Dr Sonali Razdan
As it is said Health is Wealth but do we know how staying healthy starts from maintaining a stable oral hygiene. With ageing a person encounters multiple health conditions which include esthetics as well.
Significance of geriatric oral care:
Ageing is a normal biological phenomenon with changes in organs. Many elderly patients are advised to maintain a balanced diet intake but due to poor oral conditions the requirements are not met. Root stumps, caries, periodontal disease, multiple mobile teeth, ill fitting dentures, and edentulous are some of the issues faced by them. Not only nutritional deficiencies but sometimes poor esthetics can have psychological effects.
Few oral conditions:
Caries- Presence of multiple caries in oral cavity can lead to functional loss. Regular dental checkups can prevent caries from progressing to a total decay. We have options of restorations with highly efficient and esthetic material. Timely restorations or fillings can prevent extractions and edentulous state. In cases of severe caries also we have an option of RCTs and then placing a prosthetic crown over it for functional (mastication) and esthetic (appearance) rehabilitation.
Periodontal issues:
Our teeth are held by periodontal ligaments in the socket. If these ligaments are not in a healthy state it can lead to mobility up to a level of grade III. To prevent this maintaining oral hygiene is of utmost importance. Sometimes caries cannot be seen in a tooth but due to presence of plaque and excess calculus the ligaments are affected causing loosening of tooth. Calculus and plaque is due to the bacterial infestation hampering longevity of a tooth. As we age and due to excess busy schedules we do not visit dentist regularly and do not go for cleaning process of teeth. As a result many elderly patients face mobile teeth issues in later ages. The simplest way is to prevent this from progressing by paying 6 monthly visits to the dentist. It is recommended that scaling or cleaning of the teeth should be done once every six months. The myths are that scaling can cause tooth loosening but the fact is that maintaining a proper hygiene is the only way to protect teeth. Proper brushing, flossing, and rinsing are the preventive measures which can be followed at home.
Prosthodontic rehabilitation
In many cases it has been observed that if a tooth is broken and only root is present in the socket it is unnoticed as sometimes there is no pain but in certain instances the left over root may cause pain, swelling, or pus discharge. The ultimate treatment is to get them extracted followed by replacing with an artificial tooth.
In cases of missing teeth which is mostly seen in elderly patients it can cause difficulty in chewing, or can cause esthetic issues like in case of front missing teeth. We have various options of replacing missing teeth prosthetic ally. With recent advances in dentistry we have more precision work. Techniques like CAD-CAM have made things easier. We can replace missing tooth by giving highly esthetic lithium disilicate crowns in the anterior region, zirconia crowns, and PFM crowns. It is called as fixed partial dentures (FPD) and it can be done in case of multiple missing teeth as well. We can also replace few missing teeth with RPDs which are partial dentures.
For fully edentulous patients we can proceed with highly esthetic dentures which can be made with highly advanced techniques having more accuracy in denture fit and function.
Complete denture
We must have heard about implants or artificial replacements in other body parts and in dentistry also we have implants. This is one of the best approaches to restore a single missing tooth if oral conditions allow us like good bone strength. We can also provide with implant supported FPDs in case of multiple missing teeth. There is an option of implant supported denture also.
For fitting dentures we can proceed with relining or rebasing if the denture occlusion allows.
Maintenance of prosthodontic rehabilitation:
For complete and partial removable dentures we advise patients to remove them at night as it gives rest to the oral mucosa. If patients have any issues with denture like ulcers or difficulty chewing we can get them adjusted in the clinic. We can also use simple homely techniques like warm saline rinses to give relief to the oral mucosa for any ulcer or trauma from the dentures.
For fixed crowns we have to maintain proper oral hygiene with brushing, flossing, and rinsing.
Conclusion:
In today’s world with so many advancements we cannot stop our elderly population to not proceed with dental treatments. They need encouragement, motivation, and a good diagnosis followed by successful prognosis. We do have all patient friendly facilities available to proceed with any dental conditions with favorable conditions.
(The author is MDS Prosthodontics).
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