Dental care for older adults

The importance of dental care for older adults

Dental care is one of the most important aspects of personal hygiene for older adults, but it is not always an easy or achievable practice for those who suffer from mobility, dexterity or cognitive limitations. Here, we are taking a look at the importance of dental care for older people, including the common issues they may experience and how to manage them, the importance of regular dental check-ups, daily dental hygiene practices, the role diet and nutrition play in dental care, and how to support older adults with dental hygiene if you are caring for a loved one At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about dental care for older adults, we can help. 

What are some common dental issues older adults encounter, and how can they manage them? 

Older adults may experience more dental issues than younger people for a number of reasons. Firstly, years of general wear-and-tear leads to enamel wearing down over time, making teeth more susceptible to problems, and causing gums to recede. Older adults may also be taking more medications than younger people do, which can cause certain side effects such as dry mouth. In general, the ageing process can lead to a higher risk of infections developing, which means even small, seemingly insignificant issues should be treated straight away to prevent their escalation. Some dental issues that older adults commonly encounter include:

Gum Disease 

Otherwise known as periodontitis, gum disease is often the result of a plaque buildup. If this is left untreated, it can result in pain and discomfort, tooth loss, and other health problems. Periodontal disease affects more than 60% of older adults, and is thought to be the result of decreased immunity, poor dexterity for brushing, and other impairments leading to difficulty maintaining oral hygiene practices. Gum disease can be prevented through regular brushing, flossing and professional cleanings, but this can be challenging for older adults who may require help to do so. 

Tooth Decay

Tooth decay can happen to anyone, but the likelihood increases with age due to factors like receding gums and dry mouth. While dealing with tooth decay may be easier for younger people, those who are older with other health conditions may find treating tooth decay is a much bigger endeavour than it once was, and could heal more slowly due to a weakened immune system. Tooth decay can be prevented by using a dentist-recommended toothpaste, maintaining a healthy diet low in sugar to prevent cavities, and ensuring teeth are brushed at minimum twice a day, even if this means help is required from a home carer. Tooth decay can also lead to tooth sensitivity, and if this happens a desensitising toothpaste should be used, and very hot or cold food and drinks avoided.  

Dry Mouth 

Dry mouth is sometimes called xerostomia, and is a condition much more common in older adults. This is because older adults tend to take more medications for other health conditions, and these can have side effects such as dry mouth. While this may not sound like a big problem, it can be incredibly uncomfortable, affect food intake, and can eventually lead to increased risk of tooth decay. The best ways to combat dry mouth are to drink plenty of liquids throughout the day, chew sugar-free gum to encourage natural saliva production, avoid smoking or alcohol which can dry the mouth further, and use saliva substitutes – these are artificial mucus secretions that can relieve dry mouth and help with things like swallowing medication.

Tooth Loss

Older people tend to have less teeth due to tooth loss, and while this isn’t always a painful thing, it can have a negative impact on functions such as chewing and speaking, and can impact nutrition and quality of life in the long run. According to 2021 UK data, older adults are more likely to have dental prosthetics such as dentures, bridges or implants to help restore function and appearance of teeth, and these require maintenance too. That said, not all older people are destined to lose all of their teeth; with proper dental care, teeth can be preserved for a better quality of life. If you have dentures or another device, or are caring for a loved one who wears dentures, ensure you adhere to a proper cleaning and maintenance regime to prevent bacteria entering the mouth, ensure comfort, and stop infections from developing.

Oral Cancer

Older adults have a higher risk of oral cancer than younger people do, and as a result, should get regular screenings for any signs of this. According to the Mouth Cancer Foundation, 78% of mouth cancer cases occur in those aged 55+, so taking care of oral health is arguably more important for older adults. This is more common in those who smoke, so stopping smoking could help to reduce your risk. If you need support to stop smoking, you can look for local resources and groups to help, and speak to your GP for advice. 

General Mouth Issues

Other health issues involving the mouth may make brushing teeth more challenging for some. An example of this is swallowing difficulties, also known as dysphagia. This can make brushing your teeth more of a risk due to the potential for aspiration, meaning liquid could enter the airway instead of the stomach, resulting in issues such as pneumonia. Those with health conditions like age-related muscle weakness, neurological conditions such as Parkinson’s disease or dementia, chronic conditions, decreased saliva production and more may need assistance with dental care. This could be in the form of a home carer or a loved one who can oversee them brushing their teeth and carrying out other oral health tasks. If they cannot do this under supervision, a carer or loved one may need to do this for them.

Why are regular dental check-ups so important for older adults?

Regular dental check-ups are essential for older adults to maintain good physical health, but can also be fundamental for overall wellbeing and positive mental health. Few people feel clean and fresh when they have not brushed their teeth, and going many months or even years without visiting a dentist can lead to worries about tooth health that can cause anxiety to build. Studies suggest around 35% of older adults have not seen a dentist in the last year, meaning issues can accumulate and get worse with time. Dentists can check for early signs of cavities, gum disease and other conditions, as well as providing personalised advice and recommending specific products that could help increase the comfort of an older person with dentures or other oral devices. In addition, a hygienist can provide deep cleanings to remove plaque and tartar from hard-to-reach places, and leave older people with a feeling of fresh, clean, healthy teeth. Remember, as we age, we become more susceptible to dental issues like gum disease, tooth decay, dry mouth and oral cancer, so routine visits to the dentist or another oral health specialist (such as an orthodontist, or dentists who specialise in geriatric dentistry) can ensure early detection and treatment of troublesome conditions, preventing further complications and ensuring older people are not left in pain or discomfort for long. For conditions like oral cancer, early detection could even be life-saving. Regular check-ups are also absolutely vital for those with dementia, neurological issues or other conditions that may make it difficult to convey any pain they are experiencing. For those caring for an older adult who struggles to speak or share their emotions and ask for what they need, picking up on any subtle signs of pain can be difficult. Instead, daily oral care and regular check-ups from a professional can help to ensure they are never in a situation where they feel pain and cannot tell anyone. You can read more about managing pain in those with dementia in our guide to living with dementia.Age UK recommends older adults seek dental check-ups every 12 months, but a dental professional may recommend they visit as often as every 3 months depending on their health and any specific conditions they have. Keep in mind, while people of pension age do not receive free dental check-ups, those who are on certain benefits can receive these for free, so take a look at what benefits may result in free dental checks. 

How can older adults take care of their dental health?

Daily dental hygiene practices for older adults (or their caregivers, if the person is unable to perform these alone) should include:

• Brushing teeth – it is recommended to do this at least twice a day using a fluoride toothpaste
• Flossing to remove food particles and plaque from between teeth 
• Using an antiseptic mouthwash to freshen breath and ensure good oral hygiene, and reduce the amount of bacteria in the mouth that could lead to infections
• Hydrating the mouth if needed, to alleviate the feeling of dry mouth and improve oral health
• Performing regular checks for early signs of issues, such as sores in the mouth, redness around dentures, and anything else that could lead to pain down the line 
• Maintain a regular dental check-up by keeping up to date with appointments

In what ways can loved ones support older adults with dental hygiene?

If you are caring for a loved one who struggles to maintain their own oral hygiene due to mobility issues or dexterity issues then you may need to take steps to support them in maintaining their oral health. Similarly, if your loved one has neurological issues that make the importance of this daily task difficult to grasp, you may need to take responsibility for their teeth cleaning. If possible, try to encourage your loved one to take ownership of this task and to do it independently if they can. You can also educate them on why this is important for their health and to avoid painful dental issues. Those who suffer from dexterity issues may find some adaptive devices useful such as hand grips, electric toothbrushes or toothbrushes with a small head.If you are required to help them with this task, create a daily routine prioritising oral care twice a day, and discuss any specific requests they have. For example, do they prefer to clean their teeth before or after they eat breakfast in the morning? Or do they prefer the taste of a certain type of toothpaste? Take into account any current health issues they have that could affect their daily teeth brushing, such as difficulty swallowing, and make sure you carry out this task in an environment that makes the process comfortable for them. This might mean brushing their teeth in their living room chair, or with a bowl under their chin to avoid dripping on their clothes. It may be difficult for an older person to accept help with brushing their teeth as they will have been used to doing it themselves for so long. Make sure to treat them with respect and dignity when helping with this task so they do not feel embarrassed to ask for help. If you require assistance from a home carer, they can help with daily oral health needs, such as:  

• Preparing healthy meals that are low in sugar  
• Ensuring the person stays hydrated to avoid dry mouth
• Carrying out daily oral health checks to catch any early warning signs of cavities or other problems 
• Helping to brush and floss safely and effectively every day
• Booking regular dental check-ups with a professional, either to address any issues or as a preventative measure 
• Providing transport to and attending dental appointments for additional support 

Dental care for older adults involves so much more than simply brushing teeth; it is a vital part of their healthcare routine that should be prioritised on a daily basis. Maintaining good dental care has benefits for an older person’s overall health and wellbeing, so whether you are concerned about your own dental health or wondering how you can support an older loved one with their care, adopting and maintaining an effective dental hygiene routine should be a priority. If you feel you or a loved one could benefit from support from a home care professional to help with dental care you can get in touch with your local Home Instead office to learn more.Our Care Professionals are the best of the best, and highly trained to deliver the services you need. No matter what type of home care you are looking for, we can provide a tailored service that suits you or your loved one. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.