Detecting Dental Issues in Elderly or Specially Needed Family Members

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It is very difficult to manage the oral and dental hygiene of a close friend or relative and family member who cannot manage it himself or herself. For most people it is a very awful experience to have a close look into somebody’s mouth, even it it’s a loved one. But it is very necessary since, old people and people with special needs need support to ensure good oral hygiene and maintain dental health. This blog provides some easy to follow tips to what to look for and when to visit a dentist incase you are looking after an aged family member or a person with special needs.

At our clinics wherever we treat an aged patient or a patient with special needs, the first thing we check is if the patient has the capacity to consent for treatment. What it means is that this person can do the following:

  • Understand the pros and cons of the treatment being proposed
  • Remembers the information and patient education long enough to make a decision.
  • Express his/her decision
  • He/She will cooperate with the treatment.

A general rule to check the above is that if someone allows another person to brush his/her teeth then he/she may in most scenarios sit through most simple dental treatments. However, people who will not let anyone brush their teeth will be very difficult to manage on a dental chair and in most cases could be treated after they have been put to sleep with a general anaesthetic.

As a policy we do not administer general anaesthetic at Sabka Dentist Dental Clinics and usually refer a patient like the above to a hospital.

This blog provides information on the most commonly prevalent problems that people have in their mouths. Here we will try to provide some insights on what to look for, how the problems can be treated and other things that one needs to consider.

  1. Broken teeth: Teeth could break due to a number of reasons. They can have decay, which, when advanced enough, will cause cavities (holes) to form. Over time these holes will grow and, if they get big enough, the whole top of the tooth can break off, leaving just the root sticking out of the gum. Some people grind their teeth causing them to wear away or fracture. Fillings, despite what we in the dental world would like to believe, don’t tend to last for ever. When they fall out, they can leave the tooth looking broken. Finally, if someone falls over and hits their face, they may break a tooth from the impact. Generally, it is a good idea to get a broken tooth checked out by a dentist. If the person can make it into a dental surgery and cooperate with treatment – then there is often a lot we can do for them. If they have to be checked at home we are more limited in what we can do. We can smooth off rough edges to stop them cutting the cheeks or tongue and we may be able to patch up holes, but if the tooth is decayed, we will most likely only be able to slow down the rate of decay, rather than stop it.For people who cannot cooperate with any treatment awake, we have to ask if the dental problem is causing them pain? Is it making it difficult for them to eat? The answers to these questions can then be weighed up against the risks of a general anaesthetic.
  2. Loose or moving teeth: Seeing a tooth wobble about when you touch it can be a bit of a shock, but it is more common than you might realise. Adult teeth can be wobbly (or mobile which is a term most dentists use) for a number of reasons.
    • Gum disease (also known as periodontitis) can cause the bone that holds teeth in place to be lost. Over many years this will make teeth loose. Unfortunately, by the time the teeth are getting wobbly, much of the damage has already been done and the bone, once it has been lost, is unlikely to ever come back. It may be possible, with treatment, to get the teeth to firm up a little bit – but this would require the person’s teeth to be kept exquisitely clean, every day, for the rest of their lives. In some cases one has to ask whether this is a realistic prospect.
    • Overloading can be another reason why teeth become loose. An adult with a full set of teeth will have 14 or 16 teeth per jaw (depending on whether they have wisdom teeth) and the load placed on them when you bite together is spread across them all. Now imagine someone who has lost many teeth and now only has 5 or 6 left. The remaining teeth still have to take all of that load. It should not come as a surprise that this can make them a little wobbly. The good news is that this may not be a problem, and, provided they are kept clean, those teeth may keep going like that for many years.
    • Finally, infection is another common cause for teeth becoming loose. Generally these teeth will be sore to touch and may have a swelling or boil in the gum. Perhaps there will be a little pus around the tooth. These definitely need to be seen by a dentist. Important questions to bear in mind with regards to loose teeth are: Is the tooth causing any pain? Is this a recent problem or has the tooth been like this for a long time? Is it causing the person difficulties with eating? For very loose teeth, the only options may be to either leave the tooth as it is, or to remove it. Taking teeth out outside of a clinic is generally considered to be unsafe and has to be done at a dental clinic or a hospital only.
  3. Dentures: Dentists usually quote that “Dentures are not a replacement for teeth. Dentures are an alternative to having no teeth”. This is important to bear in mind when you set your expectations for what is essentially a lump of plastic to behave exactly like natural teeth. That being said, dentures can be wonderful – giving people back their smile and perhaps helping them chew food a little better. Dentures, however, have a terrible habit of getting lost. One useful tip, if you’re ever having dentures made for a loved one, is to make an extra pair. Another tip would be to neverwrap a denture in a tissue. There have been plenty of cases where people have had their dentures accidentally thrown away because somebody thought it was waste. People will often complain that their dentures have become loose over time and have started to rub. This is generally because, over time, the shape of our mouths change – especially if we have lost teeth. In these cases, if the denture is otherwise fine, it may just need re-lining to make it fit a little more snugly. This is a relatively simple procedure. If the teeth have worn or there are other problems with the denture, it may need replacement. Often, this just means that a new set of dentures need to be made, but it is worth asking a few questions first. How long has the patient been without their denture? Have they been coping well without it? Are they managing to eat well? Does the patient actually want a new set? It is important to consider that as people get older or their mental faculties decline, their ability to cope with change decreases.
  4. Ulcers: Mouth ulcers can be caused by a wide variety of things and, whilst they are normally not too serious, they can be very painful. It is certainly worth arranging for a dental checkup if they are affecting the person’s quality of life. If a single ulcer lasts more than 3 weeks, you should definitely arrange for an urgent check to make sure it isn’t anything more serious.
  5. Pain: If your loved one is finding it more difficult to eat than usual and you suspect it is a mouth or tooth problem, please arrange for an urgent appointment for a Dental Checkup. The same can be said if they are reporting or displaying signs of unusual distress or pain that appears to be coming from the mouth. Swollen faces warrant an urgent appointment.

This should cover all the most common problems you may encounter. We hope this blog has been useful to you in identifying potential issues, as well as giving you an idea of what to expect if you have to seek treatment for the ones you care for.


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One thought on “Detecting Dental Issues in Elderly or Specially Needed Family Members

  • Aayushi

    It is very necessary since, old people and people with special needs need support to ensure good oral hygiene and maintain dental health.

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