish-Netherlands Geriatric Oral Research Group in Nijmegen, the Netherlands. He was not available for an interview.

"Advances in oral health care and treatment in the past few decades have resulted in a reduced number of (toothless) individuals and the proportion of adults who retain their natural teeth until late in life has increased substantially," the authors said in the article.

But when elderly people ignore their dental hygiene or are unable to keep their mouths clean, health problems can ensue. Plus, reduced saliva production and certain medications increase the risk of oral problems, the researchers said.

The main dental consequences of poor oral care include cavities, gum disease and problems with implanted teeth.

Oral health also has an impact on health in general. Mouth problems have been tied to a higher risk of diabetes, lung conditions and heart disease.

Many frail, elderly people are not able to clean their mouths and need to rely on help from caregivers. This is especially problematic in long-term care facilities where the care must be provided by nurses and nurse assistants who may not grasp its importance, van der Putten and colleagues wrote.

They concluded that if improvements in oral healthcare aren't made, oral disease and related health issues will become a major problem for people who are frail and elderly, on par with falls, lack of mobility, incontinence and thinking and memory problems.

Thus, the researchers said, oral health "deserves significant attention of national and international politicians, policymakers, scientists and health care providers."

This is not a new problem, according to Dr. Anthony Iacopino.

Iacopino is a spokesperson for the American Dental Association and dean of the Faculty of Dentistry at the University of Manitoba in Winnipeg in Canada. He wasn't involved in the study.

"The things that are talked about in this article have been known for years," he told Reuters Health.

It's important for caregivers and adult children and grandchildren to know that elderly folks should be brushing and flossing every day, Iacopino said. If they're not able to brush and floss properly on their own, someone else needs to take care of their mouth for them.

He said the American Dental Association and state groups are working on programs to make sure dentists are available in nursing homes. Daily oral healthcare should also be provided to elderly people in long-term care centers.

"If you have any doubts about whether that's being done, perhaps spend the day there and watch the care that's been provided to be sure that mouth care is part of it. If you feel they're not getting that care, bring it to the attention of supervisors or administrators of the facility," Iacopino said.

SOURCE: http://bit.ly/1bdxcdb European Geriatric Medicine, online October 28, 2013.

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