1. 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

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

4. 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.

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

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

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

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

9. True or False
Do older adults still get cavities?

10. True or False
Do older adults get gum disease ?

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

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

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

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

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

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

17. What diseases are associated
with gum disease?

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

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

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

22. 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.

23. 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

24. How can you help? X

25. Mouth care: Concerns Cooperative Resistant Challenging behaviors
Refuse

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

28. Are there any questions