Care for older patients
Geriatric Dentistry
Care built around older mouths: dry mouth, worn enamel, root decay, and the practicalities of dentures alongside whatever medications are in play.
What changes with age
Teeth that have been in use for seventy years are not the same as teeth that have been in use for twenty. Enamel wears thinner, so the yellower dentine underneath shows through and the teeth are more sensitive. Gums recede, exposing root surface, which is softer than enamel and decays faster. Old fillings and crowns reach the end of their working life and start to leak at the margins.
The bigger change is often dry mouth. Saliva washes away food, buffers acid and carries minerals back into the enamel, and hundreds of common medications reduce it, including many for blood pressure, depression, allergies and incontinence. A mouth that has been healthy for decades can start getting cavities within a year or two of a medication change, and the cause is the dryness rather than any change in brushing.
At the appointment
Bring a current list of medications and medical conditions, and the name of the physician if there is one relevant. This is not administrative box ticking. Blood thinners, bisphosphonates, diabetes and recent cardiac or joint surgery all change how dental treatment is planned and sequenced.
The examination looks at the gums, the root surfaces, existing restorations, the fit of any denture, and the soft tissues. Cleaning may take longer where gums have receded and roots are exposed. If dexterity has become an issue, say so, because there are simpler ways to clean that work better than being told to try harder with the same brush.
Visits, Recovery and When to Call
Visits and timing
A checkup and cleaning is one appointment. Where root decay or gum disease is active, more frequent visits are usually recommended than the standard twice a year, because the aim is to catch new lesions while they are still small.
Afterwards
Nothing to recover from after an examination. After a cleaning where there was significant deposit, gums can be tender and bleed slightly for a day or two. Exposed roots can be sensitive to cold for a short period afterwards.
Call sooner if
A denture has started rubbing a sore spot, a tooth breaks, a filling comes out, you notice an ulcer or a patch in the mouth that has not healed within two weeks, or eating has become painful enough that you are avoiding food.
Dry mouth is treatable
Sipping water through the day, sugar free gum to stimulate what saliva there is, a high fluoride toothpaste, and avoiding alcohol based mouthwashes all help. It is also worth asking the prescribing physician whether an alternative medication with less drying effect exists, because sometimes one does.
Keep reading
Questions About Geriatric Dentistry?
Describe the problem on the phone. That conversation is usually enough to work out the first appointment. Mandarin, Taiwanese, English and Japanese are spoken.