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Care for the Elderly

Care for the Elderly

For patients with their own teeth, effective plaque removal is the basic and essential oral home care procedure. Removal of plaque not only prevents caries and periodontal disease but also enhances the overall sense of well-being by ensuring a mouth that feels and tastes good.

A preferred method of brushing for most older adults is a circular approach. However, no one technique is recommended for all and the best approach is one specifically designed for the individual's abilities and tooth status. The benefits of using a soft toothbrush with light pressure are well documented. 

Electric toothbrushes may be preferable to manual devices for many older adults, particularly those with diminished manual dexterity. Electric toothbrushes usually have enlarged handles and require little or no arm or wrist movement to use. 

Dentifrices or toothpastes are also recommended since they contain ingredients that help remove stains, inhibit calculus formation (tartar-control formulas) and provide a vehicle for topical fluoride. 

Teeth are less susceptible to caries when optimum amounts of fluoride (approximately 1 mg/day) have been ingested while the teeth were developing. Today's older adults did not have the benefit of fluorinated water supplies when they were children. Yet, applying topical fluoride compounds to erupted teeth enhances the benefits from systemic fluorides in both children and adults. Periodic applications should be supplemented by daily use of a fluoride-containing dentifrice. There is no evidence that fluoride use at recommended doses is dangerous. 

Dental floss is the basic instrument for removal of plaque from between the teeth. Older adults with impaired manual dexterity may find the use of a floss holder to be helpful. However, there are drawbacks to this device, and individual instruction in its use is recommended. 

Certain mouthwashes or rinses may be beneficial to the individual's oral health, whereas others may be detrimental, may exacerbate existing pathologic conditions, or may have no effect at all. It is important for the dental professional to determine what if any rinse a person needs to use. 

"Cosmetic rinses," which are used primarily for a mouth-freshening effect have major disadvantages. They contain alcohol (6-29%), which can dry and irritate the mouth. Their effects are transient, yet they do succeed in disguising the underlying cause of bad breath, which then may not be attended to properly.

Dentures need to be cleaned after each meal to remove the soft debris. Once a day, dentures should be brushed and cleaned thoroughly and allowed to soak overnight or for at least a few hours. When dentures are out of the mouth they should be stored in a water-filled container. They should always be rinsed thoroughly before insertion into the mouth.