Good Health Requires a Healthy Mouth

A dog watching people go by at Echo Dale Park, Medicine Hat. (Dr. Noorali Bharwani)
A dog watching people go by at Echo Dale Park, Medicine Hat. (Dr. Noorali Bharwani)

An article in the Canadian Medical Association Journal (CMAJ September 2, 2014) titled, “Good health requires a healthy mouth: improving the oral health of Canada’s seniors” says one in six seniors decline recommended dental treatment because of cost.

The Canadian Health Measures Survey reported that one in six seniors aged 60 to 79 years in the community had untreated dental caries. More than half had periodontal disease, with 15 per cent having evidence of severe disease. About one in five had no remaining teeth.

Joan L Rush, Lawyer (retired) comments on the above article in the CMAJ. Rush’s letter is titled, “The dental profession fails those most in need.” She says more than 3.8 million Canadians are disabled, and 26 per cent of this group are defined to have very severe disabilities. These people face terrible barriers getting necessary dental treatment. This group is subject to inequality in oral health both in terms of prevalence of disease and unmet dental care.

As most of us know, dental and periodontal infection has serious health implications for all individuals but especially older people. Periodontal infection is associated with systemic diseases such as coronary artery disease, stroke and aspiration pneumonia. These are very serious conditions.

There is some evidence that dental disease has been linked with diabetes, rheumatoid arthritis and obesity, among other conditions, the strongest evidence for a relationship is found with cardiovascular disease, says the article.

Why do seniors have more dental problems?

Most seniors claim to brush and floss as regularly as younger people, says the article. But there are several factors contributing to an increased risk of poor oral health in this age group. For example, as the aging process proceeds, the salivary glands reduce the amount of saliva production and increase the bacterial load in the mouth.

Other oral issues, which may affect dental care in the seniors, are: attachment of gums to teeth loosens, mechanical difficulty with brushing and flossing, chronic diseases and poor nutrition contribute to reduced immunity against infection, leading to periodontal disease.

In Canada, only Alberta and Yukon Territories provide financial assistance for dental care to people over the age of 65 years who meet certain conditions. On retirement, most Canadians lose their dental benefits and many cannot afford private insurance. What is interesting is severe periodontal disease was most prevalent in those without health insurance. In fact, a lack of health insurance was the only factor that appeared to influence the prevalence of severe disease.

The authors of the article hope that the Canadian Dental Association will create a roadmap that will lead to tangible positive oral health outcomes for seniors. I wonder how long is that going to take. But there are measures that we can take to keep our teeth and gums healthy. Here is what the Mayo Clinic website recommends:
1. Brush your teeth at least twice a day.
2. Floss daily.
3. Eat a healthy diet and limit between-meal snacks.
4. Replace your toothbrush every three to four months or sooner if bristles are frayed.
5. Schedule regular dental checkups. Contact your dentist as soon as an oral health problem arises.

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