There is a crisis affecting older Americans today, and it receives far less attention than it deserves. This issue exists for a large majority of aging adults over 65 in the country, and this demographic is growing every day. It is both an economic crisis, and a healthcare crisis, costing seniors millions of dollars a year, and leading to untold pain, suffering, and complications.
What is this crisis?
It’s the general misconception about the importance of oral health care for seniors.
Unlike standard preventative medical care, such as an annual physical or stress test, senior dental care is often viewed as an optional piece in the health care puzzle.
A common myth that is especially pervasive among older Americans is the idea that losing your teeth and eventually relying on dentures is simply an inevitable part of getting older. That’s not true!
Combining those prevailing ideas with the fact that Medicare doesn’t cover general dental services and private dental insurance plans are often out of reach of seniors on fixed incomes, the end result is a large number of Americans over the age of 65 who are neglecting their oral health.
The facts show, however, that the senior years is a terrible time to neglect your oral health:
- Certain oral health conditions become more common and more dangerous as we age.
- Loss of strength and coordination can make brushing and flossing our teeth more difficult as we get older.
- A higher use of prescription medications and the aging process both promote xerostomia (aka Dry Mouth) which only makes oral health conditions worse.
- Poor oral health or oral health conditions that are left untreated can lead to other, more serious, health problems.
Let’s dive a little deeper into each of these issues, then we can explore what seniors can do to maintain excellent oral health throughout their lives, and how seniors on fixed incomes can afford to do so consistently.
Why senior oral health care is so important
Maintaining good oral health is actually important for everyone, regardless of age. In the United States, children have long been provided access to coverage for semi annual dental cleanings and examinations. Working adults generally have some form of dental insurance available to them — either through their jobs or through one or more government programs including the Healthcare Marketplace — although whether or not they choose to pay for it is a matter of budget and priorities.
Seniors, however, are limited in their available choices for dental insurance, and are often working with tight, fixed budgets that offer little room for more insurance premiums or out-of-pocket oral health care. This issue arises at the point where this demographic is physically most susceptible to developing dangerous oral health conditions.
Here are some common examples of how aging affects oral health:
- Receding gums - It’s very common for gum tissue to recede as we age, for much the same reason that skin tissue loses elasticity and begins to wrinkle. This recession of the gums exposes more of the root material of our teeth, making cavities and root-related infections more easy to develop in the senior population.
- Dry mouth (xerostomia) - Chronic dry mouth is a common side effect of taking certain prescription medications, which many older adults must do. It can also be a symptom of such common conditions as diabetes, Alzheimer’s disease, and Parkinson’s disease. This chronic lack of moisture in the mouth makes cavities, cracked lips, and fissured tongue much more likely in seniors.
- Impeded manual dexterity - As we age, various conditions, including arthritis, or simply weakness or a lack of coordination, can make it increasingly difficult to use our hands and arms as we used to. Two practices that often suffer as a result of this lack of manual dexterity is daily toothbrushing and flossing, both of which are vital to good oral health.
- Cognitive or memory loss - Alzheimer’s and similar conditions are certainly the most well-known, but various forms of dementia and memory issues can affect seniors for a variety of reasons. Along with so many other aspects of daily life, oral health can often be neglected as this occurs.
If you are currently over 65, or if you’re caring for an aging parent or grandparent, keep an eye out for the following signs and symptoms of potentially serious oral health conditions:
- Sore or irritated gums (especially beneath dentures) - If your parent is experiencing pain, discomfort, chafing, or inflammation under their dentures, it could be a sign of a damaged or poorly fit denture. Or, it could be due to a fungal build up. It’s best to have the dentures and the inflammation checked by a professional.
- Unexplained tooth loss - If your parent loses one or more teeth for reasons unknown, they should be examined by a dentist immediately. It may be a sign of asymptomatic periodontal disease or it could be a sign of a condition related to bone loss (such as osteoporosis).
- Chronic dry mouth - chronic dry mouth is dangerous to the teeth and gums because saliva plays an important role in neutralizing acids and cleansing the mouth of microorganisms.
The connection between your oral health and your body’s overall health is now well established scientifically and accepted among medical professionals. Poor oral health has been directly linked with:
- High blood pressure
- Likelihood of Stroke
- Some forms of cancer
In addition, many infections that arise in the mouth have proven harmful, even fatal, when left untreated, as they can travel to other parts of the body.
Seniors face an increased risk of health issues. Failing to prioritize oral health care can not only exacerbate these already serious problems, but it can create new issues where none existed before.
What can seniors do to maintain excellent oral health?
On the other hand, taking proper care of your oral hygiene routinely at home and seeing a dental professional at least twice a year can ensure that problems starting in the mouth are kept to a minimum, that oral health issues are caught and treated early enough to keep them from affecting other systems, and that other health issues that can be diagnosed early via visual examination of the oral cavity are also caught and treated early on, which improves the success of treatment in almost all cases.
So, what is involved in proper oral hygiene at home?
- Focusing on good oral self-care habits
- Making smart nutrition choices
- Being aware of “dry mouth”
- Investing in preventive care
Good oral self-care habits
"Taking proper care of your oral hygiene routinely at home and seeing a dental professional at least twice a year can ensure that problems starting in the mouth are kept to a minimum."
The first important key to control dental care costs and maintain good oral health is primarily in your own hands. While genetics plays a role in how strong and healthy your teeth are, self-care habits like proper brushing, flossing, and rinsing have a much greater impact on whether or not you’re going to keep your teeth for life.
And, those habits can also significantly reduce your need for costly dental procedures like extractions, root canals, crowns, implants, and dentures as you get older.
How to brush your teeth properly
While it seems simple enough, it’s easy to brush your teeth incorrectly.
- Brush at least twice a day for at least two minutes each time.
- Use a quality toothpaste that includes fluoride and tartar control.
- Make a point of spending adequate time on all surfaces of every tooth.
- Brush your tongue, the roof of your mouth, and your gums as well.
It’s important to replace your toothbrush on a regular basis. Every 3-4 months is recommended, but you should replace it anytime it feels like it’s wearing out or the bristles are spreading apart.
If arthritis or other challenges make it difficult to brush properly, consider buying an electric toothbrush to maintain quality and consistency.
How to floss your teeth properly
Flossing is simple too, but it can also be done incorrectly. More often, however, it’s simply not done. While it’s viewed as optional, it’s really the only effective way to clean the surfaces of your teeth that your toothbrush can’t reach.
- First, break off about an 18-inch-long string of floss.
- Wind the ends of the floss around your middle fingers, leaving about two inches of floss between them.
- Holding it taut with your index fingers and thumbs, gently slide the floss between your teeth, working it in a back and forth motion.
- Slide it down below the gum line, but be gentle, as forceful and quick motions could damage your gum tissue. Move the floss back up in the same manner.
- Repeat this process between all of your teeth, using clean sections of floss as you go.
There are dozens of different varieties of floss and specialty flossing tools, but none are specifically better than any others. Dentists agree that the best floss for you is whatever you’re going to use everyday. So, feel free to experiment and find one you like.
How to properly use mouthwash
While mouthwash is marketed as a way to avoid bad breath, it actually plays an important role in maintaining your oral health too. Be sure you choose mouthwash that has antibacterial properties and that isn’t loaded with sugar, then follow the instructions on the label.
- Place an ounce of mouthwash in your mouth.
- Swish it around your mouth vigorously, forcing it between your teeth and across all surfaces.
- Try to keep it up for at least 30 seconds (1 minute is even better) before spitting it out.
- Never swallow mouthwash.
Rinsing regularly with antibacterial mouthwash isn’t meant to take the place of brushing and flossing your teeth. But, it can be a great alternative when you can’t brush or floss properly, especially immediately after a meal when you’re away from home. Many people find that keeping a small bottle with them when they’re out makes it convenient and easier to remember.
What foods are good for your teeth?
As noted at the beginning of this article, the idea that losing your teeth as you age is simply a myth. And, while most people recognize that eating and drinking a lot of sugary foods is not smart if you’re interested in preserving your natural teeth and avoiding extensive dental problems, it’s not as commonly recognized that there are food and beverage choices that can actually help improve your oral health, and that eating more of these foods can actually make your teeth healthier and stronger.
Here are some basic nutritional ground rules to consider:
Any food that is a good source of one or more of the following nutrients will be good for your teeth:
- Vitamin D
A balanced diet with adequate vitamins and minerals supports a strong immune system, lessens the severity of inflammation and infections, and helps improve circulation, all of which will have a positive impact on your gums and teeth (as well as your overall health.)
Finally, giving your teeth, gums, and jaws a workout by routinely enjoying healthy, crunchy foods like apples, carrots, and celery can also promote long-lasting oral health.
While these recommendations aren’t new, they are often overlooked by seniors as their activity level naturally begins to diminish. Whether you’re 9 or 99, a balanced diet and regular exercise are the foundations of a healthy body and mind, and staying vigilant in these areas will benefit more than just your oral health.
What can you do about “dry mouth”?
Xerostomia - better known as dry mouth - is extremely common in seniors. It’s a common side effect of getting older, but it’s also a side effect of many prescription drugs, and many seniors will experience it at some point.
Chronic dry mouth is caused by salivary glands that weaken over time, producing less saliva in your mouth. It can be dangerous because saliva is your body’s natural first defense against the bacteria that’s behind cavities, gum disease, and other oral health issues. Saliva also plays an important role in digestion, so dry mouth can lead to digestive trouble or even malnutrition.
It may not be possible to avoid dry mouth completely, but there are some simple steps you can take to reduce its impact on your oral health:
- Drink plenty of water
- Chew sugar-free gum or suck on sugar-free candy between meals
- Consider requesting a medicated mouthwash or other prescription solution if the problem becomes more serious
How can seniors afford quality dental care?
The three home-care strategies listed above are not only important methods of maintaining excellent oral health, they’re also important factors in being able to afford quality dental care, even if you’re working with a limited income and a tight budget.
The final factor that’s noted above is investing in preventive care:
What preventive dental care do seniors need?
No matter how well you care for your teeth by brushing, flossing, and eating good food, you will still be at a disadvantage maintaining oral health later in life without regularly visiting a dentist for a professional cleaning and examination.
This semiannual cleaning and exam will remove hardened plaque from the surface of your teeth that brushing and flossing will never fully eliminate. It also gives your dentist an opportunity to examine your mouth and identify any potential issues before they progress to the point where more expensive treatment becomes necessary.
While a regular cleaning and examination costs money, the cost of extensive treatments is much higher, especially if they’re done on an emergency basis.
As already noted, in many cases, serious health conditions like high blood pressure, diabetes, and certain types of cancer can be diagnosed earlier by a dentist than by your family doctor, because the warning signs can be present in the mouth before you’re even aware of them.
But Medicare doesn’t cover general dental services
Coverage for routine dental care is not available under Original Medicare. That means Medicare Parts A and B do not cover standard procedures such as cleanings, fillings and crowns. Medicare and Medicaid both offer coverage toward some dental services under certain circumstances, so it’s a good idea to research using their online resources if you need help affording quality care.
But, under most circumstances, seniors are on their own paying for dental care.
This is the one of the main reasons adults are urged to factor in oral healthcare when planning their retirement. But, it’s important to realize that, just because Medicare doesn’t offer dental coverage for seniors doesn’t mean no options are available for help affording needed dental services.
Local low- or no-cost dental clinics
In many communities, individuals in certain income brackets may receive low- or no-cost preventive health care at clinics, hospitals, or participating offices throughout the area. There are usually strict qualification requirements, but if you qualify, it could be wise to accept this kind of help where it’s available.
Shop around and negotiate the best price
It’s important to feel comfortable with your dentist and their staff, so many people continue going to the same dentist for years, which is fine. However, if you’re paying out-of-pocket for dental care, you may want to shop around.
Call a number of dental offices in the area and find out what they charge for any general or advanced services you may need in the near future. Then, if you find a better price, let your current provider know about it and ask if they’d be willing to match the lower price you found.
While they are skilled medical caregivers first, dentists are also business people. They understand the value of happy customers and most will prefer to lose a few dollars in profit rather than lose you as a patient.
Dental discount programs
One example of savings options some people may not be aware of is a program offering affordable dental care for seniors through a discount dental card program.
With a dental discount plan, seniors can pay a small monthly fee (which covers everyone in the household) and receive 20-50% off the normal retail cost of routine and advanced dental services when visiting any of a national panel of qualified dentists.
Since a discount program is not insurance, it doesn’t require deductibles, waiting periods, or additional fees, often ending up more affordable than dental insurance for all but the most advanced services.
Remember, dental care for seniors shouldn’t be a “luxury” service. It’s just as essential to maintaining long term health as other routine medical care exams and procedures. Learn more about how to prioritize dental care without exceeding your budget: