Oral health refers to the teeth, gums, and the entire oral-facial system that allows us to smile, speak, and chew. There are common diseases that affect oral health, like cavities, gum disease, and oral cancer. According to the State of Oral Health in Canada, approximately 75% of Canadians visit a dental clinic annually, and 86% do so as least once every two years. Collectively, Canadians have experienced significant decreases in levels of dental decay over the past 40 years. Unfortunately, access to dental care is not feasible for everyone.
However, approximately 80% of Canadians have a dentist, yet 32% of Canadians have no dental insurance. Moreover, 53% of adults between 60 and 90 years of age have no dental insurance, and 50% of Canadians in the lower-income bracket have no dental insurance. The report indicates that most seniors living in long-term care are already medically compromised and that new oral health methodologies and standards of oral care must be developed for those co-morbidity situations.
According to Dental Hygiene Canada, oral diseases are among the most preventable disease. Tooth decay and gum disease lead to pain and tooth loss, and oral cancer leads to pain, tooth loss, and premature death. Poor oral health is associated with other chronic diseases like diabetes and heart disease. Oral disease also is associated with risk behaviours like tobacco use and consuming sugary foods and beverages. As you become older, the risks increase, but proper care prevents many of these issues like anything else.
Common Oral Health Issues
Cavities are caused by a breakdown of the tooth enamel by acids produced by bacteria located in plaque. The plaque collects on the teeth and along the gum line, and in the crevices on the teeth’ chewing surfaces. For example, eating and drinking foods high in carbohydrates cause these bacteria to develop. Generally, cavities are preventable but are the most common chronic disease throughout the lifespan. Seniors tend to develop more cavities on the roots of their teeth than younger adults.
Gum disease results from infections and inflammation of the gums and bone that surround and support the teeth. Certain chronic conditions increase risks like diabetes, a weakened immune system, poor oral hygiene, and heredity. Tobacco use is a big risk factor, and if periodontal diseases are not treated, the bone that supports the teeth can be lost. Oral cancer is also a potential issue. According to the Canadian Cancer Society, in 2020, an estimated 5,400 Canadians will be diagnosed with oral cavity cancer.
Oral Health Issues for Seniors in Canada
According to Health Canada, when we age, our teeth undergo changes and are sometimes affected by chronic disease and the use of medications. Some of the changes include sensitive teeth, exposed roots, and darker or yellower teeth. Good oral hygiene helps prevent the development of lung infections like pneumonia, especially for seniors. Unfortunately, people with diabetes are at an increased risk of mouth infections like gum disease. Gum disease can also make it harder for people with diabetes to control their blood sugar levels.
Gum disease also increases the risk of heart attack and stroke. Poor oral health can also lower self-esteem, reducing social interactions, and poor oral health is associated with lower quality of life. According to an article published by the Canadian Dental Association, oral health contributes to general well-being and quality of life. The senior population faces inequity in oral health care, and as the population ages, this becomes more prevalent.
Oral problems that are commonly observed in older adults include caries, periodontal diseases, tooth loss, xerostomia, candidiasis, and cancer. The report found that almost everyone in the oldest age group at the time of the study (60 to 79 years) had at least one decayed, missing, and filled tooth. More than one-tenth of those aged 60 to 79 avoided dentists and even more declined treatment because of the cost. Approximately one quarter avoided certain foods because of oral problems, and one-tenth of participants reported persistent pain.
Generally, poor oral health affects the quality of life and imposes a psychological burden among older adults. The loss of the natural cleansing effect of salvia, for example, increases the oral bacterial load, predisposing older people to more dental problems. More adults aged 65 and over are remaining in the workforce; however, poor oral health can create psychological and social constraints.
Senior Dental Care in Canada
Canada has one of the lowest rates of publicly funded dental care in the world. The cost of dental care forces many Canadians not to receive their annual checkups. Typically, all dental care in Canada is funded privately through employer-based insurance, and non-coverage becomes an issue as people age and retire. Federally, the programs that help seniors are Veterans Affairs Canada, which provides financial support for senior dental care to qualified veterans. The non-insured health benefits program in Canada also provides a full range of preventative and restorative dental care to eligible First Nations and Inuit.
Not all provinces and territories provide dental benefits, but some do have programs for seniors. For example, Alberta has a public dental program that is best known for its commitment to seniors’ oral health. Nunavut and the Northwest Territories offer inclusive coverage for seniors. British Columbia and Prince Edward Island both offer coverage for seniors living in long-term care homes. Locally, seniors can also find resources within their municipalities.
Caring for Your Mouth and Teeth as a Senior
Caring for your oral health as a senior is essential because of certain risks. Health Canada recommends toothbrush modifications, such as a double-headed toothbrush that can help remove plaque among older adults with reduced dexterity. Modifications to the toothbrush handle may help some seniors improve toothbrushing ability. Caring for dentures and implants is also important—redness or swelling of the gums is common among older adults wearing dentures that no longer fit well.
According to the Canadian Dental Association, there are four main types of dentures. There is a fixed bridge or fixed partial denture, a partial denture or removable partial denture, complete dentures, dental implants. Seniors who have dentures need to clean them every day as plaque and tartar can build up on false teens. Dentures should be taken out every night, along with brushing your teen and gums carefully using a soft toothbrush. Seniors that have dental implants should also take care of them because they are not as strong as a natural tooth.
Seniors also struggle with dry mouth, which increases the risk of cavities and other types of infections in the mouth that lead to pain. Dry mouth is commonly caused by medications, dehydration, radiation therapy, diseases like Sjogren’s syndrome, smoking, alcohol use, and mouthwashes. Oral health is important for seniors, and numerous preventative measures help keep the mouth, teeth, and gums healthy.