Chronic diseases not only affect senior dental patients' overall health, but may also have negative effects on their Whole Mouth Health. A key part of geriatric dentistry is helping elderly patients maintain a healthy mouth when they are coping with a systemic condition. Your patients may have Parkinson's disease or Type 2 diabetes, or experience dry mouth as a result of medication use or another condition. How exactly do these chronic problems affect the mouth and how can you best care for your patients?
Declining motor skills and tremors can make brushing and flossing difficult for patients with Parkinson's disease. According to Parkinson's UK, this disease may cause drooling, difficulty swallowing and a sore or burning mouth. The journal Parkinson's Disease adds that patients with Parkinson's are more than twice as likely to experience dry mouth compared to the general population. Patients with Parkinson's disease may be physically unable to keep up with a home care routine or may fall behind on their oral hygiene out of frustration. All of these factors combined may put patients with Parkinson's disease at an increased risk for tooth decay and periodontal disease.
You can help by suggesting brushing aids like a toothbrush with a large, padded handle or an electric toothbrush. Establishing more frequent professional cleanings and teaching patients and caregivers about the associated oral health risks may also help improve home care and prevent oral consequences.
Parkinson's can be a frustrating and lonely disease, and sometimes a few words of encouragement can brighten a patient's day. The Davis Phinney Foundation has a helpful list of 'what to say and what not to say' to patients with Parkinson's.
Patients with diabetes, especially poorly controlled Type 2 diabetes, are at an increased risk for periodontitis and tooth loss. Evidence from the American Dental Association suggests that periodontitis can in turn raise blood sugar levels. Talk with your patients about their diet, lifestyle and any medications they use to manage their diabetes. Make sure your patients understand the pressure the disease may place on their oral health and the links between diabetes and severe gum disease.
Managing blood sugar levels and an increased focus on meticulous oral hygiene may improve Whole Mouth Health and overall health for patients with diabetes. Ask for your patient's permission to speak with their physician about their medical history and create a care plan together. Patients with diabetes are likely hearing advice on how to manage their condition from many sides, so be sure to spend as much time listening as you do recommending solutions. Additionally, your patients with diabetes may or may not be familiar with diabetes terminology. Gauge their knowledge and speak in terms that they understand. In the end, always be encouraging and supportive, never scolding.
Dry mouth (xerostomia) is a serious symptom for patients with Sjögren's syndrome, according to the American Dental Association. It results in an increased risk of caries, periodontal disease and tooth loss, as well as fungal and bacterial infections.
For your patients living with Sjögren's syndrome — as well as other autoimmune disorders, treatment for cancer, rheumatoid arthritis, and other conditions that cause dry mouth — create a plan to counteract the negative effects of dry mouth. Small, attainable steps like staying hydrated, sucking on sugar-free, non-acidic hard candies and using saliva substitutes may help patients manage their dry mouth symptoms.
Show compassion for older patients with chronic diseases by taking your time during exams. Being patient and methodical lets them know you are truly concerned and want to help. Ask a few key questions to help you determine a course of treatment:
- What overall and oral health effects have you noticed since your diagnosis?
- What medications are you taking? Have you noticed any side effects?
- Has your physician recommended any future treatments? Would you mind if I talk with them?
The patient has probably been inundated with information about their disease. It may be confusing and stressful, and they may not be able to accurately explain their disease, medications and other treatments. Talking directly with their physician may give you a clearer picture and allow you to create a complete oral health care plan.
For patients with chronic diseases, proactive oral health care is very important for reducing their caries and periodontitis risk. Ask your oldest patients to:
- Brush and floss diligently
- Use a fluoride toothpaste
- Avoid smoking
- Drink plenty of water
- Chew xylitol gum and suck on sugar-free, non-acidic candies
- Attend regular dental appointments, even with dentures
- Use an electric toothbrush to compensate for limited manual dexterity
Chronic systemic diseases can be frustrating for patients. Taking extra time to listen to the patient, consult their physician and create a successful home care plan may help improve elderly patients' Whole Mouth Health and quality of life.