Gum Disease and Seniors

Nurse with Elderly PatientIn our recent article we spoke about the possibilities of getting gum disease. In this article, we will be focusing more on the possibility of senior citizens getting gum disease and how we can help them avoid gum problems and help them maintain good oral health.

More than 17% of people over 65 have periodontal (gum) disease. Statistics have shown that older adults over 75, current smokers and those with lower incomes are more likely to have periodontal disease. Gum disease is the most common cause of tooth loss among the population.The disease is usually the result of an infection of the gums and surrounding tissues that hold the teeth in place. Overall, the prevalence of gum disease in seniors has decreased from the early 1970s, according to the National Health and Nutrition Examination Survey. Despite this improvement, seniors are still at a higher risk than other population groups for developing gum disease and other issues with their oral health.

Seniors Require Attentive Care

Unlike adults within the range of 18 – 60, proper dental care is for the most part, routine; however, many elderly citizens may need a little more prodding than the average adult. There can be a variety of reasons for this. Seniors tend to forget more than other people, especially if they become senile or are feeling the beginning of dementia. Loved ones and caregivers need to pay more attention to the ones they are caring for so that oral health is not overlooked. Offer them assistance with brushing and flossing. If they are self-functional, take them to the dentist every six months or more frequently if necessary. The bottom line is to pay as much attention to their oral health as you would for their physical and mental health.

Types of Gum Disease

The two forms of gum disease are gingivitis and periodontitis, both infections, and both are preventable with regular dental hygiene. Gingivitis is a mild form of gum disease where the gums become red, swollen and maybe bleed easily. Periodontitis is more severe and the infection can damage the soft tissue and bone that support teeth, resulting in gums pulling away from teeth and forming pockets that can become infected. Gum disease can be a painless condition until the advanced stage. At this point, the gums, bone and ligaments supporting the teeth could already be damaged.


“Realistically, about three out of four patients who come into the hospital have gum disease and don’t know it,” said James Sconzo, M.D., Chief of Dental Medicine at New York Presbyterian Brooklyn Methodist Hospital. “Certain medical issues, like diabetes, can result in a higher risk of gum infection.” Elderly Americans are affected by gum disease because many take prescription or over-the-counter drugs, which can result in dry mouth. Dry mouth leads to gum disease because saliva, which helps to wash away food debris and reduce plaque, decreases significantly. Dry mouth Dry mouth is not a normal part of aging but it is a side effect in more than 500 medications, including those for allergies or asthma, high blood pressure, high cholesterol, pain, depression or anxiety, Alzheimer’s and Parkinson’s diseases. This is just one reason why it’s very important to tell your dentist about any medications that the senior is taking. Your dentist can make the best recommendations to help relieve dry mouth symptoms and prevent cavities and periodontal disease.


Prevention for periodontal disease and cavities includes very thorough daily brushing and flossing, as well as regular trips to the dentist for a deep cleaning that includes preventative X-rays and plaque removal. Periodontal disease is typically diagnosed through X-rays. Treatment usually starts with a deep cleaning and depends on how much of the mouth is affected and how infected the gums are, gum surgery might be required. The extreme deep cleaning procedure requires local anesthetic before removing plaque under the gums. Other methods of prevention include drinking plenty of water in those with dry mouth as well as using sugar free gum and lozenges to stimulate saliva production, using a humidifier, and avoiding drinks that worsen dry mouth such as coffee, alcohol, fruit juice, and carbonated soft drinks.

Caring for Elderly and Disabled

When you are caring for someone who is confined to a bed or nursing home, they might have so many health problems that it becomes easy to forget about their oral health. However, it’s still important to pay attention to oral and dental health in the elderly.

Bacteria from the mouth can easily be inhaled into the lungs and cause pneumonia. Those over 65 are also at a higher risk of developing oral cancer. Specialists that work with the elderly routinely check for oral cancer symptoms. These specialists are dentists that treat gum disease in the elderly and disabled. You can locate a specialist through the Special Care Dentistry Association’s referral directory.

For those who take care of elderly that wear dentures, pay close attention to their eating habits. If they’re having difficulty eating or are not eating as much as usual, denture problems could be the cause. If you are a representative for a resident in a nursing home that needs dental care and is enrolled in Medicaid, there is a regulation called an Incurred Medical Expense (IME) that can help pay for medically necessary care as determined by a dentist. A Medicaid caseworker at a nursing facility and the dentist providing care can work together to apply this IME to pay for needed dental benefits.


Why Dental Implants Are a Real Bargain – Honestly, It’s True!

Wasn’t it Coco Channel who said that “The best things in life are free, but the second best things are very very expensive”

While you may or may not agree with that statement, when it comes to your teeth – or rather the lack of them – getting dental implants almost certainly falls into the latter category.

Sure, they’re not on an equal footing with say a Fifth Avenue penthouse apartment, or a Norman Rockwell painting, but in dental terms, implants don’t come cheap. However, despite dropping somewhere between $2500 -$4000 per tooth, they’re still a bargain!

Controversial I know but hear me out….

The Watercooler Scenario on Implant Costs

I was standing in line at a grocery store checkout a few weeks back and overheard two women in front of me talking – Okay, so I may have been eavesdropping, but the conversation went something like this…  

First woman“You remember Sheena, right?”
Second woman – “Oh yeah, I haven’t seen her for years.”

First woman – “Well I bumped into her the other day and she looked so different.”

Second woman – “whaddya mean?”

First woman – “Well, it’s her teeth! Do you remember she was never happy with her teeth?”

Second woman – “Oh yeah, I remember. Every time she smiled, she would kinda place her hand in     front of her mouth.”

First woman –   “You’ve got it! Well now she doesn’t have to.”

Second woman – “Why? What’s she had done?”

First woman – “Apparently, she’s had those implants – You know…the ones for your teeth”

By this stage I was listening so intently I didn’t hear someone saying excuse me as they tried to squeeze past. Anyway, on with the conversation…

Second woman – “Oh yeah, I’ve heard about those.”

First woman – “You’ll never guess how much they cost her.”

Second woman – “Go on!”

First woman – “About $20,000.”

Second woman – “$20,000 Jeez!” She repeated this part in a really high voice… “I’ll tell ya, we’re in the wrong job.”

With that, they paid for their groceries and left…

Meanwhile, I’m mulling over the conversation in my head and thinking firstly….“What the heck was I doing listening in on someone else’s private conversation” but more importantly…. it hit home that the initial cost of dental implants is in fact a HUGE stumbling block for some patients. And it’s an unfortunate hurdle that many people don’t see past.

But here’s the important part….

If you consider the long-term benefits that dental implants can bring, then actually, they’re worth every single cent.

Here’s why….

The Practicality of Dental Implants

Doctor and Nurse Reviewing Dental X-Ray

Let’s imagine for one second that you went down the conventional denture route. After all, modern-day dentures look pretty realistic and feel comfortable in the mouth, so why wouldn’t you?

You spend a session having impressions taken and molds done and another session (some weeks later) getting them fitted. That’s it…2 days, new teeth. Job done!

Or is it…

Firstly there’s the cleaning… By this I mean soaking and deep cleansing. Food particles collect on dentures every time you eat, so they need regular and thorough daily cleaning in order to avoid a variety of common oral problems which plague approx 87% of denture wearers.

Secondly, there’s the problem of jaw shrinkage… conventional dentures may do a great job of replacing teeth but they can’t halt the natural bone loss process that occurs when teeth are missing. As the jaw shrinks, snug fitting dentures can become loose and uncomfortable.  

Thirdly…. There’s the issue of replacement. As the jaw continues to shrink dentures need to be regularly adjusted and eventually replaced. The typical shelf life of a conventional denture is around 10 years. That’s okay, if you’re a more senior denture wearer, but if you’re younger, then you may need to replace your denture at least once or more throughout your lifetime. These are added costs which need to be factored in.

Now take dental implants….

Sure they require an initial period of 4-9 months to complete, but that’s it. Ultimately there’s no re-adjusting, no stockpiling cleaning tablets, and no fixative (did I mention the fixative?) but most importantly… provided that patients continue to brush and floss as normal, they’ll never need replacing. So in effect you pay once and once only!

Now financially, implants are suddenly starting to sound more appealing, right?

So, the next time you hear someone talk about the cost of dental implants consider this…

What price should I place on being able to smile and eat normally again, being more self-confident and… feel happier than I have done in a long time.

How much would you be willing to pay?