Planning Ahead for Oral Health
You've got your retirement plan in place—a budget for your needs, where you'll want to live, your Medicare supplemental insurance, and a plan for exercise and socialization.
But here's a pricey aspect of healthy aging that many people overlook. As we grow older, we usually have a greater need for dental care because:
- The risk of gum disease and oral cancers increases with age.
- Teeth are like any other body part; over time, they tend to wear out, especially if we haven't had good dental care throughout our lives—and if we took out our tension by grinding our teeth.
- It is harder to clean the teeth and mouth properly if we're living with arthritis, the effects of a stroke, or other conditions that limit body control and movement of the arm. And oral care can be especially challenging when a person has Alzheimer's disease or a related condition.
- Seniors are susceptible to dry mouth, a condition that often is due to side effects of common medications they take. Dry mouth promotes cavities, especially on exposed tooth root surfaces when the gums have receded.
The National Institutes of Health reports that 25 percent of people age 75 and older have lost all their teeth. Tooth loss makes it hard to eat a nutritious diet. It can lead to social isolation and depression when a person is self-conscious and has trouble speaking. And a growing number of studies show that the bacteria and inflammation caused by gum disease are linked to heart attack and dementia.
Fortunately, modern dentistry has come a long way in helping seniors retain a healthy smile, in part with advances in restorative work such as crowns, bridges and implants. This is so central to modern dentistry that the American College of Prosthodontists recently released clinical practice guidelines urging dentists to help patients not only care for their natural teeth, but also for their restorations. (Prosthodontists are specialists in the restoration and replacement of teeth.) The organization recommends at least biannual clinical examinations to clean, adjust, repair and/or replace restorations. Said prosthodontist Dr. Avinash Bindra of the University of Connecticut School of Dental Medicine, "Prosthodontists often take great pride in meticulously restoring smiles so that they look as natural as possible. Patients with multiple restorations that are supported by natural teeth or implants need to know that professional and at-home maintenance is a lifelong regimen."
For patients who have lost most or all of their teeth, dentures are another option. Modern dentures can be quite comfortable. They should be properly fitted, and the patient should be seen frequently during the adjustment period, then as often as recommended. Some dentures are removable but supported by dental implants.
However, all these increasingly sophisticated care options can present seniors with what might be the greatest hurdle to oral health: the cost of dental care, especially when it comes to implants and other restorations. Medicare does not cover routine dental care, restorations or dentures, and at present, only 15 states offer a dental benefit through Medicaid, according to the Kaiser Family Foundation. Supplemental dental insurance is available, but the premiums can be high, and a complicated restoration can quickly exceed the maximum benefit.
Yet good dental care, often including these restorations, makes a huge impact on the quality of life in later years. So it's important to keep the cost of dental care in mind during retirement planning and to be aware of payment strategies and resources that could help. Check with your financial planner and your local senior services agency to learn more.
Meanwhile, no matter what your age, here are 10 lifestyle choices that promote oral health and could make those costly restorations less necessary:
- Visit the dentist regularly. Your dentist may recommend annual or twice-a-year visits.
- If your dentist recommends, seek help from a specialist in gum health, restorations or dentures.
- Brush your teeth twice a day with a fluoride-containing toothpaste, or as recommended by your dentist. Follow your dentist's advice about brushing technique and the type of toothbrush that's best for you.
- Floss teeth at least once a day.
- If you have dentures, have them checked annually, follow your dentist's instructions about caring for them, and report any discomfort.
- Eat a well-balanced diet that is low in sugar.
- Avoid smoking. Smoking doubles the risk of gum disease, cavities and oral cancer.
- If you drink alcohol, limit your consumption to two drinks per day if you're a man, and one if you're a woman.
- If your dentist recommends a night guard, wear it every night. Talk to the dentist about other ways to reduce tooth grinding.
- If you are living with arthritis, Parkinson's disease, the effects of stroke or another condition that limits hand motion and causes loss of muscle control, talk to your dentist about using an electric toothbrush, adaptive toothbrush or special floss holders.
The role of caregivers
When a frail older person is unable to properly clean the teeth and mouth, it's important that they receive assistance. Family caregivers should talk to the dentist about the correct way to help their loved one brush, floss and care for dentures. Some dentists specialize in the care of seniors or people with dementia. If your loved one uses professional in-home care, select an agency that trains its caregivers in proper oral hygiene assistance. In-home caregivers also can take your loved one to dental appointments and help ensure a healthy diet.
Visit the American Dental Association's Adults Over 60 resource page for specialized information for seniors.
ToothWisdom, a service of Oral Health America, is an online tool to connect older adults and caregivers with education and access to care resources. Their website includes easy-to-understand information about denture care and oral health for people with dementia.
The National Institute on Aging's Alzheimer’s Disease Education and Referral Center offers a tip sheet on helping loved ones with dementia care for the teeth and mouth.