CDHA Stresses that Aging Population Faces Unique Oral Health Risks

California Dental Hygienists’ Association Stresses that

Aging Population Faces Unique Oral Health Risks

Baby Boomers, Seniors & Caregivers are urged to Make Oral Health a Priority

 

GLENDALE, Calif. (Oct. 2, 2012) –

With the population of older Americans on pace to double in the next two decades, seniors and those approaching retirement should take steps now to preserve a healthy mouth through theirgolden years, according to the California Dental Hygienists’ Association (CDHA).

 

“Aging baby boomers and seniors, and their care providers, should be paying as much attention to their oral care as they do to their cholesterol, skin quality, blood pressure and overall fitness,” said Susan Lopez, CDHA’s president. “This group faces unique oral health challenges, but with proper care there is absolutely no need for the aging process to be synonymous with tooth loss and related health problems.”

 

While it is commonly thought that tooth loss is a natural part of aging, CDHA officials say that professional prevention therapies help seniors manage their oral health needs allowing lifelong use of their teeth, which remain crucial for adequate nutrition and overall health. 

 

Many older adults have a history of periodontal disease and or gum recession. 

 

“The roots of teeth are softer and rougher than enamel, allowing more plaque to collect and making them more susceptible to root decay” said Lopez. “Without intervention and consistent care periodontal disease can lead to tooth loss. This is another important reason to receive routine dental care.” 

 

Other threats to older adults are the common cavity and oral infections, incidences of which increase with age. Lopez notes that cavities are a contagious disease influenced by many factors, including, dry mouth, side effects from medicine, Alzheimer's, dementia and other mental or physical disabilities, along with access to care. Bronchopneumonia and respiration of oral pathogens are other concerns. The bottom line is, bacterial infections of the mouth can spread throughout the body and contribute to overall health problems. 

 

The risk for cavities is increased with dry mouth – called xerostomia – which is one of the most common side effects of medications, she said. Saliva is important because it protects the mouth from cavities by naturally buffering acidic exposures and helping to move food debris out of the oral cavity. 

 

“A depletion of saliva can come from prescription and over-the-counter medications. Some popular medications that can cause the dry mouth side effect include those prescribed for cardiovascular disease, arthritis, depression and postmenopausal hormone replacements,” said Lopez.

A lack of saliva can also stem from conditions such as Sjogren’s syndrome, HIV/AIDS, diabetes, Parkinson’s and even a medical history involving radiation to the head and neck.

CDHA offered the following tips to older adults to combat dry mouth:

• Drink water throughout the day
• Try xylitol products (a natural sweetener that prevents cavities)
• Use dry mouth sprays, lozenges or rinses on a regular basis
• Avoid soft and sticky simple carbohydrate foods
• Those taking medications and suffering from dry mouth, should ask their physicians if there is an alternative medication without xerostomic effects
• Regularly see a dental professional, who can recommend fluoride and preventive products to strengthen teeth

It is especially important for caregivers and family members to be vigilant in ensuring proper oral health care for seniors unable to care for themselves.

 

“Senior citizens suffering from physical disabilities or mental illness such as dementia and Alzheimer’s either cannot care for themselves or are in a long-term care facility that may lack access to an oral health care provider,” said Lopez. 

 

Patients in nursing homes or who are homebound are encouraged to seek out the services of a specially licensed dental hygienist – known in California as a Registered Dental Hygienist in Alternative Practice (RDHAP). Frequently oral

health care providers are notified only when an infection or problem is causing the senior pain or inability to eat.

Prevention is better than emergency care. RDHAP’s can provide and administer oral health care for patients with special needs, using mobile equipment, at their place of residence on a scheduled basis. Such services often can be billed to insurance. 

 

For seniors with arthritis and other struggles that make it difficult to hold a toothbrush or floss, CDHA recommends:

• Electric toothbrushes

• Modification of a manual toothbrush with a tennis ball, bike handle, or some foil around the toothbrush handle to make it larger and easier to hold
• Alternatives to floss, including toothpicks, Waterpiks, proxybrushes, and other options, which can be discussed with their oral health care providers

 

“There will be 72 million older adults in the U.S. by 2030,” said Lopez. The need to address the specific needs of older adults is increasing. CDHA emphasizes the importance of oral health in all populations, and is a leading oral health resource. Please visit our website at

CDHA.org for more information.
 

The California Dental Hygienists’ Association (CDHA) is the authoritative voice of the state’s dental hygiene profession. CDHA represents thousands of dental hygienists in California and is dedicated to expanding opportunities for the profession and access to care for all Californians.

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XEROSTOMIA??

Xerostomia...Big word.  In short, Xerostomia is the reduction or lack of saliva.  This condition can happen due to disease, radiation, or be medication induced.  Our seniors are on many of the medications that cause the lack of production of saliva.  Saliva is your natural cleansing system in the mouth.  Without adequate saliva, the oral cavity is highly susceptible to caries ("cavities").  The oral environment becomes more acidic and that acid eats away at the enamel ("outer protective layer of tooth").   If you add sugar, sweets, mints, even fruit juice (acidic and contains sugar) to this susceptible environment, it is a recipe to rapid decay.  This is why we need to check our homebound elderly and educate them and/or their caregivers on the simple steps of prevention.  One of these simple steps being Biotene Mouthwash that stimulates saliva and has fluoride to strengthen the enamel of the teeth. 

www.ohanamobilehygiene.com      Ohana Dental Hygiene Practice    (714) 638-8709

Is neglect of oral health considered elder neglect?

"Elder Neglect" defined by the California Pen. code 15610.57 means either of the following 1) The negligent failure of any person having the care or custody of an elder or a dependent adult to exercise that degree of care that a reasonable person in a like position would exercise.(2) The negligent failure of an elder or dependent adult to exercise that degree of self care that a reasonable person in a like position would exercise. Elder Neglect includes, but is not limited to, all of the following:Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter. Failure to provide medical care for physical and mental health needs....

This definition distinctly points out "personal hygiene" and "failure to provide medical care for physical ...needs"  Maybe since the term dental is not specified in the definition caregivers feel like it is not important?  Or maybe the term "medical need"  includes the total human body except the mouth?  But the last timed I personally checked, the human mouth was located in the human body.  In fact, I do think it is located, in the most vital part of the body term the "danger/red zone" , close to blood brain barrier and highly vascular.

So, if the mouth is in the body and the body is what is in need for "medical care", why am I seeing rampant decay in homebound frail elderly,  why am I seeing cases where a frail elderly's denture has not been remove from her mouth in 5 years,  why am I seeing severe periodontal disease in Alzheimer/Dementia patients?

These questions still perplex me, especially when there are mobile practitioners like myself that willing to put in the extra time to specialized in the frail elderly and homebound. 

I got it!  Its because the mouth can't be seen.  So a caregiver will call a practitioner for inflamed gushing wounds on a client's toe, but not a red gushing wound in mouth (periodontal disease).  Luckily that toe does have skin, connective tissue, and protective surface that can slow an infection, whereas, the gum infection in the mouth dumps right into the very vascular tissue and is carried throughout the blood stream to the brain, to the heart, and to the entire body.  This pathogenic bacteria can cause heart attacks, strokes, pneumonia, and diabetes. 

So...treat:                                   But don't ....treat??????????????????:

 

Lets see what we are missing...

 

 

Candidiasis from not removing dentures daily

 

Periodontal Disease from lack of daily oral care and profession cleanings

 

Rampant painful cavities/caries/decay from lack of preventative oral interventions

 

End-stage oral cancer that could have been caught earlier with

periodic oral exams from oral professionals

 

My point in this blog is don't "neglect" your mouth, don't "neglect" your clients mouth.  Take care of total body health, which includes your oral cavity and find a mobile professional that can help those who are homebound or disabled.  Incorporate consistent dental hygiene care and daily oral care in your facilities. 

 

Ohana Dental Hygiene Practice       www.ohanamobilehygiene.com        (714) 638-8709

 

  

Gum Disease Can Kill More Than Your Smile : Dental Cleanings are VITAL Especially For The Medically Compromised

Ohana Dental Hygiene Practice    Mobile Dental Hygiene Services for the Elderly, Disabled, & Homebound
www.ohanamobilehygiene.com      (714) 638-8709

Gum Disease and Dementia

If you're over 30, chances are you've got gum disease. A new study published in the August 30, 2012 issue of the Journal of Dental Research apparently confirms the gloomy news: based on data from a nationally representative sample, 47 percent of the U.S. population has gum disease. The investigation reported that about 9 percent of Americans have mild gum disease, 30 percent have moderate disease and 8.5 percent have severe disease. Gum disease isn't just a sign of poor dental health; it can also be an indicator of cardiovascular disease. (Although the American Heart Association states that no conclusive data demonstrates that gum disease actually causes or increases the risk of heart disease and stroke). In addition, new research published in the August 2012 edition of the Journal of the American Geriatrics Society shows an association between how often you brush your teeth and the risk of dementia in old age. The investigators followed nearly 5,500 seniors for 18 years and found that those who reported brushing their teeth less than once a day were up to 65 percent more likely to develop dementia than those who brushed daily. The lead investigator suggested that the bacteria that cause gum disease may affect the central nervous system and cause inflammation and damage leading to dementia. My take? These are interesting findings, but at this point we can only say that researchers have found an association between oral hygiene and dementia, not a cause and effect. Dental health is one of the keys to good health, but it is clearly far from the only key. Low-grade, persistent infections in the oral cavity and elsewhere can burden the immune system and weaken overall health. Teeth and gums are not separate from the rest of the body, and dentistry should not be so separate from general medicine. Taking care of your teeth and gums is vital. Be sure to brush and floss daily and see your dentist regularly so that any problems can be detected and corrected. by Dr. Andrew Weil

 

www.ohanamobilehygiene.com  Ohana Dental Hygiene Practice   714-638-8709

Mobile Dental Hygiene Care for the Elderly, Disabled, & Homebound

Periodontal Disease is linked to aspiratory pneumonia...

Don't let your clients be readmitted to the hospital.

 Make sure they get the oral preventative treatment and care they need.
"Scientists have found that bacteria that grow in the oral...

cavity can be aspirated into the lung to cause respiratory diseases such as pneumonia, especially in people with periodontal disease. This discovery leads researchers to believe that these respiratory bacteria can travel from the oral cavity into the lungs to cause infection."
http://www.perio.org/consumer/mbc.respiratory.htm

Orange County Dental Hygienists' Society responses to GMA report linking x-rays to brain tumors

http://myemail.constantcontact.com/Keeping-Members-Informed--GMA-reports--Dental-x-rays-linked-to-brain-tumors.html?soid=1101774181703&aid=nuLr6y95AYQ

Oral Cancer Stats

Rates of oral cancer occurrence in the United States

Close to 40,000 Americans will be diagnosed with oral or pharyngeal cancer this year. It will cause over 8,000 deaths, killing roughly 1 person per hour, 24 hours per day. Of those 40,000 newly diagnosed individuals, only slightly more than half will be alive in 5 years. (Approximately 57%) This is a number which has not significantly improved in decades. The death rate for oral cancer is higher than that of cancers which we hear about routinely such as cervical cancer, Hodgkin's lymphoma, laryngeal cancer, cancer of the testes, and endocrine system cancers such as thyroid, or skin cancer (malignant melanoma). If you expand the definition of oral cancers to include cancer of the larynx, for which the risk factors are the same, the numbers of diagnosed cases grow to approximately 54,000 individuals, and 13,500 deaths per year in the US alone. Worldwide the problem is much greater, with over 640,000 new cases being found each year. Statistics on worldwide occurrence Oral cancers are part of a group of cancers commonly referred to as head and neck cancers, and of all head and neck cancers they comprise about 85% of that category. Brain cancer is a cancer category unto itself, and is not included in the head and neck cancer group.

Information from OCF http://oralcancerfoundation.org/facts/index.htm

ORAL CANCER IS NOT ALWAYS NOTICABLE TO THE LAY PERSON.  THIS IS WHY IT IS IMPORTANT TO SEE YOUR DENTAL PROFESSIONAL ON A REGULAR BASIS

April is ORAL CANCER AWARENESS MONTH.

 

Even though smoking and tobacco products increase your risk of oral cancer.  It is more prevalent than you think among those who don't use tobacco products.  The Oral Cancer Foundation is a great resource for up-to-date statistics and research as it relates to oral cancer.  http://oralcancerfoundation.org/ 

The Oral Cancer Examination, done by your dentist or hygienist, is the most important part of the dental visit.  There is also new and emerging devices and techniques in which oral cancer is detected and diagnosed sooner.  Most times, by the time an oral lesion is seen in the mouth, it has metastasized to a much later stage of cancer.  As a mobile hygienist, I am often the one who first detects abnormalities in the oral cavity.  Since my patients are medically compromised, it is vital for me to give a thorough oral cancer exam and note and refer any abnormalities to their medical professional. 
Kimberly Cruz, RDHAP

What is a RDHAP?

The U.S. Surgeon General released a census report on oral health in 2000. The report not only demonstrated links between oral health and systemic health, but the numbers were staggering. Detailed links between oral health and systemic health were included but not limited to heart disease, diabetes, and aspiratory pneumonia. The results determined two major groups exhibited a short fall in dental care. The elderly, in particular, was one of those groups. The State of California responded by creating a specialized licensure enabling dental hygienists the ability to maximize opportunities for improving overall systemic health through prevention. The RDHAP (Registered Dental Hygienist in Alternative Practice) license allows for the licensee to provide preventive and therapeutic dental hygiene services for the homebound, residential facilities, institutions, schools, and shortage areas designated by the State of California. The sole purpose of an RDHAP is to provide access to care despite any limitation. I felt drawn to the opportunity of performing my profession in such a

life-changing way and obtained this licensure. As a mobile hygienist, I am able to serve those who can no longer transport themselves into the office due to medical or physical disabilities. It is both humbling and rewarding to provide oral hygiene education to senior homes, skilled nursing facilities, and residences. Patients and their caregivers are provided the tools for consistent and thorough daily hygiene home care. Those who can benefit from our services are skilled nursing facility residents, assisted living residents, adult day care participants, developmentally disabled group home residents, patients in sub-acute care, patients that are homebound or bedbound, and the temporarily disabled. My patients are all ages and possess a wide range of medical challenges. Awareness is power and you have the ability to positively impact the lives of those around you by informing others about this treatment option.
Kimberly Cruz, RDHAP