Make a difference: Clean Mouth = Healthy Body Janet A. Yellowitz DMD, MPH, RDH Director of Geriatric Dentistry and Special Patient Care University of Maryland Dental School Fourth Annual Nursing Assistant Conference December 2, 2015

Today’s discussion: Key oral health concerns Review age-related changes of the mouth Helping residents keep their mouth healthy Strategies and secrets

A healthy mouth Looks good Feels good Smells good Lets you eat what you want Helps you look good Helps you speak well Have the best smile possible.

What happens to teeth and gums of adults as they get older ?

As we age, our teeth age change Color – darken/ yellow Size of pulp decreases Decreases sensitivity Increased threshold to pain

OLD teeth feel Less PAIN !!! . Result: - increased pain threshold - decreased capacity to respond to trauma - less reparative capacity

Oral motor functions change with age Orofacial musculature weakens Reduced muscle tone Diminished function Concerns: Longer time for chewing More food pocketing

True or False Do older adults still get cavities?

True or False Do older adults get gum disease ?

Tooth decay (caries) and periodontal disease (gum disease) Cavity prone years – AGAIN Most older adults have GUM disease

Most people lose their teeth when they get “old”. True or False Most people lose their teeth when they get “old”.

Do older adults need to see a dentist True or False Do older adults need to see a dentist on a routine basis?

True or False Most older adults see a dentist every year.

Older adults with teeth (natural) ~ 40% have dental caries (cavities) ~ 50% have periodontal (gum) disease Require routine professional care Require routine daily care

Periodontal disease (gum) ~ 50% have it Gingivitis Periodontal disease Signs and symptoms Bleed - Red - Inflamed Swollen - Bad taste Loosen & move

What diseases are associated with gum disease?

Gum disease Has been associated with: Diabetes Heart disease Strokes Aspiration pneumonia Poor nutrition … and the list goes on..

Oral cancer Average age – 63 years Incidence increases with age. Maryland: highest mortality for African American males Early diagnosis is the key.

How can you help? Mouth Care Primary activities: Remove bacteria Brush all teeth Brush gums Clean dentures Swab tongue/soft tissues

Denture Care Proper care includes: Rinse/Clean dentures after every meal. Thoroughly brush the dentures once a day. (use denture brush, not toothbrush) Remove the denture every night, to prevent accidents (swallowing) and fungal infections. Soak appliance overnight in denture cleaner . So how is it that we properly care for a denture? What we like to tell people is that dentures should be thoroughly brushed once a day, preferrably at night, right before bed. (During this slide – Demo proper denture brushing!) After brushing the dentures, we advise patients to brush their own teeth with a soft-bristeled toothbrush as well. During the night, the denture should be soaked in either water or, better yet, a cleaning solution which can be purchased at most convient stores (such as Efferdent or Polydent). Finally, we like to tell people with dentures or other removable appliances that they should be rinsing their mouths out with water after eating, so as to remove any gross debris left. Now I’m sure that there are many of you denture-wearers out there who haven’t taken these steps recommended daily steps and haven’t yet had any problems with their dentures. You might be wondering why we suggest these steps. The reason is because we find that people who do not clean their dentures daily are more likely to get a fungal infection of their mouths called oral candidiasis. Candidiasis and other fungal infections, like athlete’s foot, are associated with microscopic yeasts which can invade tissues. When they occur, they can break the tissue down and cause ulceration. Thus, we like to suggest these daily tips to help you prevent acquiring one of these fungal infections.

Roles and Responsibilities Key role as members of health care team. Provide care with compassion & empathy Ensure health, safety and wellness Personal hygiene Infection control Dietary care Administrative issues

How can you help? X

Mouth care: Concerns Cooperative Resistant Challenging behaviors Refuse

Mouth Care Strategies Develop operational standards Use what works Entice, bribe, cajole Be creative Maintain sense of humor!

Are there any questions