dental care
Photo: BRUCE MARS/UNSPLASH

Be proud of your mouth

Oral diseases and conditions that are associated with ageing concomitantly result in an increased need for preventive, restorative, and periodontal dental care. This is particularly true of seniors aged 65 years and over.

Nearly 19% of seniors no longer have any natural teeth. Loss of teeth increases with age and varies by race/ethnicity. Tooth loss has multiple impacts on health and well-being.

Seniors who have lost all or most of their teeth often end up avoiding fresh fruits and vegetables – basic foods for a healthy diet. Relying on soft foods that are easily chewable results in a decline in nutrition and health.

In addition to pain and difficulty speaking, toothlessness often leads to embarrassment and a loss of self-esteem contributing to loneliness and social isolation.

More than half (53%) of seniors have moderate or severe periodontal disease. There is increasing evidence of the association of periodontal disease with chronic conditions including diabetes, heart disease, and stroke.

Oral health conditions among seniors with chronic conditions are often exacerbated by use of medications. About 400 commonly used medications can cause dry mouth, which heightens the risk of oral disease.

Oral diseases and other major non-communicable diseases (NCDs) share common modifiable risk factors, such as tobacco use, alcohol consumption, psychosocial stress, and poor diet high in free sugars.

Against a backdrop of common risk factors, the primary cause of the onset and progression of common oral conditions is dental plaque – a matrix of bacteria and their by-products adhering to teeth and dentures.

Without regular removal of this biofilm, microbial communities are driven into dysbiosis, an ecological shift favouring greater pathogenic activity. Alongside other biological mechanisms, the resulting pathological footprint affects multiple organs, with strong evidence of particularly detrimental links to endocrine, cardiovascular, pulmonary, and neurological systems.

This inflammatory footprint is exacerbated by the inflammageing process, contributing towards the chronic low-grade upregulation of the proinflammatory state developed with advancing age.

There is strong evidence supporting the independent association between periodontitis and common chronic inflammatory diseases of ageing. Advanced periodontitis, the sixth most common health concern worldwide, has profound implications on systemic health. The existence of a bidirectional link between type 2 diabetes and periodontitis is unequivocal.

Severe periodontitis adversely affects blood glucose concentrations in people with and without diabetes, and the risk of developing diabetes is raised even in the presence of moderate periodontitis.

On the other hand, there is high quality evidence to support an association between cardiovascular disease and oral health, specifically the relationship between chronic periodontitis and atherosclerosis. Preclinical laboratory studies also suggest a link between periodontal disease and neurogenerative disorders.

It is plausible that when people develop later stages of dementia, the ability to care for their mouth becomes more challenging, leading to an increase in poor oral hygiene and periodontal disease. For these reasons, the oral health community frequently calls for the mouth to be put back in the body – i.e., for non-dental practitioners to recognise the importance of oral health’s contributions towards general health.

Article submitted by the HPA Group