Products provide creative solutions for older adults' oral care
By Amber Auger, RDH, MPH
According to the Center for Disease Control and Prevention (CDC), nearly one third of patients age 65 and older have untreated tooth decay.1 National data demonstrates that 7% of adults ages 65 and over have had tooth pain at least twice during the last six months, and only 1% had access to care. The CDC reports 70% of the geriatric population has periodontal disease.2 The lack of proper oral health care in the geriatric population is an epidemic that dental professionals are called to change.
Promoting oral health of geriatric patients requires engagement of caregivers and access to products that will decrease risk of decay, including:
Fluoride varnish: Clinical studies continue to confirm the power of a fluoride application, demonstrating a 50% to 70% decrease of tooth decay.3 A wonderful thing about fluoride varnishes for geriatric patients is the effectiveness and the ease of application. Fluoride applications can be placed by nurses or caregivers after a brief training from a dental professional. For example, if a patient has a high DMF (decayed, missing, filled), xerostomia, or lacks meticulous homecare, fluoride varnishes and nightly fluoride trays can be sent home with patients to help reduce their risk of decay.
Toothpaste: High fluoride toothpaste such as Prevident 5000 by Colgate, Clinpro 5000 by 3M, and Dayli by Preventech offer hypersensitivity relief and work to remineralize the enamel surface. The utilization of high fluoride demonstrated "significant remineralization of root caries in just three months (38%) and six months (57%)."4 Use of high fluoride toothpaste on a consistent daily basis allows incipient decay to be remineralized and reduces the patient's sensitivity.
Xerostomia: The xerostomia battle can be a nightmare! Dental hygienists have become very familiar with recommending Biotene as a solution. New technologies allow for a wider variety of dry mouth options that aren't as thick to allow for greater compliance. CloSYS offers a product called Silver, which contains high fluoride in the sulfate free form. Chlorine dioxide is the active ingredient in CloSYS that allows for a rapid decrease in bacteria growth without the intense flavoring, which provides relief for sensitive mouths.5
The key to change in geriatric oral health is motivation of caregivers and patients. Utilization of disclosing tables before and after brushing will aid in patient and caregiver engagement. Getting to know older patients on a personal level will enable the clinician to determine what adjunctive therapies are the best. It may require dramatic images to show patients how serious their current condition could get; let's not be afraid to change our patients' oral health for the better. RDH
Amber Auger, RDH, MPH, practices dental hygiene in Boston, Mass. She holds her master's in Public Health and is a faculty member of Mount Ida College. She is an advisor for Jameson Management, and teaches indoor cycling. She can be contacted at [email protected].
1. Vargas, et al. The Oral Health of Older Americans. Available at: http://www.cdc.gov/nchs/data/ahcd/agingtrends/03oral.pdf. Accessed April 24, 2016.
2. CDC. Periodontal Disease. 2016. Available at: http://www.cdc.gov/oralhealth/conditions/index.htm. Accessed April 24, 2016.
3. ADA. Fluoride Facts. Available at: http://www.ada.org/~/media/ADA/Member%20Center/FIles/fluoridation_facts.ashx. Accessed April 3, 2016.
4. Colgate Professional. Prevident 5000. 2016. Available at: http://www.colgateprofessional.com/products/colgate-prevident-5000-plus/overview. Accessed April 24, 2016.
5. CloSYS. CloSYS. Available at: https://closys.com. Accessed April 25, 2016.