Aging Well: Improving older adults' oral health



• The Northwest Colorado Dental Coalition provides dental services to low-income adults and children who qualify for Medicaid or Child Health Plan Plus. The program, which also offers a sliding fee schedule for those who quality based on income, provides dental care in Routt, Moffat, Rio Blanco, Grand and Jackson counties. For more information, call 824-8000 or e-mail nwcodental@qwesto...

• Residents who receive Old Age Pension public assistance qualify for help with dental services through the Colorado Dental Assistance Program for Seniors. The program helps with dentures and repair, tooth extractions, exams and X-rays, fillings and cleanings. For more information, call 303-692-3652.

• For tips on good oral health for older adults, log onto

There is good news and bad news when it comes to older adults' oral health.

Although more adults are keeping their teeth into old age, physical, cognitive and financial problems can make it difficult for them to ward off oral decay and disease.

"The biggest problem with the elderly is they basically outlive their teeth," said Gary Fresques, a dentist in Steamboat Springs who performs dental work on residents at The Doak Walker Care Center.

He explained that even people with healthy, well-maintained teeth and gums will likely need to have old dental work such as fillings and crowns replaced after the age of 50. As they age, illnesses can make oral maintenance difficult and, without the help of others, oral hygiene easily falls by the wayside.

"Without exception, every (older) patient that comes in my office has tons of food and debris stuck in their teeth ... and have rampant decay - it's sad," Fresques said.

Oral health problems in older adults can have a profound effect on a person's overall health and quality of life. Dental disease can be painful, prevent a person from enjoying food and eating nutritiously and also affect his or her ability to laugh, smile, talk and be social.

Researchers also suspect links between periodontitis, or advanced gum disease, and other serious health problems such as cardiovascular disease, stroke and bacterial pneumonia. People with conditions such as diabetes, HIV and AIDS also may be at higher risk for developing severe periodontal disease.

Oral health problems

Individuals can help themselves and those they care for by learning about common oral problems and preventative practices.

Two of the most common oral conditions are dental carries or cavities and periodontal (gum) disease.

Nearly one-third of adults 65 and older have untreated tooth decay, according to the U.S. Centers for Disease Control, which recommends using a fluoride toothpaste and drinking fluoridated water to help reduce and prevent cavities.

There is some public concern about potential health effects of consuming certain levels of fluoride. For research and other information related to this, log on to Click on "A-Z topics" and "Fluoride & Fluoridation."

Bacterial plaque can cause inflammation of the gums or gingivitis, the mildest of periodontal diseases. Good oral hygiene, including brushing, flossing and visiting a dentist to have hard plaque deposits or tartar removed, can prevent or reverse gingivitis. If left untreated, however, gingivitis can lead to infection of the tissue and bone that support the teeth, and ultimately tooth loss.

Mouth and throat cancers, though not prevalent, are also a concern, particularly among older adults. About 28,000 Americans are diagnosed with oral cancers involving the mouth, tongue, lips and pharynx each year, according to the CDC.

Most people diagnosed with oral cancer are older than 60 and have a history of tobacco use and heavy alcohol consumption. Cigarette smoking also can complicate tooth decay, gum disease and dental procedures.

Regular dental exams are important for catching oral cancer early. Once a person feels pain related to oral cancer, the disease usually has progressed to an advanced stage.

Risk factors, limitations

Many older adults experience dry mouth or a lack of saliva which helps protect tissues in the mouth and rebuilds tooth enamel. Dry mouth can make it difficult to chew, speak or swallow and make it hard to wear dentures.

Many common medications - including antihistamines, diuretics and antidepressants - can cause dry mouth. Some medical treatments, such as chemotherapy, also can reduce saliva.

There are medications to help improve saliva production, and fluoride rinses can provide extra protection against tooth decay in people with dry mouth.

Physical limitations associated with arthritis and other conditions make it harder to brush and floss teeth. Electric toothbrushes, toothbrushes with larger handles and other adaptive techniques can make these tasks easier.

Many elderly people, however, depend on caregivers at home or at long-term care facilities for their daily oral care. This can be tough on caregivers, who may not have the training to give proper care and identify problems or the persistence to provide care to patients who complain.

Perhaps the biggest problem leading to poor oral health in older adults is a lack of funds for routine dental exams and procedures. Older adults who have dental insurance usually lose it once they retire. Medicare does not cover routine dental services.

In Colorado, Medicaid benefits do not currently include dental services for adults, though groups such as Oral Health Awareness Colorado!, a coalition of advocacy groups, state agencies and other interested parties, is working to change that.

Locally, help is available for low-income adults and children needing dental care through the Northwest Colorado Dental Coalition, which has a clinic in Craig and also provides services in Steamboat. The program provides care to those on Medicaid and CHP+ and offers a sliding fee schedule for those who quality based on income.

Help also is available for qualified low income older adults through the state's Dental Assistance Program for Seniors (see breakout for contact information for both programs).

This article contains information from the American Society on Aging at and "The Oral Health of Older Americans," a report from the CDC.

- Tamera Manzanares writes for the Aging Well program and can be reached at Aging Well, a division of Northwest Colorado Visiting Nurse Association, is a community-based program of healthy aging for adults age 50 and older. For more information or to view past articles, log onto or call 871-7606.


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