Oral health is one aspect of our physical wellbeing that we seem to take for granted. As we age, it becomes more and more important to look after our oral health, especially when there could be issues with mastication (the process of chewing food before it’s swallowed) and various other nutritional problems. Left untreated, it may become more difficult to even consume foods, which further compounds your overall wellbeing.
Whether it involves dental hygiene or dietary restrictions, oral health is a critical part of our overall health, especially for senior citizens. As mentioned earlier, difficulties with oral health can diminish your overall nutritional intake or put you at risk of other health complications. This article will go through various oral health problems that might arise as you age.
Given that Malaysia is set to become an ageing society by 2030 – with more than 15 percent of the population composed of older adults – it’s even more important to emphasise the importance of looking after ones’ oral health.
Assessing Oral Health
It’s recommended that you and your loved ones see your dentist at least twice a year to look after your oral health before troubling symptoms cause problems. It might seem trivial, but just like any other health complication, catching them early can mean the difference between a speedy recovery and a lengthy (and maybe even painful) adverse health episode.
An assessment of one’s oral health isn’t just a matter of looking into their mouth and keeping an eye out for possible symptoms. It may sometimes require a more holistic approach that also includes physical and cognitive health checks. Things that the medical team may note include “socioeconomic conditions,” the presence of other underlying conditions, and any prescriptions (for medications or supplements) you may be taking.
Your dietary intake is also another crucial aspect that’s considered: diet does play a major role in your oral health, especially given the propensity of Malaysians to indulge in their favourite foods, whether or not they’re high in sugar, fats, or other unhealthy additives. Even smoking can cause long-term complications in one’s oral health.
Types of Oral Health Complications Among Seniors
Oral health complications come in different forms, some being relatively easy to treat while others may be more severe. Here are some of the most common complications that may arise.
Dry Mouth (Xerostomia)
You may have a dry mouth when there’s not enough saliva to keep your mouth wet. While the thought of it might seem a little gross, saliva is actually important for your oral health. For one, it helps prevent tooth decay and keeps your gums healthy, too. It’s also important in helping you chew your food, tasting and enjoying them, as well as making the food easier to swallow.
If there’s not enough saliva in your mouth, you are at risk of various complications such as tooth decay, gum infection, and even difficulties in chewing, swallowing, and even talking. If you wear dentures, having them on may feel more uncomfortable than normal. Your dentures can potentially rub against the gums or the roof of the mouth and cause discomfort or pain.
If you or your loved one has a dry mouth, have them stay hydrated as often as possible. Make a point to avoid sugary drinks, coffee, and even tea, as some of these can cause dehydration. Be sure to cut down on alcohol and tobacco consumption, too.
Mouth sores may be due to a number of reasons, ranging from simple mouth-related injuries to viral infections. For example, canker sores may be caused by accidentally biting your lip while eating or even by overzealous brushing of your teeth. In most cases, mouth sores will heal on their own after a few weeks, though they do still cause some degree of discomfort or pain. In other cases, mouth sores may be a sign of an underlying condition that may be severe and requires immediate medical attention.
Mouth sores mainly cause pain or discomfort when you’re eating, drinking, and even talking to others. This may depend on where the sore is located within your oral cavity. If you find that you frequently get mouth sores, or if other symptoms suddenly present themselves not long after the mouth sores first appeared, consult a doctor immediately for a thorough examination.
Tooth Decay (Cavities)
Dental cavities (holes in your teeth) are a sign of tooth decay. It usually occurs when a bacteria known as dental plaque builds up on your teeth. This bacteria will slowly cause damage to the enamel coating surrounding your teeth, which eventually causes cavities. The bacteria use sugary and starchy foods we consume to produce acids that chip away at your teeth’s enamel coating.
Enamel can repair itself over time by using minerals from saliva and fluoride from your toothpaste or other sources, but constant exposure to dental plaque will still cause it to erode. When there are cavities in your teeth, a dentist will repair the damage with fillings. However, plaque may also affect teeth with fillings by causing new decay in unaffected areas. Exposed tooth roots are also at high risk of decay.
It is therefore important to brush your teeth with fluoride toothpaste to protect your teeth from the harmful effects of plaque. It’s recommended that you brush twice daily for optimal results. Ensure that you also floss your teeth frequently as well.
Gum Disease (Gingivitis and Periodontitis)
Gum disease affects the gums and surrounding tissues that keep your teeth in place. This happens when dental plaque builds up “along and under your gum line”. Unlike plaque that builds up on your teeth, this plaque becomes hardened after 72 hours and can’t easily be removed by brushing or flossing.
Gum disease comes in two forms: gingivitis and periodontitis. Gingivitis is a milder infection that’s preventable and reversible by simply taking care of your oral health. Symptoms usually involve inflammation of the gums and becoming easier to bleed; your gums may look redder and more swollen due to this. You’ll feel discomfort or irritation in your gums, but your teeth are still fine.
On the other hand, periodontitis is a more severe form of gum disease that damages your gums and tissues holding your teeth in place. The gums will pull away from your teeth and create pockets (basically, spaces) that can easily be infected. As the plaque spreads past the gum line, your immune system will kick in to fight off the propagating bacteria. A combination of bacterial toxins and the body’s protective enzymes can end up breaking down the bone and connective tissues that hold your teeth in place; left untreated, your gums, bones, and tissues become irreparable and your teeth become loose and have to be removed.
If you or your loved one has gum disease, there may be no obvious symptoms that indicate it’s affecting you. Even so, gum disease will still progress and cause you many problems with eating and drinking. A dental examination will determine if you do have gum disease and steps will be taken to prevent it from worsening.
Brushing and flossing your teeth regularly, rinsing your mouth with antibacterial mouthwash, quitting smoking, and maintaining a healthy diet are all steps you can take to prevent gum disease from affecting yourself or your elderly loved ones.
Burning Mouth Syndrome (BMS)
BMS occurs when you feel as if your mouth is “burning, scalding, or tingling.” It may happen if you have a dry mouth; sometimes, this may also be accompanied by numbness that comes and goes. BMS affects any part of the mouth, including the tongue, and can last for a very long time in some people.
The one challenge with diagnosing burning mouth syndrome is that there’s still a lack of knowledge about what causes it. Most of the time, a dental/oral examination turns up nothing suspicious that could be causing this. In other cases, a particular oral habit (such as clenching your teeth) might be what’s causing BMS.
BMS is divided into primary and secondary BMS.
- Primary BMS occurs when there isn’t an underlying medical condition or a side effect of medication or treatments that are causing BMS.
- Secondary BMS is when an underlying medical condition is causing BMS and can be remedied by treating this underlying condition. You may also be given training to manage unhealthy oral habits to help with treating BMS if needed.
Temporomandibular Disorders (TMDs)
TMDs are disorders that affect your jaw muscles, temporomandibular joints (or TMJ, which connect your lower jaw to the skull), and any surrounding muscles and nerves. TMDs comprise 30 different conditions, all of which contribute to pain and dysfunction of the jaw and its movements. Symptoms can include:
- Pain in the muscles, tissues, or other parts of the jaw
- Pain that spreads to your neck and face
- Sudden, unexplained headaches accompanying pain in your jaw, neck, or face
- Stiff jaw
- Difficulty chewing or even talking
- Heightened teeth sensitivity
- Facial pain that comes and goes
- Clicking, grinding, or popping noises when moving your jaw
- Ringing in your ears
- Degenerative joint disease in the TMJ
Diagnosing for TMDs is tricky as there may be various factors that could cause a disorder. Generally, an injury to the jaw (such as blunt force trauma) can cause TMD or it could even be due to erosion of parts of the TMJ. In some cases, symptoms can happen without any warning. There are also ways you can end up causing TMDs without realising it, such as frequently grinding your teeth, nervous habits of chewing on the tip of your pen, or even taking big bites out of your food which can strain your jaw muscles. Further studies are needed to accurately determine what may be the actual causes of TMDs, including why they are more prevalent among women than men.
A complete medical examination may be needed to identify possible signs of TMDs or to ascertain the causes of potential symptoms of TMDs. Sometimes, symptoms may go away on their own, so doctors may recommend simple lifestyle modifications until you recover, such as eating soft foods. Physical therapy and medications may be needed for serious cases, which aim to help restore physical function in your jaw and ease any pain or discomfort. For more severe cases, surgery may be needed as a final resort to treat TMDs.
Sometimes referred to as mouth cancer, oral cancer affects not just your mouth and its insides, but also parts of your throat. Oral cancer is considered one of the most common cancers in Asia with a mortality rate of over 120,000 in 2020. If left untreated, cancer cells can eventually spread to other parts of the body – particularly the head and neck – and can be fatal.
Like most cancers, oral cancer is caused by mutated cells that rapidly and uncontrollably multiply. As this continues, these cells eventually form a tumour. Tumours may cause a significant number of complications, especially in later stages where the cancer becomes more aggressive and affects other parts of the body. The exact cause of oral cancer is still being investigated, but risk factors that can increase your risk of oral cancer include:
- Frequent smoking
- Frequent alcohol consumption
- Excessive exposure to sunlight
- A HPV infection
- A weak immune system
It’s important to catch signs of oral cancer early as it is much easier to treat than in later stages. Symptoms of oral cancer include:
- Sores that form on the lips or inside the mouth that easily bleed
- White/reddish patches on the inside of the mouth
- Bleeding inside the mouth that happens without warning
- Persistent sore throat that doesn’t go away
- A lump in the neck
- Difficulty chewing or talking
- Swelling of the jaw, causing dentures to not fit properly
- Unexpected pain in the mouth
An early oral cancer examination is used to look for early signs of oral cancer, which usually consists of a thorough mouth examination to look for obvious symptoms. A biopsy may be ordered for further lab tests to determine if it is oral cancer; the doctor will take some samples of your inner mouth lining to conduct lab tests to accurately determine if it’s oral cancer or not. Treating oral cancer usually involves surgery, chemotherapy, immunotherapy, radiotherapy, or a combination of treatment methods.
Caregiving for Oral Health
It’s important to guide your elderly loved ones in taking care of their oral health, especially if they might not be physically able to do a good job of brushing their teeth or flossing. Without proper care, it can adversely affect their overall wellbeing. For example, some seniors may already have difficulties eating due to frailty, such as being unable to properly hold cutlery or to adequately feed themselves on their own. Oral health conditions that crop up may end up exacerbating their physical health, making it even more difficult for them to get the nutrition they need.
Here are some tips that might help you with caregiving for them.
- Teach your loved ones the recommended oral health practices. This extends beyond brushing twice a day and regular flossing. For example, a lot of people still equate vigorous brushing of teeth as the best way to get rid of plaque from their teeth and gums. In reality, this might end up causing you harm by causing gums to bleed. Show your loved ones how to properly brush and floss their teeth; if you’re not sure yourself, don’t hesitate to ask your dentist or oral healthcare provider for tips and best practices.
- Adapt to your loved ones’ needs. You might need to change their regular toothbrush or toothpaste if they might have issues (such as gums easily bleeding). You might need to have toothpaste and toothbrush ready at the bathroom sink in case they have cognitive complications, such as dementia. Whatever your loved one’s condition might be, it pays to be prepared for anything. Speak to your doctor about how you can adjust to your loved one’s needs.
- Practice good oral habits outside of hygiene. This may include proper eating techniques so you don’t strain the temporomandibular joints or other parts of your mouth or jaw.
- Make a trip to the dentist at least once a year, so they can assess your oral health and determine what needs to be done to better take care of it or even spot warning signs of an upcoming oral health issue. Don’t just see them only when there’s a problem; early detection can save the life of yourself or your loved ones.
- Quit smoking and alcohol consumption. For the latter, you can still consume it infrequently, but it’s best to keep it to a very low amount (one glass a day, and no more than seven a week, though less or none at all is better).
- Watch what you eat and drink as well. Cut down on food and drink that can potentially cause tooth decay or gum disease, such as those rich in sugar and fats. If you or your loved one has difficulty eating certain types of food, replace it with something that’s easier to chew to prevent complications like tooth damage or bleeding gums. Make sure to drink plenty of water, too, to prevent dry mouth complications.
- If you or your loved one uses dentures, proper denture care can go a long way in improving your quality of life. Speak to your dentist at length for best practices to keep them in good condition, such as the frequency of cleaning them and how to do it.
- If you or your loved one have other medical conditions, do your best to mitigate the symptoms, as this can help to reduce the risk of oral health complications from arising. Your doctor may have a treatment and recovery plan to help you with this, so stick to it as closely as possible. If it’s an emergency, quickly head to the nearest hospital at once.
Affordable Oral Care Services in Malaysia
Getting affordable community-based dental care is fairly easy thanks to the wide network of over 1,670 dental facilities around the country. These include mobile dental clinics as well which may cover rural areas that don’t have ready access to dental care providers. You can find the complete list here for your convenience.
You can also consult this list of dental fees for various diagnostic tests and other procedures via the Ministry of Health’s website. Take note that it was last updated in 2019, so payment amounts may be different from what is charged today. It’s still useful to give you a general idea of how much you’ll need to pay for dental care.
Need Help with Oral Healthcare?
If you’re caregiving on your own, it can prove to be quite a challenge to juggle all your commitments while still looking after your loved one. Don’t worry, though, as our Care Professionals can assist your loved one with performing general oral hygiene practices and keeping your oral health in good shape. You can also count on us to assist them with dental appointments or oral health treatments.
Whatever your needs may be, feel free to contact us for a consultation with our Care Advisors. We’ll be more than happy to help you come up with the best care plan that suits your oral health needs. Download our app now to find out more and start booking quality care for your loved one!
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