June 16, 2022
This paid room is sponsored by Siouxland Oral & Maxillofacial Surgery.
This month’s topic is geriatric care: what is it and who is in it? Well, the answer to that question honestly depends on your definition of the word “geriatric”. AARP would like you to believe he’s 55+ – case closed. On the other hand, we have seen many people in our practice who are physically fit, mentally sharp and can still drive a car just fine at 100!
A few years ago we decided that if you turned 100 and needed oral surgery tooth extractions, you would get them for free. There must be a benefit and recognition to reach the 100 year mark.
We can remember three patients who came to our office for tooth extraction a few years ago; all in the same month and all over 100 years old! One patient had her driver’s license and drove a car, another had her driver’s license but only drove occasionally, and the third had her driver’s license but did not drive because she liked having a reason for her little one. -daughter accompanies him to appointments. The point here is that perceptions of “geriatric” care are clearly different for everyone.
The nebulous phrase “studies show” is part of today’s article. Studies show that if you have good teeth as you age, you will have a better quality of life. These same studies, however, come with the caveat that you need to be able to maintain and care for your dental health as you get older.
The decision tree for which treatments you choose is between about age 65 and 70. It also raises the question of whether the patient has the mental and physical capacity to maintain the dental work they have and whether they will be able to continue to maintain good oral hygiene for the next five years and beyond. So, when deciding on dental care, you not only need to consider the best treatment options right now, but also how to maintain the sustainability of that treatment throughout your life.
Taking the example of our centenarians, a treatment plan with crowns, bridges and even implants at 80 or 90 was a solid choice because these treatments maintain their quality of life. This same attitude, however, for patients who need advanced skilled nursing care, even to brush their teeth in a nursing home, may not be a good idea. You might ask why. Well, the treatment itself can cause the patient to have a cascade of aftercare problems as they cannot sustain the work done properly. Failure to maintain it could lead to widespread tooth decay, periodontal disease, and infection.
Older people often cannot or will not – because they are stoic – verbalize any discomfort they are feeling. Studies show that people who can maintain their teeth well into old age actually have a better quality of life. This includes people with natural teeth with partial dentures, crowns and bridges, individual dental implants, and complete dentures supported by dental implants. It all depends on the individual’s ability to maintain good oral hygiene to protect the teeth and the dental work that has been done.
Unfortunately, there are many people who age and also noticeably decline in their 60s or 60s. For these patients, dentures are perhaps the superior alternative. In some cases of chronic dental destruction, maintaining teeth that are at gum level, but not causing pain or infection, is the best answer.
In summary, many geriatric patients have difficulty maintaining good oral hygiene, so it behooves younger generations to take our elders to their dental appointments at least two or three times a year for a dental evaluation. Often the family must also help brush their teeth or obtain electric toothbrushes for these patients. Do an internet search for “full arch toothbrushes”. These devices look like sports mouthguards; they brush their teeth when they are bitten and require almost no dexterity. Good, consistent oral care decreases bacteria counts and has been shown to significantly improve overall health.
The simple conclusion for this month is to adapt the care of aging patients according to their current and anticipated abilities. With that in mind, what you think is the best treatment sometimes isn’t. The patient’s short-term and long-term condition should always be considered before initiating definitive treatment.
We hope this has been informative for you, and we look forward to seeing you again next month!
Please see our future monthly articles covering a variety of dental and surgical topics.
To learn more about Siouxland Oral and Maxillofacial Surgery, visit siouxlandoralsurgery.com.