During National Smile Month (18th May to 18th June) the Oral Health Foundation are raising awareness of important health issues, ready to put a smile on everybody's face. We are really pleased to bring you this blog from Dr Ben Atkins, President of the Oral Health Foundation.
A little more than a generation ago, around one in every three adults in the United Kingdom did not have a single one of their natural teeth. By the time older adults needed care they were unlikely to have any of their own teeth and provision of denture care and replacement dentures was relatively easy to organise.
My mother tells me as a child my gran arrived at the local fair, with a scarf around her face after having all her teeth removed at the local dentist.
Thankfully a lot has changed in the intervening years and everybody now expects to keep most, if not all, of their own teeth throughout their whole life.
But this itself poses serious problems for older people who through illness or frailty may not be able to carry out the routine oral hygiene procedures necessary to maintain their oral health. Consideration of an oral care routine should be an essential part of any care plan. It can be extremely distressing for older people no longer to be able to care for their teeth as they have always done.
First-hand accounts from older people also show how barriers stop them getting even basic oral health care.
These include anxiety from previous (outdated) experiences, issues relating to poor general health which have a knock-on effect on oral health, side-effects of medication, the cost of treatment and even the physical aspect of being unable to travel to a dentist from a care home or acute hospital.
There are also age-related issues such as forgetfulness and physical limitations, which mean even the most basic of oral health behaviour, such as twice daily brushing, becomes a more complicated process.
Poor oral health has well established links to systemic diseases such as heart disease, diabetes, pneumonia and even dementia.
Oral health is an area where care must be managed closely and carefully, as without effective intervention the outcome could be potentially deadly in elderly people with bacteria from a poorly cleaned mouth leading to aspiration pneumonia.
The medications which older people need should be monitored for any oral health side-effects which can cause further harm. One common side effect of drugs is a dry mouth. It sounds slightly innocuous but can lead to accelerated gum disease and tooth decay which link closely to severe systemic diseases.
Sadly, there is not nearly enough provision afforded to health authorities to provide in house oral health services for everyone, so it’s a case of managing elderly people’s care effectively to prevent any potential problems, as with everyone’s oral health, prevention is always better than a cure.
Many nurses and carers express embarrassment at carrying out oral hygiene for those in their care, feeling in some way this is more intimate than many of the other hygiene functions carried out. But implementing a basic provision of twice daily brushing, with a fluoride toothpaste, alongside insuring a healthy diet can be hugely effective and provide a great service for the older person, helping them to maintain their dignity by feeling they have a clean mouth.
Providing information is also key and care givers need to understand the importance of maintaining good oral health. Signposting the links to systemic diseases and psychological effects of poor oral health.
The effects of looking after our oral health does not stop at our mouth, it goes far beyond that.
Top tips for helping older people care for their teeth:
Build a relationship with local dental practices to arrange care home visits and educational materials.
Pick the right brush. Using an electric toothbrush can help people with mobility problems to reach all areas of their teeth.
Carers can help guide older people when brushing. If the older adult you are caring for is in a wheelchair, you may find it easier to stand behind them when assisting with brushing.