Oral health problems are one of the most common health issues experienced by elderly people.

More than three quarters of those aged over 65 in Grampian still have natural teeth yet sadly these are often in very poor condition. Even for those with no natural teeth remaining, a regular oral care routine is essential for overall health and quality of life. An unhealthy mouth can cause pain, make communication difficult and can also limit food choice, increasing the risk of malnutrition. Poor oral health can also increase the risk of developing respiratory infections, including pneumonia.

• For those with natural teeth

  For those with natural teeth, brush twice a day with fluoride toothpaste and a small headed toothbrush with soft to medium strength bristles. Adults with limited dexterity may benefit from a brush with a long, thick handle which is easier to grip and manoeuvre around the mouth. You can also try wrapping a regular toothbrush handle with aluminium (tin) foil or masking tape to make it easier to handle. An electric toothbrush may also be useful for those unable to brush as thoroughly as they used to.
  
  Medical conditions such as arthritis can make it difficult for some elderly people to maintain a regular brushing routine and this is where carers can be of help. Our Key Tips for Carers page contains some helpful advice for assisting someone to brush their teeth. For those with conditions such as Dementia and Alzheimer’s disease however, brushing can be traumatic and may cause harm if done incorrectly. Your dentist or hygienist will be able to advise you on the best methods of oral health prevention in these circumstances.    
  
  Finally, be sure to visit the dentist regularly for a check up. This is important not only for the health of your teeth, but to check for signs of oral cancer. Oral cancer may affect the lips, throat or surfaces of the mouth and over 80% of new cases are diagnosed in those over 50. If you notice any white spots, sores in the mouth or ulcers which do not disappear after 2 weeks, get it checked by a doctor or dentist. For advice about finding a dentist, click here.      
  
  

• For those with false teeth, dentures or no remaining teeth

  For those with dentures or false teeth, these must be cleaned daily to remove plaque and food residue. The general rule is to ‘Brush, Soak, Rinse.’ Remove the dentures and brush them using a toothbrush with soft-to-medium strength bristles and either denture cream or antibacterial handwash and water. Avoid using toothpaste as this is too abrasive and will scratch the denture. Also, be sure to always clean dentures over a bowl of water or towel in case you drop them.  
  
  After brushing, soak the dentures in denture cleaner or antibacterial handwash and water. For dentures which have metal components, use dilute chlorohexidine to avoid corosion. Finally, give the dentures a thorough rinse another to remove any loosened food particles before returning to the mouth.  
  
  Dentists usually advise removal of the dentures overnight to allow the mouth to rest. If the dentures are removed at any time, they must be left in cold or room temperature water to prevent them cracking or losing their shape.

  
  Even for those with no natural teeth remaining, it’s important to maintain a regular oral hygiene routine to keep the mouth healthy and feeling good. Daily brushing of the gums and tongue with a soft bristled toothbrush and toothpaste will help remove food particles and any bacteria which may be present. This keeps the mouth clean, breath fresh and reduces the risk of gum problems, pneumonia and other common medical conditions to which the elderly are susceptible.
  
  It’s also important to visit the dentist annually to check for signs of oral cancer. Oral cancer may affect the lips, throat or surfaces of the mouth and over 80% of new cases are diagnosed in those over 50. If you notice any white spots, sores in the mouth or ulcers which do not disappear after 2 weeks, get it checked by a doctor or dentist. For advice about finding a dentist, click here.      
  
  

• Dry Mouth

  Many elderly people also experience ‘dry mouth,’ a condition which affects the flow of saliva, causing it to become thick and sticky. This can have a harmful affect on their nutritional state as without enough saliva, eating and swallowing can become difficult. It can also harm oral health as saliva helps to fight the bacteria which cause diseases of the teeth and gums. Whilst there is no cure for the condition, your dentist or pharmacist can recommend products to easy the symptoms. Sipping water or chewing sugar free gum can also provide temporary relief.

If you provide care for an elderly person as part of your professional role, Health Scotland have developed a series of oral care plans which can be used to help you support their oral health. Adapted versions of these resources can be downloaded on the 'Key Tips for Carers' page.