Posts for: January, 2019

By Randall J. Bartoe, DDS, PLC
January 17, 2019
Category: Oral Health
Tags: oral health   seniors  
4DentalCareAreastoKeepinMindfortheSeniorAdultinYourLife

Like many people, you might be caring for an elderly parent or family member. That care should include a focus on their teeth and gums — a healthy mouth is vitally important to their overall health, nutrition and well-being. Because of the aging process, this can be challenging.

Here are 4 areas where you should focus your attention to assure the senior adult in your life has the healthiest mouth possible.

Make adjustments for hygiene. As we grow older, arthritis and similar conditions make brushing and flossing difficult to perform. You can help your senior adult keep up these vital tasks by switching to a powered toothbrush or refitting their brush with a bike handle or tennis ball to make gripping easier. Pre-loaded floss holders or water irrigators are effective alternatives to manual flossing if it becomes too difficult.

Have dentures or other appliances checked regularly. Many older people wear full or partial dentures. Due to the nature of these appliances, the risk of bone loss over time is greater, which can eventually affect their fit. Their dentist should check them regularly and reline or repair them if possible. Eventually, they may need a new appliance to match any changing contours in the mouth.

Be aware of age-related dental issues. Age-related conditions of both the mouth and the body (like osteoporosis, which can affect bone density) can impact dental health. For example, an older person can develop lower saliva flow, often due to medications they’re taking. This, as well as gastric reflux common in older people, increases acidity and a higher risk of tooth decay. Past dental work like fillings, crowns or bridges may also make hygiene and additional treatment more difficult.

Keep up regular dental visits. In light of all this, it’s crucial to keep up with regular dental visits for continuing teeth and gum health. Besides cleanings, these visits are also important for monitoring signs of tooth decay, periodontal (gum) disease and oral cancer. It’s also a good opportunity to gauge the effectiveness of their hygiene efforts and suggest adjustments.

If you would like more information on dental care for older adults, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Aging & Dental Health.”


By Randall J. Bartoe, DDS, PLC
January 07, 2019
Category: Oral Health
Tags: osteoporosis  
ManageYourOsteoporosisMedicationtoAvoidJawboneProblems

Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.

Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.

Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax™, and denosumab or Prolia™. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.

In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.

The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.

Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.

Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.

If you would like more information on the effect of osteoporosis treatment on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Osteoporosis Drugs & Dental Treatment.”