Geriatric Dentistry
Thursday, July 8, 2004

Dear Dr. Mady: I am the primary caregiver for my mother who is now seventy-nine years old. She can no longer do a good job at brushing her teeth and she is complaining occasionally of pain. She still has some of her natural teeth. What can I do to help?-Jenna in Emeryville

Dear Jenna: I practice a lot of geriatric dentistry both in my own practice and at retirement residences. Because of this experience I can assure you that this is a very common problem as we age. Few retirement residences provide dental care and for seniors still residing at home or with family, the access is difficult and the dental education of caregivers is usually less than adequate.

What you are describing is a very common situation. Dental care and maintenance may even be of minimal importance to your mom. Most of the elderly grew up believing that you only visit a doctor or dentist when you are in pain that you couldn’t stand anymore. It was often even a boxing match between pain and pocket book to see who would win.

I know that dental problems can not be directly compared with cancer, but if we hypothetically compare the two we can better understand the situation that your mom and many other seniors are in. Let’s imagine you have pain in your stomach and you keep taking antacids and other over the counter medicines to relieve it. Eventually the pain gets so bad that you have to do something about it but by the time you get to the doctor it’s too late. Then the doctor tells you “you have cancer in an advanced stage, there is nothing we can do”. Well in reality it is the same with tooth pain, but the consequences can be correlated at a different level.

If you waited until your molar really hurt before you seek the help of a dentist it may cost you in excess of $600 just for the root canal (not including a possible exam and x-ray fee, and cost of a filling and crown). If you would have gone in when you felt a little sensitivity or when a small amount of your tooth chipped away, you may have gotten out the door for a minimal charge even as low at $100. Your only other alternative to root canal would be the loss of a major chewing tooth. I know that this comparison goes to the extreme but my point is that if you put things off and don’t pay attention to regular maintenance and any warning signs, you will eventually pay the price. This price may be your life, as in the case of cancer, or your wallet and quality of life with respect to eating, as in the case of your teeth.

The same situation exists for your mom. I know that older individuals didn’t and many still don’t believe in dental care. The expectation as time went on was fewer teeth and more dental prostheses (dentures and partial dentures). Early prevention and treatment is consistently the best option. There is nothing that compares to natural teeth but for those with or without any natural teeth, regular home care and treatment is fundamental to the physical and mental well being of the elderly.

A big part of the problem with seniors is that many cannot grip the toothbrush properly anymore. Some have problems mentally and merely forget to brush. If your mom has trouble gripping the toothbrush, buy one with a larger rubberized handle. If that doesn’t work put tape or something around the handle to make it bigger or try assisting her yourself in brushing at least once per day.

If forgetfulness is the issue, post a reminder sign in the bathroom near the sink.

The bottom line is don’t ignore and avoid the dental care of your mom. You as the caregiver are the key to helping her with this and to improving her quality of life. Take her to the dentist for regular exams and if she cannot get out, ask her dentist to come to her. If this is not feasible then call the local dental society and see if there is a dentist who makes house calls. If she is showing any slight signs of any discomfort, address it immediately, because putting off any type of health care does have consequences, physically, emotionally and financially!


This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



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