Debby Ward Sales manager, GC UK discusses the challenges an ageing population poses to dentistry – and how to tackle some of the most common oral health problems old age can bring.
In the UK, not only are people living longer than ever before, but increasing numbers of people are also retaining their natural teeth well into old age.
While this is undoubtedly positive news in the main, an ageing population also brings with it an increased number of health challenges, especially when it comes to maintaining oral health and dentition.
In a 2017 report by the Royal College of Surgeons, it was estimated that in the UK more than 1.8 million people aged 65 years and over could have an urgent dental condition such as dental pain, oral sepsis or extensive untreated decay. Furthermore, by 2040 this estimate could increase by more than 50% due to population growth alone.
Keeping our natural teeth into later life means an increasing need for dental treatment and restorative work. As people age it can become more difficult to maintain good oral health as loss of dexterity, long-term health conditions and/or the onset of dementia can make even the practice of twice-daily brushing a significant problem.
One of the known side-effects of medications used to treat disease later in life is salivary dysfunction (dry mouth), which increases the risk of tooth decay and oral infections as patients lose the beneficial antimicrobial properties of saliva.
Elderly people with poor oral health are more likely to experience pain and discomfort in their mouth and jaw, or struggle with ill-fitting dentures, leading to difficulties in eating and drinking. This can result in nutritional deficiencies that severely impact their overall general health.
Furthermore, as concern grows around the increase in oral cancers, regular dental check-ups are essential for early diagnosis and treatment. Mouth cancer can particularly affect older people, with NHS data showing that more than two thirds of cases are found in adults over the age of 55, illustrating the need for older people to be able to easily access dental services, including those in care homes.
Treating the elderly
For most clinicians, treating elderly patients is an everyday occurrence. As this demographic grows, it is essential that dental professionals are prepared to treat the conditions this will bring.
Elderly patients with salivary dysfunctions linked to medical conditions or medications can undergo a rapid increase in the risk of both coronal and root surface caries. By elevating the levels of calcium in saliva and dental plaque, a topically applied mousse can reduce the harmful effects of plaque-derived acids and enhance remineralisation.
Tooth Mousse from GC is one such product. It is a water-based cream containing Recaldent, a compound derived from the milk protein, casein.
It has long been known that milk and its derivatives have a protective effect on teeth. Research has shown that this is due to a part of the casein protein called casein phosphopeptide (CPP), which carries calcium and phosphate ions in the form of amorphous calcium phosphate (ACP).
Recaldent technology is also found in GC’s MI Varnish, which is used to prevent hypersensitivity in older patients. It is especially effective after professional hygiene treatment or in cases of occlusal wear – one of the most common problems in the older dentate population.
GC Tooth Mousse is a water-based cream containing Recaldent, a compound derived from the milk protein, casein
MI Varnish is used to prevent hypersensitivity in older patients
The fluoride, calcium and phosphate found in pHneutral MI Varnish combine to form a strong protective coating on the teeth, while enhancing enamel acid resistance and inhibiting demineralisation. This can help prevent palatal or lingual root caries in elderly patients wearing dentures who do not remove and clean them regularly, which, for a clinician, are very difficult to treat.
Older dentition generally has multiple restorations, often with faulty margins or in need of repair. This, coupled with poor oral hygiene and dry mouth, increases the risks of secondary caries.
The choice of restorative material in elderly patients requires careful consideration and one of the most popular, alongside standard composites, is a mercuryfree glass ionomer designed to restore teeth in a durable and aesthetic way.
Many elderly patients especially cannot tolerate long treatments and are more interested in restoring function rather than form, with one of the major challenges for clinicians being bonding composite to sclerotic dentine.
The latest member of GC’s glass hybrid family is the Equia Forte HT bulk fill long-term restorative system.
Building on the success of Equia Forte, new particles and fillers make for a more translucent, aesthetic
restoration, indicated for class I and class V restorations, as well as stress-bearing (with specific preparation) and non-stress-bearing class II restorations and core buildups.
High fluoride release at the tooth-restorative interface makes this an ideal restorative treatment for both paediatric and elderly patients.
Tooth loss is not inevitable
While wrinkles and greying hair are inevitable with age, tooth loss is not. Routine conservative restorative dentistry and the application of oral hygiene measures together form a solid basis for the dental management of the elderly.
There has never been a better time to get ready to cater to the needs, demands and challenges of geriatric preventive and restorative dentistry.
Royal College of Surgeons (2017). Improving older people’s oral health
For more information contact GC UK