Caring for those in Need

Dentistry and the Elderly

The Baby Boomers, post-World War II Americans born between 1945 and 1964, are one of the nation's largest generations. During their lifetimes, they have benefited from vast improvements in medicine, dentistry, and public health education, and are our longest- living generation.

BY Scott Ruvo, DDS | February 2023 | Category: Healthcare

Dentistry and the Elderly

When the Baby Boomers were born, Americans could expect to live about 63 years. These days US life expectancy is about 79 years, allowing Baby Boomers well over a decade more time to enjoy family, friends, retirement and hobbies.

As people age, though, they can face more health challenges. For example, bone density and immune systems naturally weaken, which effects oral health by increasing the risk of gum disease and tooth loss. Patients can also face physical and mental disabilities due to accidents, strokes, Alzheimer’s and other dementia-related diseases. Other forms of disabilities stem from neuropathy or loss of mobility due to chemotherapy and other medical treatments or severe arthritis. Whatever the root cause, patients can be left unable to properly brush their teeth for two minutes a day, twice a day, or floss. Lack of proper hygiene can lead to poor oral health, which many recent studies have linked to developing other chronic medical conditions, including diabetes and heart disease. However, while disabilities may present challenges to maintaining one’s oral and overall health, there may be simple solutions to overcome these obstacles.

One of the most common problems dentists see with elderly patients is xerostomia – or what’s commonly known as dry mouth. This condition is often a side effect of medications used to treat other diseases. Patients with dry mouth don’t produce enough saliva to keep their mouths wet, which can cause several problems. A moist mouth helps prevent the growth of bacteria, which can cause Halitosis or bad-smelling breath. Saliva is also essential for helping you swallow food better. Saliva has enzymes that help break down sugars and fats that help you process these foods. Lastly, saliva helps wash the teeth after eating. (Think of it like a car in a car wash.)

So, not producing enough saliva can result in plaque on the teeth after patients eat, leading to rapid, rampant tooth decay, and an increased risk of developing cavities.

The first defense against dry mouth is to drink plenty of water during and after eating. “Swish and swallow” water after eating to help get the food off your teeth and into the stomach. You don’t want the plaque (food and bacteria) to sit on the teeth for too long and cause decay. When not eating, you can use sugar-free lozenges and gum to help stimulate saliva flow, helping keep the mouth moist. Artificial saliva products such as “Biotene,” “Xerostom” and others can also help. Patients might also consider speaking to their physicians about changing to a different medication that doesn’t cause dry mouth, or decreasing the dosage of the one they’re on, to decrease the side effect of dry mouth. Oral rinses with extra fluoride also help prevent decay.

Another issue many older patients with physical and mental disabilities have, is routine oral hygiene, such as brushing and flossing. Sometimes this is due to problems with dexterity, like not being able to firmly grasp a toothbrush or complete the motions needed to clean their teeth properly. This can be overcome by utilizing an electric toothbrush (there are many brands on the market), a waterpik (Waterpik), or an Air Flosser (made by Phillips Sonicare). Handles of these devices can also be modified with straps to help hold them.

Many older, disabled patients have caregivers, or they live in retirement homes with assisted living care. Caregivers must understand the importance of maintaining a loved one or patient’s oral health.

Another issue is lost dentures. You have no idea how many dentures I’ve had to remake because a caregiver has lost or accidentally thrown out a patient’s denture. Dentures can be made with the patient’s name on them, which helps caregivers make sure the right patient has the right denture. It is also essential to place dentures in a regular spot where the denture can soak overnight, and the patient and caregiver will always know where it is.

Often, the food served in nursing homes and other senior living facilities is cooked softer to make it easier for patients to chew and prevent choking. The downside is that soft foods can get stuck between a patient’s teeth and be more difficult to remove. This can cause decay in between and circumferentially around the teeth. Thus, it’s important to ensure caregivers understand and properly maintain their patient’s oral hygiene.

Regular dental checkups are also a must. It is far better to catch a cavity early, than wait until it is a bigger, more severe problem. Older patients with higher levels of decay may consider seeing their dentist as frequently as every 2-4 months to keep things manageable, even if just to get an exam. It is far less expensive to do small fillings than to have to do major dental work.

 Aging is a natural process and doesn’t have to result in patients suffering painful dental problems, losing their teeth, or being unable to chew properly and enjoy their food. Patients can retain their teeth for a lifetime with proper care and maintenance. Maintaining good oral health also significantly contributes to more personal confidence and a better quality of life. 


Scott Ruvo, DDS graduated from University of Illinois Chicago Dental School and has been in private practice in Sparta NJ for over 25 years. Dr. Ruvo is an attending at the Morristown Hospital Dental clinic where he enjoys teaching residents.  He is an active member of the American Dental Association and is a Trustee in the New Jersey Dental Association.   Dr. Ruvo grew up and lives in Sussex County, where he enjoys fishing, hiking, biking and Photography, with his wife and two children. 

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