Prosthodontist: Towards making elderly healthy

Dr Reecha Gupta
With aging, there is alteration in taste sensation, enamel tends to wear away, dry mouth, receding gums, decrease in saliva quantity and many others.
Loss of teeth is a major reason that older people cannot chew well and thus may not consume enough nutrients. As a result of tooth/teeth loss, the portion of the jaw bone that hold these teeth in place gradually recedes and does not maintain its previous height resulting in pain in temporomandibular joint. Tooth loss not only effects functional, social and psychological wellbeing of the patients but the remaining dentition as well. Even then the person does not replace his missing teeth, reason may be either due to lack of awareness that failure to replace missing teeth may cause the remaining dentition to further deteriorate or casual approach towards oral cavity, dentition in particular.
Negligence of oral healthcare gradually results in partial or complete edentulism leading to impaired diet, limited nutritional choices decreased body weight, loss of muscle tone and overalldepletion of general health.
Who is a Prosthodontist?
A dentist who has received additional 3 years of training and education in replacement of missing teeth and facial structures.
Prosthodontics is the dental specialty pertaining to the maintenance of the oral function, comfort, appearance, and health of patients with clinical conditions associated with missing teeth and maxillofacial tissues by using biocompatible substitutes.
The speciality comprises of Removable Prosthodontics, Fixed prosthodontics, Maxillofacial Prosthodontics,Implant Prosthodontics.
Role of Prosthodontist:
God is the Ultimate creator, but prosthodontists recreate what the time, age and nuisances of life has taken away from an individual. The overall goal is to improve the quality of life of an individual.
By the age of 60 years or above most of the elderly become completely or partially edentulous or their remaining teeth are in a state unable to function properly leading to compromised nutritional intake. A “Balanced” diet is a must for such individuals. A balanced diet is one which contains a variety of food in appropriate quantities and proportions that the need for energy, amino acids, vitamins, minerals, fats, carbohydrates and other nutrient is adequately met.
Dietary needs of an elderly: Consuming a healthy diet throughout the life-course helps to prevent malnutrition in all its forms. With increasing age, this becomes all the more important to have balanced diet.
In order to meet the needed body requirement to elderly, “Edentulism” is the biggest hurdle. Let us understand, “what is edentulism?” and “Is edentulism a permanent state?”
Edentulism is the loss of teeth. It may vary from few to complete loss of teeth. In growing economies, lack ofawareness related to dental treatment is one of the biggest reason of edentulism leading various elderly to end up with complete/partial edentulousness. Once this condition present itself it is irreversible and can only be treated by getting your teeth replaced by complete or partial dentures.
Why Dentures?
Dentures are removable prostheses. They are not embedded in the bone like natural teeth, they are placed over the remaining gums. Dentures are the artificial teeth set designed by Specialist (Prosthodontist) for patients with no teeth. Dentures help them eat & speak the way they did with their natural teeth. Although we cannot replace what God has given, but Complete denture is a satisfactory substitute.
Complete dentures not only help them chew, enables them to speak the way they did with their natural teeth, improves their look, gives fullness to lips and cheeks but also makes them feel more confident. So, one can get a normal life just like before.
Life with dentures
* A strange feeling in the beginning is very much normal. The habit of wearing a complete denture may take some time.
* Sore spot – One may experience sore spotswithin 24-48 hours of wearing a denture. It is not advisable to adjust the dentures by themselves as this may break or fracture the denture or even harm your mouth.
* Chewing with new denture – Learning to chew with new denture needs patience and require some practice. Chewing has to be gradual from liquid to semi-soft to soft to hard. Make sure to cut the food into small pieces and then chew slowly with up and down motion and minimum sideways motion. Practice to chew on both sides of your mouth and not to bite with the front teeth. This will prevent the dentures from dislodging. Sticky foods should be avoided in the beginning.
* Speaking with new dentures – Speech may be impaired in the beginning but gets adapted fast. Practice reading aloud in front of a mirror and see the change.
* Increased Saliva – It is very normal to have increased salivary flow with new complete dentures but it decreases with time.
Dietary recommendations for new denture wearer:
First post-insertion day
* Vegetable-fruit group: juices
* Bread-cereal group: gruels cooked in either milk or water.
* Milk group: fluid milk may be taken in any form.
* Meat group: eggs in eggnogs, pureed meats, or soups.
Second and third post insertion day
* Vegetable-Fruit group: Juices; Tender cooked fruits and vegetables, (seedless and skinless)
* Bread-cereal group: cooked cereals, softened breads boiled, rice.
* Milk group: Fluid milk and cottage cheese.
* Meat group: Tender chicken/fish, scrambled eggs, thick soups, etc.
Fourth day and after
Sore spots have healed,
Firmer foods can be eaten in
Should be cut into small pieces before eating.
“Let’spledge just not be “Elderly” but a “Healthy Elderly”. Afterall selfcare is not self-indulgence but self-preservation.
Don’t regret growing older,
It is a privilege denied to many!!
(The author is working as Professor & Head, Department of Prosthodontics Indira Gandhi Govt. Dental College, Jammu.)