I recently had a conversation with Denise Hunter, dental hygienist, around dental care and the elderly. I was quite amazed at how different oral hygiene can be for the elderly.
As a starter, appointment times need to be different – not too early in the morning, or late in the evening. The dental chair is not levered back so much as this may bring on choking, coughing or breathing difficulties. Of course getting to the surgery in the first place can be a mission – there needs to be lifts and ready access for wheelchairs.
Once in the chair elderly people need time to adjust, the head rest needs to be made comfortable, and often a pillow is needed. They cannot stay in the chair too long either. Opening the mouth fully can be uncomfortable, and of course the elderly would probably rather have a chat than actual treatments!
Unfortunately the cost of dental care is a barrier for many older people, especially when they are only on Superannuation. It is often a good idea to shop around and get different quotes if the treatment is going to be expensive. Some dentists offer discounts for SuperGold Card Holders or Community Service Card holders, and you can apply to WINZ for a non recoverable special needs grant for emergency treatment. You can also apply for an advance on your Super to pay for dentures or dental treatment. In both cases, entitlement is based on income and savings and there are limits to how much can be given.
Denise always asks her clients what medication they are on – almost all drugs have some side effects, dry mouth (lack of saliva), thrush, cold sores, ulcers – the list goes on and on! Sometimes the elderly have a broken tooth which is not reported – this can result in decay and ulcers.
What is really important is the routine you establish. The use of electric toothbrushes is recommended, but sometimes dexterity is diminished and additional assistance is required. The Arthritis Society can help with large handles for toothbrushes, which make for easier use.
Often when people retire their lifestyle changes. There is more tea and coffee taken, along with that chocolate biscuits, and more snacking. This has a detrimental effect on teeth. Also, older people tend not eat so well – often the soft food favoured by the elderly does not contain enough protein (eating steak – difficult to chew, and in any case living on their own does not always encourage much cooking from scratch). It is important to eat lots of green vegetables and an overall balanced diet.
Denise in her imitable way, asks her clients about their diet, notices facial skin changes such as moles, and in general makes a summary of the health her patient since the last time they have been in the surgery. Changes happen fast as you age, so it is important to note changes.
Tips for elderly care:
- Visit your dentist at least every six months if possible.
- Have a dental routine and make your family aware of it – especially if going into a rest home.
- An electric toothbrush is a wonderful aid – appliances which assist from arthritis society can be a game changer.
- Use a high fluoride toothpaste
- For sensitive teeth use desensitising toothpaste
- Use interdental aids, such as brushes, Reach Flosser, and Floss. Remove dentures at night.
- The use of curasept gel for gum inflammation
With many thanks to Denise Hunter, dental hygienist, at Ben Catherwood Dental Surgery, 90, The Terrace, Wellington. Phone: 472 3510.
Community Support Co Ordinator