On October 16, 2021, Seniors Today conducted its weekly Health Live webinar with leading endodontist Dr Asha Narde speaking about managing dental health issues in the elderly. Dr Noor Gill captures the takeaways.
Dr Asha Narde, a Conservative Dentist and Endodontist, has been in clinical practice at Juhu, Mumbai since 1995. She graduated from Nair Hospital Dental College in 1990 and subsequently did her post graduation from the KLES Dental College, Belgaum, in 1994. Dr Asha Narde is a Consulting Endodontist at The Centre For Advanced Dentistry, Breach Candy Hospital and for the past 16 years has been working alongside Dr Rajeev Narvekar in South Mumbai.
A great majority of her patients are 60 years and above, and providing optimum dental care has been her mission. She is part of the fraternity that trains young dentists in the field of Geriatric Dentistry to understand and provide the needs of the ageing population in an objective manner.
Dr Asha Narde started by talking about how most of the people have now stopped wearing masks or maintaining social distancing. She urged the audience to take their safety in their own hands and ensure that when they go out in public, they have an N95 mask in place and try to avoid crowded places and wash your hands after coming back and sanitise them in between as well.
In our country, dental health, many a times is not given top priority. 50% of the patients above 60 years of age are medically compromised and are on medications for co-morbidities. This has dental implications as well. With all the systemic diseases and the ongoing medications, dental health is overlooked. And knowingly or unknowingly, all the medical conditions and the ongoing medications have implications on the dental and oral health. One of the most common complains that the elderly have is dry mouth. All the medications on is taking can sometimes lead to atrophy of the salivary glands as a result of which the buffer capacity of the mouth is reduced. This also leads to the inner cheek and tongue getting red. At times it also gets ulcerated, the corner of the mouth develops cracked and the tongue too can get fissured.
Dry mouth is also a common complaint observed in cancer patients undergoing radiation therapy or chemotherapy.
When the salivation is reduced, the teeth too tend to dry out, the oral hygiene is not maintained well, the food tends to get trapped between the teeth and that leads to cavities.
As people grow older, the cavities are not just on the chewing surfaces, the teeth over a period of time get blunted as well and the sides of the teeth also develop cavities as the size of the teeth reduces and the gums keep going down and that leads to more cavities around the roots of the teeth.
As the gum health deteriorates, the teeth tend to become loose.
Food getting stuck leads to inflammation of the gums and it can also lead to recession of the gums.
As a normal physiological process, our gums tend to wear with age, the chewing surfaces get flattened out with what is called atresia.
Sometimes the sides of the teeth wear out rapidly and this is called abrasion. It could be because of brushing or certain conditions or diseases that make the enamel at the side of the teeth soft and tend to disintegrate.
Some health issues such as acidity tends to cause erosion of the teeth.
In a diabetic patient, many a times, the oral hygiene, if not maintained well, can lead to inflammation of the gums if the glycaemic control of the patient is poor. Such patients come to the dentists with abscesses around the teeth.
Diabetic patients should visit a dentist on the regular, at least once in 6 months and keep their blood sugar levels in check.
Hypertensive patients are put on various medications, the earlier generation of medications used to cause enlargement of the gums when there was food trapped around it, which would act as the trigger and the gums would get sore, enlarged and lead to bleeding. This should not be ignored. You should visit the dentist, share your concerns with him, get a thorough and regular clean-up. And if your dentist feels that the gum enlargement is due to certain hypertensive medications that you’re on, you need to get back to your physician and let them know about the same.
In hypertensive patients, there is a tendency for gum bleeds to occur.
It is important to inform your treating dentist about the medication you are on.
If you are undergoing any dental procedure, it is advised that you inform your dentist about any medications that you are on, or if you are on any active medication. Say for example if you have bronchial asthma, there are certain local anaesthetic drugs that need to be avoided; like in this case it will be lignocaine and adrenaline.
In patients with parkinsonism, Dr Narde advices that you visit your dentist at least every 3 months.
A few general dental care tips:
