Geriatric Patients and Dental Emergencies Elderly patients are at higher risk of infection and complications from dental problems. It is important to recognize the signs of a dental emergency and seek professional treatment as soon as possible.
Geriatric Patients and Dental Emergencies
Elderly patients are at higher risk of infection and complications from dental problems. It is important to recognize the signs of a dental emergency and seek professional treatment as soon as possible.
Below are the most common dental problems that lead to dental emergencies for elderly patients.
Toothaches can be caused by moderately sized cavities or from exposed dentin. Patients can take ibuprofen and Tylenol to help manage their discomfort. If there is swelling, a cold pack can be applied to help reduce swelling until the patient can receive treatment.
If the toothache only occurs when the tooth is exposed to cold liquids, it is likely dentinal hypersensitivity. Although this condition is reversible, it is a good idea to see a dentist to rule out anything more serious. Clove oil can be applied to temporarily relieve some of the sensitivity until a patient can see their dental provider.
Broken Filling or Crown
Over time, dental work can wear out and chip or break off. This can become serious if bacteria enters the inner part of the tooth and the tooth becomes infected. Until they can be seen by a dentist, wax can be placed into the broken part of the tooth to help cover any sharp edges. They may take over the counter anti-inflammatories and apply clove oil if the tooth is sensitive.
Cracked or Broken Tooth
Cracks and fractures can occur from hard foods or an accident such as a fall. Not all fractures are serious or require emergency treatment, but if the area is causing pain, patients should see a dentist as soon as possible. They may take ibuprofen and tylenol as needed to manage pain until they can be treated. If a large piece of the tooth broke off and they still have the fragment, it can be placed in milk or water and brought to the dental appointment. If there is bleeding where the tooth was fractured, light pressure may be applied with clean gauze or cloth. Ice packs can be applied to reduce any swelling of the face.
Depending on the severity of the damage, our lab may be able to repair the denture within 24 hours. If the denture is damaged beyond repair, they may need a new denture.
If they are unable to see a dentist immediately, they may purchase a denture repair kit at a pharmacy. This will temporarily hold the denture together until permanent repairs can be made. Trying to repair a denture at home does pose some risk to damaging it further, so if they can wait until their dental appointment, it is generally better to have it repaired professionally.
Dental Abscess or Infection
Severe pain can be a sign of a dental abscess. It is important to call a dental office to schedule an emergency appointment as soon as possible. Use ice to help reduce swelling, but avoid using heat. Heat will intensify the pain. If you notice a pimple on the gum tissue near the tooth, you may drain it using a sterile needle. This will temporarily relieve the pressure. Give the patient ibuprofen and tylenol until their appointment to control the inflammation and pain.
Loose or Dislodged Permanent Tooth
Try to only handle the dislodged tooth by the crown (white part) to avoid damaging it further. Rinse it using water, milk or saline. You may reinsert the tooth into the socket. Once it is in place, the patient may gently bite against a piece of gauze to keep the tooth stable. If you are unable to reinsert the tooth, place it in milk to keep it viable until you arrive a the dental office. Be sure the patient sees a dentist as soon as possible.
Bleeding gums when brushing can be a sign of gingivitis or periodontal disease. Abrasion of the gum tissue from brushing aggressively or eating crunchy foods can cause bleeding gums. If the gums do not heal within 1-2 weeks, you may need to make a dental appointment to examine the area.
The best way to avoid dental emergencies is by receiving routine dental care. It is important to have a dental exam at least twice a year to make sure teeth and gums stay healthy.
10 Most common dental conditions that affect the elderly population:
More than 500 different species of bacteria can be found in the oral cavity. Many of these bacteria are necessary to maintain health. When an imbalance of good and bad bacteria occurs, the body responds by creating inflammation. In the mouth, this usually presents with red, swollen gums. Usually with regular professional cleanings and improvements in daily plaque removal, this inflammation can be resolved.
#2 Chronic Periodontitis
If the inflammation in the gums goes untreated and become chronic, the bone which surrounds the teeth can be compromised. This leads to tooth mobility and eventually tooth loss. Periodontal disease is the leading cause of tooth loss in adults. This condition typically has very few symptoms, and does not hurt until it is in the very advanced stages. Treatment for this condition includes a deep cleaning under local anesthesia followed by regular maintenance cleanings every 3-4 months to control the inflammation and stabilize bone levels. If patients have already lost significant bone around teeth, replacing teeth is necessary. Patients would benefit from taking a probiotic to help regulate the balance of good and bad bacteria in the body as well as supplementation of vitamin D if needed. Avoiding refined sugar in the diet, staying hydrated and quitting tobacco products will help improve immune function and positively impact periodontal disease.
#3 Tooth Decay
Geriatric patients often take a variety of medications for pre-existing medical conditions. Many of these medications cause dry mouth. Saliva is one of the body’s natural protective mechanisms for the teeth. It contains enzymes which neutralize acids from the food we eat, maintaining an ideal pH level in the mouth to support enamel strength.
As we age, muscles in the face lose elasticity. This prevents a natural self-cleansing mechanism of the muscles moving against the teeth while we chew from occuring. This results in food particles becoming trapped against teeth and contributes to tooth decay.
Patients who suffer from Alzheimer’s disease or dementia may have difficulty remembering to brush and floss their teeth, leading to cavities.
Patients with a history of bone loss around the teeth may have exposed root surfaces. This part of the tooth’s structure is more porous and susceptible to tooth decay. Arthritis causes limited dexterity in the hands, make brushing and flossing difficult.
The solution to this is improving oral hygiene habits, avoiding excessively sugary foods or drinks between meals, using fluoride mouthrinses and visiting a dental provider regularly for checkups and cleanings.
#4 Halitosis (Bad Breath)
There are a number of different reasons why patients may suffer from chronic halitosis. Failing dental restorations with recurrent decay or infection, chronic gum disease from an overpopulation of harmful bacteria, stomach or GI issues, dehydration and poor oral hygiene are all common causes. Patients should see a dental provider regularly for checkups and cleanings to rule out tooth-related causes. If halitosis persists, they should see their physician to rule out any systemic causes.
#5 Candida or Oral Thrush
This is a fungal infection caused by overgrowth of candida albicans. It is more likely for patients with reduced immune function. Severe cases can be treated with antifungal medications. Milder cases may be managed with probiotics and coconut or sesame oil-pulling.
#6 Poorly-fitting Dentures
When patients have had teeth removed, the bone in the jaw begins to dissolve over time. This causes dentures to stop fitting properly. Patients with poorly fitting dentures have difficulty chewing and speaking. Reduced chewing makes eating healthy foods difficult, which has a negative impact on managing other health problems or preventing inflammatory conditions.
#7 Red and Ulcerated Soft Tissue Under Poorly-Fitting Denture
Movement and rocking of a poorly-fitting denture during chewing causes sores and allows food to become trapped underneath the denture and irritate the soft tissues during meals. Patients with poorly fitting dentures should see a dentist to make adjustments to their denture or place a more permanent tooth replacement option for them.
#8 Red Tongue (glossitis)
A shiny, painful red tongue may indicate that a patient has a vitamin B12, folic acid or iron deficiency. It can be related to other medical conditions as well like the herpes virus, undiagnosed celiac disease or allergies to medications.
#9 Non-healing Mouth Sores
This could be from a chronic source of irritation like a poorly-fitting denture or something more serious like oral cancer. Sores that do not show improvement or healing in two weeks should be evaluated for a biopsy.
#10 Cracked, Dry Skin in Corners of Mouth or Angular Chelitis
This can be from an overgrowth of candida, inflammation from bacteria or vitamin B or iron-deficiency from poor nutritional absorption. The cause should be evaluated by a physician.