Oral hygiene, systemic health, and the aging population: A review of "Dying from Dirty Teeth"

Angie Stone is one of the few clinicians who has dedicated herself to advancing geriatric health through dentistry. As a dental hygienist and brain longevity specialist, she brings unique experiences and a perspective that makes her publication, Dying from Dirty Teeth. Why the Lack of Proper Oral Care Is Killing Nursing Home Residents and How to Prevent It is an invaluable and underutilized resource.¹

Stone’s heartbreaking experiences with patients who are suffering due to neglected oral care that often leads to preventable death compelled her to write this book. Her message is urgent yet empowering: while there is an astronomical problem, there is also a realistic and actionable solution.

The problem

Dying from Dirty Teeth is packed with statistics and studies illustrating how the lack of regular oral care in elderly populations worsens conditions that can lead to death. For aging adults, poor oral health has been directly connected to conditions such as aspiration pneumonia, heart disease, stroke, diabetes, chronic obstructive pulmonary disease (COPD), and dementia.

In nursing homes and other long-term care facilities, neglecting daily oral care isn’t just a quality-of-life issue; it’s often a matter of life and death. Aspiration pneumonia, for example, is largely preventable with proper oral hygiene, yet it remains one of the leading causes of death for older adults. The cost of dental care, staffing shortages, and lack of training for caregivers all contribute to this widespread neglect.

Low quality of life

Beyond the risk of systemic disease, poor oral hygiene directly impacts quality of life. Without regular oral care, older adults may endure chronic pain, difficulty eating, and social isolation. Oral infections, loose teeth, and inflamed gums can make simple activities such as eating, talking, and smiling difficult and painful. By addressing these issues, we’re not only saving lives, but also giving elderly people the dignity and comfort they deserve.

The solution

For those of us who are committed to prevention, Dying from Dirty Teeth provides a roadmap. Hygienists are ideally positioned to tackle this problem head-on. Laws have changed and continue to change in our favor. Many states now allow dental hygienists to provide preventive services in nontraditional settings, either independently or through collaborative agreements with dentists. This opens doors for us to reach elderly patients directly in residential facilities.

While dental offices aren’t always equipped to see patients with special needs, we can become prepared. Stone emphasizes the importance of training ourselves in transfer techniques, becoming memory care certified, and adapting our communication to support elderly patients with cognitive issues.

Partnering with the Certified Nursing Assistant (CNA) workforce is another key step. CNAs are with residents daily, yet the majority lack training in oral care. By implementing training programs in these facilities, we can equip CNAs to provide better daily oral care for their elderly patients.

Such programs should cover the link between oral and systemic health, the basics of infection control, and hands-on techniques for safely caring for seniors’ oral health. Helpful topics include how to position residents for brushing, gentle techniques to avoid causing discomfort, xylitol, and the proper use of toothettes for patients who struggle with traditional brushing.

A call to action

Hygienists, you are desperately needed. Your expertise and passion for oral health uniquely qualify you to take on this challenge. Elderly patients are vulnerable, and their oral care needs are not being met. Dying from Dirty Teeth doesn’t just outline a problem—it presents a solution we can implement right now.

We have the power to help the elderly population live their final years in health, dignity, and comfort. Our community has this rare opportunity to address a massive problem with real solutions, and it’s our responsibility as health-care professionals to resolve it.

Reference

1. Stone A. Dying from Dirty Teeth. Why the Lack of Proper Oral Care Is Killing Nursing Home Residents and How to Prevent It. Indie Books International. March 6, 2015. https://www.amazon.com/dying-dirty-teeth-killing-residents/dp/1941870112