The Changing Scenario

Aging is a normal physiological phenomenon, unstoppable and biologically driven. Advancements in medical sciences and technology have led to the emergence of newer and better modalities of healthcare including prevention and treatment leading to increasing the lifespan of the individuals. According to WHO the global population is on the rise with elders growing around 2.5% annually. India is a vast country, and its 8% of the population constitutes elderly.

The Elderly Population

The elderly population starts from 65 years onwards and can be looked upon as those 65-74 (young old; healthy and active), 75-84 (mid old; active but with systemic issues), > 85 (oldest old; less active more ill). At every stage oral care need to be addressed so that teeth and gums can be made to last till the very end.

The Challenges of Aging

Medical Conditions: There is an increase in medical issues after 65 years. Most common challenges faced are high blood pressure, arthritis, coronary heart disease, diabetes, stroke, and cancer. Medical conditions along with poor dental health and awareness can compromise the quality of life.
Lack of Dental Health utilization: Awareness, education, socioeconomic conditions of patient, attitude, insurance, and access can be a deterrent for going to dentist for dental care

Nutrition imbalance: Elder population may also suffer from nutritional and vitamin deficiency due to inadequate intake or poor absorption. Lack of teeth, ill-fitting dentures, pain in teeth or poor oral hygiene can prevent proper chewing and taste perception leading to malnourishment.

Age and Dental Changes

Teeth become dark and stained and show signs of wear. Increased wear can also lead to sensitivity, cracking and cavity formation
Oral mucosa becomes thin and is more prone to cuts due to denture wearing or aggressive tooth brushing. There may be burning sensation with reduced tolerance to spicy and hot food
Salivary flow decreases and could be due to medicines for a medical problem or otherwise due to salivary glands shrinkage. Decreased salivation can lead to root caries and untimely tooth loss if not prevented
Gums and tooth bone recede and if oral prophylaxis is not maintained greater damage can occur with eventual less or poor bone for fabrication of dentures or Implant Bridge compromising the quality of life.

Preventive Dental Services for Elderly

Plaque and Tartar control should be achieved both by professional cleaning once in every six months and through home care regime
Electrical toothbrushes can be of great assistance in elderly. Effective use of fluoride and Chlorhexidine based mouthwash can prevent cavity and gum recession
Preventive check-ups and fillings can reduce tooth damage and tooth loss.
A modern solution like the dental implant is a big boon for elderly and can assist in fabricating full mouth implant-supported fixed denture besides replacing one or few missing teeth. Implant treatment is good option and more natural like and can be safely considered in elderly (with controlled medical conditions)
Loose ill-fitting dentures should be modified and relined by comfort liner or converted into implant retained removable dentures which are economical solutions to fixed implant-supported bridges or dentures.
Preventive check up also screens elderly for oral cancer and allows timely action if required.

About the Authors:
Prof (Dr.) Sharad Gupta is a Dental specialist practicing with his wife Dr. Vishakha Gupta at their state of art centre Identity+, based in Gurgaon and New Delhi for last 16 years. They use best types of equipment, experience, and material to serve their clients through their concept of complete and family dentistry. The couple is dedicated to helping elderly retain their smile till the very end by conducting awareness talks, consultation camps and affordable dental care for the elderly. Their mission is to help elderly chew and speak well with their natural teeth and to deliver only the most likely dental solutions to their clients.

They can be reached out at www.identityplus.in and contacted on 0124-6515895, 011-25126068 or reached via email: info @identityplus.in