Dr Mandeep Kaur
1st October is celebrated as the International Day for Elderly People each year which was first established at 14th of December in the year 1990 by the United Nations General Assembly. It was started celebrating for the first time on October 1st in the year 1991 to aware the people about issues which affects the elders as well as to appreciate their contribution towards the society.
Adequate nutrition is a vital factor in promoting the health and wellbeing of the aged. Inadequate nutrition may contribute to an accelerated physical and mental degeneration. Poor oral health can be a detrimental factor to nutritional status and health. Disorders of the oral cavity have contributed to poor eating habits in the elderly. Loose painful teeth or ill-fitting dentures may result in a reduced desire or ability to eat. A compromised nutritional status, in turn can further undermine the integrity of the oral cavity are closely interrelated, diet and nutrition should be considered as an integral part of the oral health assessment and management of the elderly.
Dental status is considered to be an important contributing factor to health and adequate nutrition in elderly. Missing dentition and ill-fitting dentures cause difficulty in chewing and perception of taste of foods. The dentists are hence in an ideal position to contribute to the well-being of the elderly population. Dentists should be alert to nutritional risk factors in the elderly population and by careful screening can intervene in the early stages of nutritional problems when such interventions can be most valuable and effective.
The main oral health problems of old age that is mouth dryness and dental caries have been attributed to the reduced salivary flow. Oral mucosa becomes increasingly thin, smooth with age and that it acquires satin like edematous appearance with loss of elasticity and stippling. The tongue become smoother with loss of filiform papillae. With age, there is a tendency for development of sublingual varices and an increasing susceptibility to various pathological conditions such as Candidal infections and a decreased rate of wound healing.
The macroscopic changes taking place with age in the teeth change in form and occur with age. Wear and attrition affect the tooth form. The perikymata and imbrication lines are lost, giving the enamel surface a flat appearance with less detail than in newly erupted teeth. The dental pulp in teeth from old individuals differs from that in younger teeth by having more fibers and fewer cells, and hence reduces in volume. Rate of formation of cementum diminishes with age. Furthermore increase in the fluoride and magnesium content is seen with age. Age changes in morphology of teeth have important clinical implications as these changes may influence the outcomes of the restorative treatments and also have a great bearing on the reparative responses.
The susceptibility of the periodontium to plaque-induced periodontal breakdown may be influenced by the aging process or by specific health problems of the aging patient like diabetes mellitus, ischemic heart disease and chronic respiratory disease.
Specific protocol must be tailored to meet the unique needs of the individual patient which includes mechanical and manual plaque removal, rinses, electric devices, adaptive aids, denture care, counselling and motivation. Oral health services should be organized and developed to secure adequate early detection, prevention and treatment of oral health problems for all elderly people, whether living at home or in hospitals or in institutions. The achievement of such a service goes beyond what the dental profession can do alone. It requires the involvement of other health professionals, health care workers of the elderly people. However, it presents a realistic goal that could assure good quality of life and a reduction in the dental expenses for the elderly patients.
(The author is Assistant Professor Deptt of Oral Pathology & Microbiology Indira Gandhi Govt Dental College, Jammu)
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