Elevated routines for our aging population

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Posted by: Dental Design 21st October 2023

We want people who are living longer lives, to be living healthy, happy ones.

The challenges that come with an aging population are many, and complex. There is a socioeconomic context; people in deprived areas, characterised by poor housing, high-unemployment and low incomes, have a lower life expectancy than those who don’t.[i] The link between social inequalities and life expectancy was amplified by the Covid-19 pandemic, which had an “unequal impact” on population sub-groups.[ii]

In 2019, a report by the Alzheimer’s Society found that there were around 900,000 people in the UK with dementia, predicted to rise to 1.6 million by 2040.[iii] Most of these are aged over 65. The same report also estimated that 70% of people living in care homes, and 60% of those who rely on homecare, are living with dementia.

Dentistry, already a system under pressure, will be part of the nationwide response to help people stay in good health for as long as possible as they get older. Age can affect oral health in many ways. Years of normal-level function means more wear and tear, and gingival recession, common in the elderly, exposes the neck of the tooth, increasing the risk of caries. Other problems can be caused by past restorative work, delivered at a time when a minimally-invasive, conservative approach wasn’t favoured as it is today. Xerostomia, characterised by reduced salivary flow, can be due to medication, illness and dehydration. If a patient’s dexterity and/or eyesight has started to fail, this can make it harder to clean their teeth properly, also around dentures, bridgework and dental implants. Limited dexterity and mobility in old age can have a nutritional impact too; a person may start eating fewer foods that require preparation like peeling, slicing and chopping. So, less fresh fruit and veg in the diet and more reliance on processed meals, that can be high in salt, fat and sugar.

It must also be stressed, however, that there are older patients – and you will know this, because you’ll see them every day – who are very interested in maintaining a healthy lifestyle. They are active and engaged and, when they’re at the practice, will listen to your advice and take on board any changes to their daily routine you recommend they make.

It is also crucial that dental professionals make the point that tooth loss is not a certainty of old age. If people are willing and able to practise good habits and behaviours, they can keep their own teeth and avoid disease for many more years. A life of poor oral health, and with teeth they are embarrassed by, isn’t what they want. A beautiful, functional smile and optimised mouth hygiene is central to wellbeing, to being able to live with dignity and socialise, and for eating a wide range of foods. If the patient wears a denture or has a dental implant, this will be just as important to their sense of self; the key is knowing how to keep cleaning, comprehensively and effectively, to prevent caries and periodontal disease.

For some patients, such as those with dementia or extremely limited dexterity, they will need a specialised care plan, involving other agencies. For others, base consultations on good conversation. Find out the problems they have and discover their unique barriers to care. For example, they may have noticed increased sensitivity, or be confused by nutritional advice. They may have anxiety or phobia. If their mouth is dry, discuss the impact of any prescription medicines they may be using and give tips to improve comfort. Encourage them to be open and honest, as this will enable you to help them better. Ensure they know the value of coming to see you regularly; sometimes disease progresses without symptoms.

If they are worried about cost, recommend high-quality, high-value tools that will be easy for them to use and greatly improve their health. Cleaning interdentally can be performed once a day with tools designed to be effective, and with no risk of injury. The CPS Prime range of interdental brushes, from premium Swiss oral health brand Curaprox, for example, come in various sizes for even the narrowest space. With once-daily and correct use, a quick sweep in and out, they prevent against inflammation. Comfortable to hold and use, only the brush head – not the handle – need replacing after a period of time.

Our aging population does come with challenges, and there are comorbidities that can come with advanced years, that will affect oral health. Being older – and you’ll have patients in their 70s, 80s and beyond who’ll reject the idea that they’re elderly! – does mean taking even better care of your teeth, to reduce the increased risk of disease. By building good relationships, and with elevated routines, you can help these patients enjoy aesthetics, health and function for a long time to come.