Dentists hear it all the time, and the pain of hearing it never stops. Our elderly friends and family members confide earnestly that they are old and no longer require the care of a dentist. It is not the loss of camaraderie that concerns us; it is that this person we are close to does not understand why they still need our professional help.
For example, one elderly friend is about 80 years old. This friend has all or almost all of her teeth and no pain. Yes, she probably does not need typical dental treatments in the form of fillings, crowns or dentures. However, anyone who has teeth is likely to develop gum disease. Gum disease is not uncomfortable unless it is very advanced. The bacteria that cause gum disease may cause infections elsewhere in the body. Infection is especially likely after surgery or if the patient takes medications that lower resistance to infection.
A well known example of the effect of oral bacteria in the presence of a common medication occurs when patients take bisphosphonates. Elderly men and women take bisphosphonates such as Boneva and Fosamax to strengthen bones and reduce pain during chemotherapy. A few years ago, the lay press (television, newspapers, radio news and the internet) reported that people who take bisphosphonates are more likely than others to develop osseous necrosis of the lower jaw, a painful condition in which the bone of the lower jaw dies. People with healthy teeth and gums are much less likely to develop this condition.
Surgeons are aware of the connection between oral health and the success of organ transplants. Before any transplant procedure, the surgeon is likely to ask their patient to have a dentist evaluate their oral health. Patients who avoid dental care for long periods may find that dental conditions that are normally treatable such as gum disease or root canal infection are not treatable in the time allotted by the surgeon. These patients may find their only option is to remove any affected teeth. Later, the dentist will be able to make removable dentures or partial dentures.
The elderly have many health problems that cause dental disease. The most common oral health issue may be xerostomia or dry mouth. Over 425 medications cause xerostomia. Many common and unusual diseases cause xerostomia including diabetes and rheumatoid arthritis. Xerostomia is a part of aging. The lack of saliva makes the patient much more likely to develop oral infections and tooth decay. Dentists know how to diagnose and treat xerostomia.
When I was a dental student, my grandfather confided that he had not seen a dentist in many years. He wore full upper and lower dentures and was very happy with them. Here are the reasons even my toothless 70 year old grandfather should have continued to visit a dentist. First, my grandfather was a cigarette smoker. (Sorry Mom, Grandpa swore me to secrecy.) Smoking and alcohol are risk factors for oral cancer. Grandpa’s severe headaches may have been due to wearing old dentures. Worn dentures can cause headaches by requiring the wearer to close farther to chew. Over closing jaw muscles is painful. My grandfather had a mouth odor problem. No one could tell him. I could not say anything even when I was a dental student. That would be disrespectful. A common yeast infection caused the odor. Two weeks of medical treatment and professional cleaning of his dentures would probably take care of the problem.
Physicians and dentists recommend that children see a dentist by their first birthday. There is never a birthday after which a dentist is not needed. There is no age that needs a dentist more or less.