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Teeth are forever oral health and the older adult

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Nov 4th 2013

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Teeth are forever oral health and the older adult

  1. 1. Teeth Are Forever: Oral Health and the Older Adult Saskatchewan Dental Assistants’ Association 2012 1
  2. 2. The paradigm shift relative to dental treatment… REALITIES OF 2012 2
  3. 3. Societal Shifts Our population is living longer 3
  4. 4. In The Past Twenty years ago… 4
  5. 5. Cosmetic Dentistry Baby Boomers have had access dental insurance programs and extensive oral care 5
  6. 6. Prepared Teeth for Crown and Bridge 6
  7. 7. Dental Implants Everybody is getting implants these days! 7
  8. 8. Implant Procedure Actual screws are placed into the bone structure and serve as an attachment for a replacement tooth. 8
  9. 9. 9
  10. 10. A Type of Removable Over-denture 10
  11. 11. Actual view of implants and denture in place You need to know what you are working with and the incredible expense involved in these types of treatments. Caregivers need to know! 11
  12. 12. Implant Care Implications Caregivers need to be aware that this type of dental treatment is becoming more common. The attachments need to be cleaned on a daily basis. The client will need regular dental hygiene care. These attachments can break or need to be tightened in a dental office… 12
  13. 13. Access Everyone has different issues! 13
  14. 14. Access to Care 95% of the population over 65 live at home 5% are homebound 17% have mobility limitations THEREFORE over 70% can still travel to the dentist. Majority of older adults are healthy and dependent! 14
  15. 15. Access to Care Access to care can be physical, geographic, medical, cognitive and financial… 15
  16. 16. Seniors ORAL CARE ISSUES 16
  17. 17. Considerations Oral health is linked to general health – Chewing, swallowing & nutrition – Pain – Affect quality of life issues such as self image, communication & social interaction – Increased susceptibility to systemic infectious diseases, especially pneumonia… 17
  18. 18. Dexterity Issues Frailty: increases the need for regular oral assessment 18
  19. 19. Mobility Issues Homebound: may be unable to attend the dental office and may have increased need for assistance 19
  20. 20. Considerations for Dental Care Transportation to dental clinic Accompanied by a caregiver Shorter appointments Bring a printed list of medications 20
  21. 21. As people live longer and retain more teeth that are often more heavily restored they will require significantly more complex treatment, therefore considerable emphasis should be placed on caries prevention and education. PREVENTION & MANAGEMENT 21
  22. 22. Dental Services Regular check-ups with your dentist Regularly cleanings – May need to be as often as 4 times a year – Reduces bacterial invasion of the lungs Edentulous? – All dental prosthesis require reassessment and maintenance over time – Your mouth still needs to be examined 22
  23. 23. Prevention Before problems develop sound preventive habits need to be adopted Brushing twice a day – Consider an electric toothbrush Flossing – Floss aids are available to assist an individual with manual dexterity issues Mouth rinses – Anticariogenic products (chlorhexadine rinse) 23
  24. 24. Diet Dietary Counselling Minimal consumption of fermentable dietary sugars and carbohydrates Healthy between meal snacks Boost and Ensure are sticky and high in sugar (unless sugar free) Read labels! Choose items with less fat, trans fat, saturated fat, sugar and sodium 24
  25. 25. TOOTH CLEANING Rinse the brush with warm water and place a small amount of toothpaste on the bristles 25
  26. 26. TOOTH CLEANING Place bristles of the brush on the tooth and massage back and forth to remove the plaque from all the surfaces. It is important to brush the teeth and gums. 26
  27. 27. TOOTH CLEANING Move around the mouth in sequence, to contact all of the teeth 27
  28. 28. TOOTH CLEANING Finally, rinse the mouth with water. 28
  29. 29. FLOSSING Floss comes in may forms (unwaxed, waxed and yarn) Select the one that works the best for you. 29
  30. 30. FLOSSING Take a 40-50 cm piece of floss, wind it around the middle fingers of each hand. Control with index fingers or thumbs 5 cm of floss so that it can pass comfortable and flexibly between the teeth. 30
  31. 31. FLOSSING The plaque is removed by moving the floss up and down against the surfaces of each tooth 31
  32. 32. FLOSSING Make sure each “in-between” surface of the teeth is floss, and the floss passes up and down cleaning the tooth’s surface. Discard the floss after use. 32
  33. 33. INTERPROXIMAL BRUSHES Interproximal brushes are brushes used to clean the surfaces between the teeth. 33
  34. 34. BRUSH TECHNIQUE Insert the brush between the teeth, and clean with an in-and-out motion. The brushes do wear our so they must be replaced, but can be rinsed off and reused while still in good shape. 34
  35. 35. FLOSS HOLDERS The addition of a handle may make it easier to floss. There are several designs. 35
  36. 36. USING A FLOSS HOLDER Use the floss holder in a similar manner to finger flossing. 36
  37. 37. GUM CLEANING The gum around teeth or under dentures should be cleaned with a brush every day. 37
  38. 38. MASSAGE GUMS & ROOF OF MOUTH A toothbrush moistened with water can be used to massage the gums, the roof of the mouth and the tongue. This removes food debris, improves circulation and prevents bad breath. 38
  39. 39. BRUSH TONGUE 39
  40. 40. DENTURE CLEANING Dentures should be removed from the mouth and brushed thoroughly at least once a day. Clean the inside service. Clean over a sink filled with water in case you drop it. 40
  41. 41. DENTURE CLEANING A toothbrush will remove plaque and food remnants effectively. Avoid abrasive cleansers including toothpaste. 41
  42. 42. DENTURE CLEANING It is usually best to remove your dentures while sleeping. If you prefer to wear them continuously, the area under and around the denture must be kept very clean. Dentures should be dry when not in your mouth and should be stored in a marked container. 42
  43. 43. Medical Factors Dry Mouth (Xerostomia) is caused by the natural aging process and certain medications; (blood pressure medication, antihistamines, Parkinson Disease medication, incontinence medications etc.) Stroke, arthritis & multiple sclerosis etc. Diabetes: bone loss, increased gingivitis, slower healing times…. 43
  44. 44. Medical Factors (cont’) Denture sores that impair eating Candida yeast in the mouth (treat denture as well as mouth) Cancer treatment and post cancer medications 44
  45. 45. Zero Oral Care 45
  46. 46. Progression of Zero Care 46
  47. 47. Just Zero! 47
  48. 48. Caries Prevention Can Include: Xylitol sweetener Fluoride Products: mouthwashes, fluoride varnish etc. MI Paste (available at dental offices) Cheddar cheese 48
  49. 49. Dry Mouth & Treatment Dry mouth is a serious side effect of diseases, medication and conditions A dry mouth can cause rampant decay, difficulty swallowing, denture retention, bad breath, speaking difficulty and mouth sensitivity There are a variety of products on the market that can lessen the effects of the condition 49
  50. 50. Long Term Care Bedridden: a client will require an individual care plan based on accepted best care practices 50
  51. 51. Alzheimer Disease With the progression of Alzheimer Disease this individual will require daily, consistent care… 51
  52. 52. Dental Issues 52
  53. 53. Together, making a difference 53
  54. 54. Early identification and rational management of potential dental problems will support better health, sustained function and a fun and graceful old age! THANK YOU! 54
  55. 55. Teeth are forever! 55

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