As a patient gets older or diagnosed with dementia or Alzheimer’s, they tend to pay less attention to their dental care. These patients become dependent on others to care for their teeth.
Geriatric patients may not have kept up with their dental care and have food trapped in their teeth from not brushing their teeth for prolonged periods of time. Depending on the age of the patient, the oral assessment conducted, and the condition of the patient mentally and physically, we come up with the needed treatment plan.
Usually, they are also complicated with systemic diseases such as high blood pressure, diabetes, high cholesterol, stroke and are on a large amount of medications. Older patients also have had joint replacements, strokes or are dealing with Alzheimer’s and dementia which can result in a very combative or stoic patient who may not be able to communicate their needs to us.
Depending on the general health status of the patient, conservative treatment is usually the best option. Placing the patient on regular more frequent cleaning regimen is the best defense for prevention of further destruction of the patient’s teeth and gums. If the patient is very old or their medical condition does not warrant surgery, the remaining roots can be left in the patient’s jaws.
If patient experiences dry mouth, they will have a higher rate of decay. Saliva helps wash away food debris and neutralize the acidity of the mouth after eating. Many medications can cause the patient’s saliva flow to decrease which can cause the patient to have a lot of decay.
Complications from medical conditions can cause severe decay due to the side effects of a large concoction of medications that they may be taking. Geriatric patients with special needs due to strokes or joint replacements restricting them to having to be in a wheelchair can be transferred to the dental chair, while others would have to be treated directly from the wheelchair. Some patients may have to be treated at their residence if they are bed bound.
Patients who’ve had a stroke may have to be upright due to the inability to swallow or if they have no ability to be treated in a recline position. If oral surgery is necessary, a consultation with the patient’s physician may be required to temporarily suspend the use of any blood thinners or aspirin prior to the surgery. Patients who have had joint replacements in recent years or with a heart murmur or valve complications will require antibiotic premedication before dental treatment.
It is very important for elderly patients, their friends and family not to neglect dental care, so they can maintain the best possible quality of life for as long as possible.