This paid piece is sponsored by Siouxland Oral & Maxillofacial Surgery.
This month’s topic is geriatric care: What is it, and who is included? Well, the answer to that question honestly depends on your definition of the word “geriatric.” The AARP would like you to think it is 55 and older — case closed. On the other hand, we have seen many people in our practice that are physically fit, mentally sharp and can still very competently drive a car at 100 years old!
A few years back, we decided that if you reached 100 years old and you needed oral surgery tooth extractions, you would get them for free. There has to be a benefit and recognition to reaching the 100-year milestone.
We can recall three patients who came to our office in need of a tooth extraction a few years back; all in the same month and all 100-plus years old! One patient had her driver’s license and drove a car, another had her driver’s license but only drove occasionally, and the third had her driver’s license but did not drive because she liked to have a reason for her granddaughter to come with her to appointments. The point here is that perceptions of “geriatric” care clearly are different for everyone.
The nebulous phrase “studies show” is part of today’s article. Studies do show that if you have a good dentition as you age, you will have a better quality of life. Those same studies, however, come with the caveat that you must be able to maintain and take care of your dental health as you age.
The decision tree as to what treatments you select is at about 65 to 70 years of age. It also poses the questions of if the patient has the mental and physical ability to maintain the dental work they have and if will they be able to continue to maintain good oral hygiene for the next five-plus years. So when deciding on dental care, you need to look at not only the best treatment options right now but also how to maintain the durability of that treatment over your lifetime.
Taking our centenarians as an example, a treatment plan with crowns, bridges and even implants when they were 80 or 90 were solid choices because those treatments maintain their quality of life. That same attitude, however, for patients who need advanced skilled nursing to even brush their teeth in a nursing home may not be a wise idea. You might ask why. Well, the treatment itself may set up the patient for a cascade of follow-on problems because they cannot correctly maintain the work that was done. Failure to maintain could result in widespread tooth decay, periodontal disease and infections.
Many times, the elderly cannot or will not — because they are stoic — verbalize any discomfort that they have. Studies show that people who can maintain their dentition to advanced age truly have a better quality of life. This includes people with some natural teeth with partial dentures, crowns and bridges, individual dental implants, and full dentures supported by dental implants. It all depends on the individual being able to maintain good oral hygiene to protect the teeth and the dental work that has been done.
Unfortunately, there are many folks getting on in years who also are declining noticeably in their 60s or 70s. For these patients, dentures are perhaps the superior alternative. In some cases of chronic destruction of the dentition, maintaining teeth that are at the gum line — but not causing pain or infection — is the best answer.
In summation, many geriatric patients have difficulty maintaining good oral hygiene, so it is incumbent on the younger generations to take our elders to their dental appointments at least two or three times a year for dental assessment. Many times, family also must help with tooth brushing or obtaining electric toothbrushes for these patients. Do an internet search for “full arch toothbrushes.” These devices look like sports tooth-guards; they brush the teeth when you bite into them and require almost no dexterity. Good, consistent oral care decreases bacterial counts and has been shown to significantly improve overall health.
The straightforward takeaway for this month is to tailor the care for aging patients based on their current and anticipated abilities. With this in mind, what you may think is the best treatment sometimes is in fact not. One must always consider the short- and long-term condition of the patient before initiating definitive treatment.
We hope this was informative for you, and we look forward to visiting with you again next month!
Please look for our future monthly articles covering a variety of dental and surgical topics.
To learn more about Siouxland Oral & Maxillofacial Surgery, go to siouxlandoralsurgery.com.