According to the Center for Disease Control (CDC), nearly one third of patients age 65 and older have untreated tooth decay.~~1 National data demonstrates that 7 percent of adults ages 65 and over have had tooth pain at least twice during the last 6 months and only 1% had access to care.~~2 The CDC reports 70 percent of the Geriatric population has Periodontal Disease.~~2 The lack of proper oral health care in the Geriatric population is an epidemic that dental professionals are called to change. Promoting oral health of Geriatric patients requires engagement of caregivers and access to products that will decrease risk of decay.
Fluoride Varnish on patients
Clinical studies continue to confirm the power of a fluoride application, demonstrating a 50-70% decrease of tooth decay.~~3 A wonderful thing about fluoride varnishes for geriatric patients is the effectiveness and the ease of application. Fluoride applications can be placed by nurses or caregivers after a brief training from a dental professional. For example, if a patient has a high DMF (decayed, missing filled), xerostomia or lacks meticulous homecare, fluoride varnishes and nightly fluoride trays can be sent home with the patient to help reduce their risk of decay.
High fluoride toothpaste such as Prevident 5000 by Colgate, Clinpro 5000 by 3M and Dalyi by Preventech offer hypersentivity relief and work to reminerlize the enamel surface. The utilization of high fluoride demonstrated “significant remineralization of root caries in just 3 months (38%) and 6 months (57%)”.~~4 Use of high fluoride toothpaste on a consistent daily basis allows incipient decay to be reminerlized and reduces the patients sensitivity.
The xerostomia battle can be a nightmare! Dental hygienists have become very familiar with recommending Biotene® as a solution. New technologies allow for a wider variety of dry mouth options that aren’t as thick to allow for greater compliance. CloSYS offers a product called Silver™ which contains high fluoride in the sulfate free form.5 Chloride Dioxide is the active ingredient in CloSYS that allows for a rapid decrease in bacteria growth without the intense flavoring which provides relief for sensitive mouths.~~5
The key to change in Geriatric oral health is motivation of caregivers and the patient. Utilization of disclosing tables before and after brushing will aid in patient and caregiver engagement. Getting to know the patient on a personal level will enable the clinician to determine what adjunctive therapies are the best. It may require dramatic images to show the patient how serious their current condition could get- let’s not be afraid to change our patients oral health for the better.