As reported by The Hartford Courant, March 16, 2004.

People Keep Teeth, Still Have Problems

By Korky Vann

Forget the old jokes about grandma and her false teeth. Statistics show that today's seniors are more likely to be using tooth whiteners than denture adhesives.

According to the Centers for Disease Control and Prevention, fewer than 25 percent of people over 65 are toothless. A survey by American Dental Association and Oral-B found that most respondents 65 and older said their teeth are in better condition than their parents' were at their age. More than half said a smile is the first thing they notice about other people. Almost all believe that healthy gums and teeth are very important to their overall health.

But while today's older adults are more likely to keep their teeth for a lifetime, they often have unique conditions that can affect their dental health. And as the numbers of seniors increase, so does the need for dentists skilled in the treatment of geriatric patients. A report in the current issue of the journal General Dentistry calls for dentists to "address the special needs of older patients and tailor treatment plans to fit those changing needs."

"The reality is, there are going to be more and more older patients," said Dr. James W. Little, spokesman for the Academy of General Dentistry.

Currently, though, there is no formal geriatric dentistry specialty, says Dr. Ruth Goldblatt, an assistant professor in the Department of Behavioral Sciences and Community Health at the University of Connecticut School of Dental Medicine in Farmington

"Will there be someday? I sure hope so," says Goldblatt, who is also the director of dental services at the Hebrew Home, a long-term-care facility in Bloomfield. "Older patients come with a myriad of issues that go far beyond what's going on in their mouths, and we need dentists who are able to effectively treat them."

It's a challenging task. Currently, about 85 percent of individuals 85 and older have one or more chronic illnesses, and 30 percent have three or more. Older adults take an average of six to eight medications, some of which can cause side effects detrimental to oral health. In many cases, elderly patients' immune systems are weak, making periodontal disease and other dental problems harder to manage, and recent studies have linked periodontal disease to heart disease, respiratory disease and diabetes.

Arthritis, stroke, Parkinson's, Alzheimer's and other conditions can make brushing and flossing difficult. As people age, saliva output is reduced, making them more susceptible to cavities and periodontal disease. Dry mouth can also cause problems with dentures and mouth sores. Missing teeth, ill-fitting dentures, cavities, gum disease or infection can cause difficulty eating and lead to a range of physical and emotional problems.

"Dental health problems can lead to a change in quality of life very quickly," says Goldblatt. "One or two small issues can trigger more problems. Older adults don't have the bounce-back factor of younger patients. And money is often an issue. Routine dental care is not covered under Medicare or most health insurance plans. You can't just treat the problem at hand; you have to look at the big picture."

Dental treatment should be tailored to the needs and preferences of the individual, regardless of age. Goldblatt's 80-year-old mother, for example, recently got dental implants and is doing very well. To help ensure older patients get the best possible dental care, Goldblatt suggests the following:

  • Be sure to have a list of all your medications and dosages, including vitamins, over-the-counter remedies and herbal supplements. Alert your dentist any time your medications or dosages change. Provide your dentist with a list of all your health-care providers, and be sure he or she is aware of all your health issues.
  • If you are a snowbird who winters in the south, you may have more than one dental-care provider. If so, be sure to keep each up to date on dental treatments you've received. Let your dentist know if money is a concern and what your treatment priorities are.

"Dentists need to be sure there is good communication between the patient, family members, care-givers and other health-care providers," says Goldblatt. "Patients need to be informed advocates and active participants in any dental treatment decisions."