Sonya Dunbar, MHA, RDH, checks the oral health of a senior resident in a long-term care facility.

An SOS for senior oral health

Nov. 10, 2021
When Sonya Dunbar's grandmother moved into a long-term care facility, the hygienist saw the dire need for oral health care among the elderly. It became Sonya's life's work.

One of the hardest decisions I’ve ever had to make was putting my grandmother, Madea, into a long-term care facility. I knew in my heart that no one would love and take care of her better than I had. But the reality was that bills needed to be paid and I had to work to make sure they got paid.

We found a long-term home for Madea, and it took months for the two of us to adjust to the new life we were living. While she was a resident of the senior living facility, I became a long-term outside caregiver for the facility. I did not realize it then, but my grandmother was my first patient.

Oral health has value beyond a clean mouth

A clean mouth will not only prevent cavities in seniors, but it is also vital to their general health. As I tell them, oral health is connected to overall health. For example, gum disease, the number one oral health condition, can lead to or aggravate many diseases that can be fatal. There is strong evidence linking gum disease and heart disease. If a senior suffers from gum disease, some of the bacteria in the person’s mouth can enter their bloodstream and travel to the heart. This can cause a buildup of plaque that can harden the arteries, hindering proper blood flow and increasing the risk of a stroke and/or heart attack.1 Gum disease is also closely linked to high blood pressure.2

Watch Sonya's recent video with Dr. Pamela Maragliano-Muniz about aging patients

What we need to do

Dying from a dirty mouth is not an option! We all know that brushing and flossing will go a long way in maintaining the oral health of seniors. But it is equally important for them to use the right oral care products. One of the products that has helped in the treatment of my patients through the years is Remin Pro from Voco. I apply it to patients’ teeth following professional cleanings. Remin Pro works instantly and immediately provides a pleasant feeling in the patient’s mouth.

I remember one of my patients who I’ll call Mrs. Kate, the nicest 89-year-old you’d ever want to meet. Mrs. Kate had most of her natural teeth and was very meticulous about her oral care. She told me she could no longer enjoy her favorite strawberry ice cream because it hurt her teeth. We noticed she had a large amount of recession, and I gave her a tube of Remin Pro mint flavor for treatment. She loved it. After a few months of daily use, she was back to enjoying her strawberry ice cream.

Remin Pro works well because it contains three key ingredients that boost oral health. The first is 1,450 ppm of fluoride. When this comes in contact with the saliva on the tooth surface, it is converted to acid-resistant fluorapatite.3 Fluoride strengthens the tooth enamel and helps it become more resistant to acid attacks, which cause tooth decay. The second ingredient is nanohydroxyapatite in the form of calcium and phosphate. Studies show that nanohydroxyapatite reduces the formation of caries, seals tooth surfaces, repairs incipient caries, and whitens teeth and increases tooth gloss. There is evidence that nanohydroxyapatite delays plaque formation.4 Plaque is the first type of bacteria that will latch to the enamel surface before more virulent bacteria attach to the plaque as it ages.

The final ingredient in Remin Pro is xylitol, which is a natural sugar found in some fruits and produced in small amounts by our bodies. Xylitol does not allow the growth of cariogenic Streptococcus mutants (caries bacteria) because the S mutants does not metabolize xylitol. Therefore, the effects of these bacteria are greatly reduced by xylitol, which makes it possible for the mouth to remineralize damaged teeth with minimal interruption. In addition, studies suggest that minerals such as calcium, phosphate, and fluoride work better to repair the enamel of the teeth when xylitol is present.5

Ease of use in mobile settings

Remin Pro is portable and can be used in mobile settings. The 40 gastrostomy tube contains 60 applications that you can leave with the patient for continued use. You can take it with you to nursing homes, schools, and elsewhere to treat patients. Due to the easy application of Remin Pro, it’s easy to train new hygienists on using the product in a mobile setting.

All in all, the commitment to maintain good oral practices and regularly visit their dental professional will protect the oral health of seniors. It can also help elders avoid many other serious health complications.

Editor's note: This article appeared in the November 2021 print edition of RDH.


1. Aoyama N, Kobayashi N, Hanatani T, et al. Periodontal condition in Japanese coronary heart disease patients: a comparison between coronary and non‐coronary heart diseases. J Perio Res. 2019;54(3):259-265. 

2. Dunbar S, Kauffman A. The Tooth and Nothing but the Truth: A Geriatric Dental Hygienist and Geriatric Dentist’s Guide to Oral Care for the Aging Population. 2021. Authorhouse. 

3. Machado V, Aguilera EM, Botelho J, et al. Association between periodontitis and high blood pressure: results from the study of periodontal health in Almada-Seixal (SoPHiAS). J Clin Med. 2020;9(5):1585. 

4. Ten Cate JM. Contemporary perspective on the use of fluoride products in caries prevention. Brit Dent J. 2013;214(4):161-167. 

5. Harks I, Jockel-Schneider Y, Schlagenhauf U, May TW, et al. Impact of the daily use of a microcrystal hydroxyapatite dentifrice on de novo plaque formation and clinical/microbiological parameters of periodontal health. A randomized trial. PloS one. 2016;11(7):e0160142.

Sonya Dunbar, MHA, RDH, aka the Geriatric Tooth Fairy, is a national speaker guided by almost 30 years of experience in private practice, skilled nursing facilities, and academia. She is a geriatric oral health educator who is pursuing a PhD in gerontology. Dunbar works diligently to educate people on the importance of oral health during aging. She is an entrepreneur and cultural diversity workplace coach who increases cultural awareness, knowledge, and communication through interactive workshops. She is cofounder of the National Mobile & Teledentistry Dental Conference and the American Mobile Dentistry & Teledentistry Alliance. The National Day Archives has proclaimed November 9 Geriatric Tooth Fairy Day.