Elderly Dental Care

Dr. YIU Ka Ki, Louise

Clinical Associate in General Dentistry

Conservative Dentistry

Thanks to the rising quality of life and life expectancy, it becomes even more important for the elderly to take care of their teeth and oral health. 

Our teeth are subject to continual wear and tear over time. The damage is especially serious in the Chinese population as bones and shells are also consumed in local cuisines. Other common senior dental problems include gum disease and tumours on the tongue or the inside of the mouth. Oral tumours may be mistaken for mere canker sores or ulcers. With regular examination, they can be treated at an early stage.

Common Senior Dental Problems

1. Cracked Tooth Syndrome and Attrition

Most Hong Kong people eat more meat and fewer vegetables. As bones and shells are usually served and consumed in local cuisines, cracks are not uncommon in the enamel or dentin of people aged above 50. Sometimes the cracks may even reach the periodontal region and the pulp, causing dental decay.     

The cracks and wear may also make the outer tooth layer thinner over time, leading to heightened tooth sensitivity and malocclusion, i.e. improper alignment of teeth. Mere dental filling of one or two teeth does not help. Tooth extraction is also not desirable as old people can least afford the loss of teeth. 

Thanks to the advance in conservative dentistry, full mouth reconstruction is now a viable option for the elderly with malocclusion. In full mouth reconstruction, 3D models of both upper and lower jaws are created to simulate and assess actual occlusion. Instead of extraction or further tooth cutting, tooth damage and cracks can be repaired with less harm. It also delays the need for extraction or dental implant.

2. Yellow Teeth

Under the outer enamel is the yellow-colored dentin. Dentin begins to show as the enamel gets thinner with time. Instead of having these teeth crowned, tooth whitening procedure is recommended for senior patients with yellow teeth. This procedure is more conservative and causes no damage to the existing teeth.

3. Gum Shrinking away from the Teeth

Most senior people may use toothpicks to dislodge food particles between teeth. As the gum recedes with age, the crevices between teeth also get wider, thereby housing more bacteria. Dental decay may even occur on the root surfaces of the teeth, possibly causing teeth fracture in cavity-prone patients with receding gum. This can easily be treated by restoring the cavities with fluoride-releasing glass ionomers, and the material itself will help prevent further decay.

4. Pain due to Soft Tissue Injury

Seniors with sinusitis may also suffer from migraines. The pain may radiate to the jaw area, and is thus often mistaken for toothache. Sinusitis can be relieved by anti-inflammatory medication. Therefore it is important to have the correct diagnosis first

There are Always More Solutions than Problems

Dental problems may get worse due to other senior health conditions, including diabetes, high blood pressure and osteoporosis. Seniors with these health problems are more prone to wound infection after tooth extraction, and special care is needed when treating these patients. Sometimes a dental visit may be too exhausting for the elderly, especially for the wheelchair-bound.  

Some patients may show up for consultation with foreign domestic helpers. Given the communication problem and a limited understanding of their own conditions, senior patients have to be attended to with patience and require detailed explanation from dentists. 

Despite all the possible hassle, seniors are encouraged to seek immediate treatment whenever necessary to reduce discomfort and delay further deterioration. Thanks to a tailored approach, dentists can address specific concerns of individual patients, and most importantly, help them maintain long-term oral health.

With regular check-up and good maintenance, you can possibly stay free of dentures even at 80 or 90 years old. Even for denture wearers, taking good care of the remaining teeth is just as important for dentures rely on these teeth for support and retention to function properly. A dental check-up is recommended every 6 months for patients aged 60 to 70, while more frequent visits are required in case of periodontitis. Frequent scale and root planning will delay further gum recession.

Fluid or soft foods are usually prepared for very old patients with swallowing difficulties. These foods are often sticky in texture, and to reduce the risk of cavity, fluoride treatment is recommended.

In light of the risk of non-stop wound bleeding during treatment, patients who are on certain medications, e.g. aspirin, should discuss with their family doctors in advance as to whether the medications should be stopped before dental treatment.