Older Adults

Oral health in later life becomes a major part of general health and well-being. With increasing age, good oral hygiene becomes more difficult to accomplish, years of dental disease and its repair take their toll, and saliva may not provide the protection against disease that it once did. Food may be more difficult to chew and the perception of taste may diminish.

Good oral health throughout childhood and adulthood is the best preparation for oral health in later life. Thorough oral hygiene performed by toothbrushing twice a day and between teeth cleaning, either with floss or interdental brushes, is essential. If dentures are worn, they need good cleaning by brushing with a specially designed brush as well. Remember: good care of the mouth is as important in later life as good care for the rest of the body.


About dry mouth and how it may affect your dental health
How frequently to have dental visits
Your risk for dental decay and root cavities


Your dentist all the medications you are taking, including those that your physician prescribed and any over-the-counter medicines, too


Brush your teeth at least twice a day and clean between the teeth at least once per day
Choose a toothbrush that has a large handle if you have arthritis and have difficulty gripping the brush handle


To have regular dental check-ups
To change your toothbrush at least every three months
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To avoid too many sugary snacks

Not many years ago, it was generally accepted that ‘old people’ will simply have lost all their teeth and be wearing dentures. However, today’s older adults have had the benefits of fluoride to prevent cavities, better designed oral hygiene aids such as tapered-bristle tooth brushes, and dental care that has shifted in focus from extractions-and-dentures to preventing disease and improving esthetics and function. Because of these evolutions, many older adults today have nearly all their natural teeth, and fewer and fewer people wear dentures.

Taking care of your teeth is as important now as ever. A nutritious diet, low in sugar and rich in calcium and other nutrients, as well as thorough brushing and interdental cleaning is as important for you as it is for any young children among your family and friends. As you get older, good oral hygiene becomes more of a challenge to do well and the risk of cavities increases. Saliva protects teeth against cavities, but a common side effect of many medications is a condition known as dry mouth - less saliva flow to keep the mouth flushed clear of food debris and fewer minerals to repair early cavities.

If you wear dentures, remember to clean them thoroughly at least once a day with a denture cleanser and a denture brush. Rinse the dentures after meals and give them a gentle brushing to remove any food particles. Bacteria and other microbes stick to the surfaces of dentures and can enter any nooks and crannies in the denture. Thorough cleaning is vitally important.

Whether you have all or some of your own teeth, or you wear complete dentures, it is important that you still have regular check-ups. Your dentist will be able to advise you how frequently these should be, based upon your oral health and medical status.

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Even if you have no natural teeth, an annual oral cancer screening examination is very important.

There are over 400 different prescription and over-the-counter medications with known side effects that may impede the function of your salivary glands. Often, taking only one of these will make little noticeable difference, but two or more are much more likely to alter the quantity and quality of your saliva. The common dental health consequence of dry mouth are dental caries, especially of the roots of the teeth, a condition known as root caries. If you wear removable dentures, they are more likely to rub and cause sores and abrasions as the saliva normally lubricates and protects the lining of your mouth.

If you think your mouth is dry, consult your dentist or dental hygienist to check the situation and recommend additional preventive therapies to help prevent root caries and to make your mouth more comfortable. Also, consult with the physician who prescribes your medication, as sometimes it is possible to substitute another medication with the same therapeutic effect, but one that may not affect your salivary glands as much.

Figure: Many medications, both prescription and over-the-counter, have dry mouth listed as a side-effect

Figure: If gum recession has occurred, root caries is a common occurrence with dry mouth, as the protection from the saliva is diminished

It is possible to get toothbrushes with specially designed handles that enhance the grip of the brush and enable more thorough cleaning. Power toothbrushes have large handles that are easy to grip, and their rotary heads and oscillating actions will clean the teeth and gums.

Dental floss can be a challenge, but use of specially designed interdental brushes or picks can clean as thoroughly as floss and are easier to use.

Caring for an older adult’s oral health is as important as addressing any of their other health and comfort needs. Daily oral hygiene is very important. Depending on the physical ability of the person, they may still be able to brush and perform interdental cleaning, but simply need to be reminded. If you are caring for their oral hygiene needs, consult the person’s dentist or dental hygienist to determine how best and how frequently oral hygiene should be performed, and for the need for any additional prevention such as fluoride mouthrinses or gels. Natural teeth are at risk of dental decay, so in addition to fluoride for decay prevention, don’t forget to control the amount and frequency of candies and other sugar-containing snacks and beverages. Xylitol is a natural sugar substitute. Xylitol-containing products that do not contain other sugars may help provide protection from dental decay.

Cleaning dentures is also very important. Dentures should be removed and brushed to clean away food debris and dental plaque. Soaking in a denture cleanser is an additional method of cleaning and can reach where a brush may not. While the dentures are out of the mouth, rinse the mouth to remove food debris. If a denture adhesive is used, make sure none is stuck on the person’s gums or palate. Don't forget that even denture wearers require an annual check-up to evaluate the function and fit of the denture, and to perform an oral cancer screening.

Figure: Dentures should be cleaned by brushing and then soaking.