Dental and Periodontal Disease Screening-Senior

Dental and Periodontal Disease Screening-Senior

Dental and Periodontal Disease Screening

Summary of Recommendation and Evidence

Population Recommendation Grade
(What's This?)
Screening of both genders.

This screening is recommended for seniors.

B

Dental Problems

Darkened teeth: Caused, to some extent, by changes in dentin -- the bone-like tissue that underlies the tooth enamel -- and by a lifetime of consuming stain-causing foods and beverages. Also caused by thinning of the outer enamel layer that lets the darker yellower dentin show through.

Dry mouth: Dry mouth is caused by reduced saliva flow, which can be a result of cancer treatments that use radiation to the head and neck area, as well as certain diseases, such as Sjögren's syndrome, and medication side effects. Many medicines can cause dry mouth.

Diminished sense of taste: While advancing age impairs the sense of taste, diseases, medications, and dentures can also contribute to this sensory loss.

Root decay: This is caused by exposure of the tooth root to decay-causing acids. The tooth roots become exposed as gum tissue recedes from the tooth. Roots do not have any enamel to protect them and are more prone to decay than the crown part of the tooth.

Gum disease: Caused by plaque and made worse by food left in teeth, use of tobacco products, poor-fitting bridges and dentures, poor diets, and certain diseases, such as anemia, cancer, and diabetes, this is often a problem for older adults.

Tooth loss: Gum disease is a leading cause of tooth loss.

Uneven jawbone: This is caused by tooth and then not replacing missing teeth. This allows the rest of the teeth to drift and shift into open spaces.

Denture-induced stomatitis: Ill-fitting dentures, poor dental hygiene, or a buildup of the fungus Candida albicans cause this condition, which is inflammation of the tissue underlying a denture.

Thrush: Diseases or drugs that affect the immune system can trigger the overgrowth of the fungus Candida albicans in the mouth.

Age in and of itself is not a dominant or sole factor in determining oral health. However, certain medical conditions, such as arthritis in the hands and fingers, may make brushing or flossing teeth difficult to impossible to perform. Drugs can also affect oral health and may make a change in your dental treatment necessary.

Periodontal Disease

  • Usually starts with gingivitis: red and slightly swollen gums caused by accumulation of plaque on the tooth if left untreated, gingivitis may progress to "periodontitis"
  • Chronic bacterial infection in the mouth
  • Can occur at any age but is prevalent in older adults

Symptoms

  • Tender, bleeding gums
  • Painful chewing
  • Chronic bad breath
  • Teeth that are sensitive to cold/heat
  • Change in fit or comfort of partial dentures
  • Receding gums
  • Untreated periodontitis may lead to destruction of gums and tissues that support teeth
  • Teeth may become loose and if untreated tooth extraction may be required

Impact on physical health

  • Gums pull away from the teeth and form pockets that become infected
  • Immune system fights the bacteria as plaque spreads and expands below gum line
  • Bacterial toxins and immune system response may break down bone and connective tissue
  • Evidence of relationship between cardiovascular disease and poor oral health
  • Oral infections increase glucose levels in blood and make diabetes harder to control

Risk factors

  • Smoking (can lower chances for successful treatment)
  • Hormonal changes (women)
  • Genetics
  • Age
  • Vitamine C deficiency
  • Poor diet
  • Poorly fitted partial dentures or bridges
  • Poorly aligned teeth
  • Medications that reduce saliva and cause dry mouth increase vulnerability to gum disease
  • Medications that cause abnormal overgrowth of gum tissue make proper oral hygiene more difficult
  • Illnesses including cancer or AIDS and their treatments may negatively affect health of gums
  • Illnesses including diabetes and Parkinson’s disease may affect salivary glands and cause dry mouth, which increases production of bacteria

Diagnosis

  • Symptoms may be sign of serious problem
  • See your dentist
  • Dentist or hygienist may take medical history to identify underlying conditions or risk factors
  • Dentist or hygienist will examine gums
  • May use "probe" to check for and measure pockets (this is usually painless)
  • May take x-ray to determine if bone loss has occurred
  • May refer to periodontist if needed

Prevention

  • Reduce sugar intake
  • Stop smoking
  • Use toothpaste containing fluoride
  • Brush teeth twice a day
  • Floss daily
  • Antimicrobial mouth rinse can assist in controlling plaque
  • Visit dentist regularly
  • Take a complete list of all medications to dental appointments and advise dentist of side effects including dry mouth
  • Maintain cleanliness of dentures and dental bridges
  • Ensure dentures and bridges fit properly

Treatment

  • Deep cleaning (scaling and root planing)
  • Dentist may prescribe medication as part of treatment (medication alone is insufficient treatment)
  • Dentist may recommend surgery including flap surgery, or bone and tissue grafts