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Dental care after retirement


 By Olga Kraeva, DMD

Weymouth – America is aging. People live longer nowadays and it has become more crucial for me as a dentist to find a way to help my elderly patients to save their teeth. At my dental school, Boston University, I had the opportunity to work with the elderly population in the geriatric dentistry department. It was a great experience for me as a student to treat patients by visiting their home and making dentures. All clinical steps to denture impressions were done at the patient’s home. This experience influenced me to work with the elderly population in my own practice. Seeing my patients on a daily basis inspired me to think about the program and some steps that could be done to protect my patients from cavities or gum disease.

Every day we faced several dental conditions and our patients concerns.

To save every tooth in your mouth is a priority, as various studies have determined that a minimum of 20 functional teeth are necessary to guarantee good digestion of food.

Cavities remains a major oral health problem among the elderly for various reasons: age-related salivary changes, a poor diet, exposure of the root surface by gingival recession, and a greater likelihood of drug treatment with xerostomia as a side effect– all can cause the decay of teeth. The six-month cleaning and checkups help diagnose early stages of cavities and treat them with less damage to the tooth.

Root decay may cause the potential loss of the whole tooth. The tooth roots become exposed as gum tissue recedes from the tooth. Roots do not have any enamel to protect them and are more prone to decay than the crown part of the tooth.

Studies demonstrate that the topical effect of fluoride in an adult’s mouth during the early stages of decay can not only stop the decay process but also make the teeth more resistant to future decay and cavities. 
Dental decay is reduced by 27% in adults who use toothpaste with fluoride and drink fluoridated water. 
Fluoridation conserves natural tooth structure by preventing the need for initial fillings and subsequent replacement of fillings. The fluoride varnish should be applied twice a year during the routine teeth cleanings.

In 2015, the Department of Health and Human Services recommended a then-newly calibrated ratio of fluoride to water at .7 mg/L, or parts per million. The American Dental Association DA supported this recommendation. According to the Weymouth Department of Public Work water quality summary report of 2016 states that Fluoride level is 0.45 – 0.73 ppm in tap water of Weymouth.

When the cavities or gum diseases are not treated, the tooth has to be extracted. The loss a lot of teeth in a mouth can cause the rest of the teeth to drift and shift into the open spaces. That is why the denture placement should be considered after tooth extraction. The immediate denture – is a denture inserted same day at teeth extraction one of the solutions. Unfortunately, the bone present today may be gone tomorrow. If the immediate denture is placed into the mouth this denture needs to be relined (add additional lacer of acrylic) after 4-6 months of the teeth extractions. Sometimes a patient is too tired to visit a dentist and does not want to have extra expenses so the patient skips the steps of relining the denture. As a result, the denture becomes loose, fits poorly, often causing more bone resorption.

Another option to save the bone structure is to place the implants the day of extraction. Recently, I placed two implants for one of our patients due to severe decay of all his lower teeth. The implants were placed the same day of teeth extraction and covered 100 % by DentaQuest dental insurance because this patient is older than 65. 
The immediate insertions of the implant on the lower jaw is more beneficial because it causes less resorption and more denture stability. It is an easy procedure compared to placement of implants after a few years after all teeth extraction when the bone “shrinks.”

Dry mouth is caused by reduced saliva flow, which can be as a result of cancer treatments that use radiation to the head and neck area, as well as certain diseases, and medication side effects. There are different mouth sprays, rinse or tablets to reduce the dry mouth symptoms.

Age in and of itself is not a dominant or sole factor in determining oral health. However, certain medical conditions, such as arthritis in the hands and fingers, may make brushing or flossing teeth difficult to impossible to perform. A solution is an electrical tooth brush. In our office you can test-drive the Oral B electrical tooth brush. Our hygienists will help match the tooth brush to a patient’s needs.

When was the last time you had a dental cleaning or check up? This simple procedure is a major part of an oral health care regiment needed to prevent cavities, gum disease, or tooth loss. The oral prophylaxis can prevent the need of costly dental treatment. And everybody needs to do it only twice a year. 

MyPhotoEdAbout the Author: Olga Kraeva, DMD, maintains her clinic, Dental Aid 1, in Weymouth, located in the Lakeview Medical Building, 884 Washington St., (Rt. 53), situated one block from Walmart and Shaw’s Plaza. Please call her at 781-340-5361 or visit https://www.dentalaid1.com to learn more.