Oral Health Concerns

Appearance is important to people of all age groups, and older adults are no exception. Many older adults report that a clean mouth makes them feel healthier, look better, and feel more comfortable.69 Since many individuals residing in nursing homes cannot care for themselves, they require assistance with oral care. Associations between xerostomia and bronchopneumonia, plaque and respiratory pathogens, and periodontal disease and cardiovascular disease are of concern, particularly for the chronically ill and fragile older adult.69 As functional capacity declines, the individual is at greater risk for caries, periodontal disease, and tooth loss. These conditions further lead to pain, infection, access to care and financing issues, and systemic complications. In addition, most older adults in long-term care facilities take up to 10 or more medications daily.56 Drug-induced oral side effects are very common.

Unfortunately, the nursing home staff typically seeks dental intervention when tooth loss or ill-fitting dentures interfere with a resident’s eating or infection causes the resident to complain of pain or discomfort. Missing, decayed, or fractured teeth require the consumption of soft foods that are usually highly cariogenic, potentiating the risk for caries. In addition, weight, facial appearance, communication, and socialization also are adversely affected by poor oral conditions. Residents and even staff members often misplace prosthetic oral appliances and this poses an additional oral health concern. Denture identification markings are advised for all residents who wear prostheses73 (Figure11).