Plaque control for elderly with physical limitations
Dr.Karishma Jaradi, Aesthetic Dentist, Dentzz Dental Care Centres
Oral health is not distinct from your general wellbeing and can have a direct link to your overall health. Which is why it’s so essential to develop and uphold oral care habit during any age.
Maintaining oral hygiene is undeniably difficult and different in old age. As for seniors and people with disabilities that impair mobility, traditional dental care routines may be complex and challenging. Their plaque removal struggles may be enhanced by adaptation of manual plaque control aids or by use of an electric device. The strategy and implementation of all-inclusive preventive dentistry procedures for elders with physical limitations presents the dental profession with many challenges.
In India, with its population of over one billion people, those who are older than 60 years of age constitute a percentile of about 7 – 10% of the total population, which amounts to 75 -80 million, incidence of oral cancer, which is an old age disease, is highest. Of added concern may be the manifestation of systemic disease that not only influences the patient’s ability to maintain oral hygiene and promotion of oral health, but can actually be related to the existence of certain oral diseases. Though impairments are not life threatening, they affect a person’s quality-of-life. Thus, planning treatment for the senior dental patient includes an understanding of the chronic diseases the patient lives with daily, as this play a critical role in the acceptance and success of the dental treatment plans.
Preventive dentistry components for the elderly with physical limitations
Electric devices: This can be an invaluable aid for the elderly when used properly. These devices have enlarged handles, which may be grasped more easily than the standard manual toothbrush handle. The key advantage derives that they are motor driven, thus requiring little or no arm or wrist movement, and the need to make consistent movements. Some of the electric plaque removal devices are designed in such a way that the action stops if too much pressure is applied.
Adaptive aids: If an elderly person’s grip is weakened by a condition such as an arthritis, they encounter difficulty in grasping the slender handle of a conventional toothbrush, floss holder, or other home care aid. To enable the patient to perform effective plaque removal, the handle can be enlarged or built up so that it can be grasped easily and comfortably.
Mechanical plaque removal: The plaque retention in the elderly is aggravated by the presence of restorations, gingival recession and missing teeth. The elderly disabled should be helped to develop the ability to brush effectively and thoroughly. Those who have diminished manual dexterity may benefit from the use of traditional mechanical, electric or manual brushes that have been adapted or customized for each person.
Rinses: Chlorhexidine rinse has various applications for treatment of elderly. It is primarily indicated for gingivitis. Though, it is effective against a range of plaque bacteria, thus enhancing the patient’s mechanical plaque control efforts. Fluoride has known to prevent the development of caries that is more prone to older patients.
Denture care: The treatment for dentures in the elderly patients suffering from any kind of physical disabilities is a very crucial affair. When ‘immediate dentures’ are being positioned, in order to substitute enamels that have just been extracted, in most cases a waiting period is usually desirable before starting off with a permanent treatment, such as an implant or placing of a bridge. Another suitable option for the physically impaired elderly patients are the use of mini-implants. Being comparatively smaller in size these can be placed without any hassle. Permanent dentures are more stable and the wearer will be a lot more confident with them. Also many elders believe erroneously that once all their teeth have been extracted they no longer need to be concerned about oral health. But, irrespectively the elderly who wear dentures should be taught proper home care of both dentures and tissues.
Digestion plays an important role in majorly impairing the oral healthcare in the physically challenged elderly community. Because of factors like less ability to self-manage due to functional dependency, bad digestion due to loss of teeth, physical weakness and mental deficiency. Similarly, modifications in speech also has an active role to play in damaging the oral health of the physically challenged elders. Any kind of malfunction or modifications related to the functioning of mouth, lips or tongue can cause a major disturbance in their oral health.
The major blockade in oral hygiene of the elderly community would be the underestimation of the oral health care need by them and giving less weight on the fact that it is not limited to emergency care. Conversely, with changing attitudes the oral health goal should include: Retaining teeth and keeping them healthy and pearly.
