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Dental and Oral Health (Seniors)

Tooth Decay in Older Adults - Causes and Contributing Factors

Different factors can cause or contribute to tooth decay in older adults. The following are some examples of possible problems that older adults might face with their daily oral hygiene.

Inability to hold the toothbrush

A lack of strength because of arthritis, stroke, or other such illness can make even holding the handle of a toothbrush difficult.

A solution to this problem could be to put the toothbrush in a Velcro strap; stick the toothbrush handle into a tennis ball or slide it in a bicycle handlebar grip. You can also carefully wrap the handle of the toothbrush with aluminum foil to make it bulky and easier to hold. Toothbrush with grip

Toothbrush with Ball

Inability to squeeze a tube of toothpaste

Again, a lack of strength because of arthritis, stroke, loss of dexterity, or other physical limitations can make this usually simple task become a chore.

To make squeezing the toothpaste tube easier, place the opened tube of toothpaste on the sink, slightly over the edge of the basin. Hold or place the toothbrush in the sink underneath, and using fingers or the side of the hand, gently press the tube to squeeze out the toothpaste.

There are also toothpaste products that are available in a pump dispenser. These may be easier to use and may work best for older adults who are unable to remove the cap from the tube of toothpaste. Also, toothpaste dispensers that easily put the correct amount of toothpaste on the brush are available online.



Difficulty flossing

Flossing toolHolding and using a string of floss can be a problem for an individual with loss of dexterity in the hands and fingers.

To solve this problem, ask the caregiver for assistance with this part of the daily oral care regimen, or use a floss holder similar to what is pictured to the left. A caregiver may find using a floss holder easier.


Conditions that can make brushing and flossing difficult

Assistance with daily oral hygiene is often needed for older adults with loss of strength, mobility or dexterity, or other functional loss. Some possible conditions that can make brushing and flossing more difficult include the following:


Forgetting to brush the teeth

An illness such as Alzheimer's or another form of dementia or frailty may be the reason patients are not doing their daily hygiene, including brushing the teeth. This type of older adult will most likely need assistance and supervision with oral hygiene.

Be aware that a wet toothbrush does not mean the teeth were brushed; the patient may be brushing the same teeth over and over, using the wrong end of the toothbrush, or just wetting it. A family member or other caregiver can help the patient with his or her daily oral hygiene care. Assisting the Elderly

Some helpful tips to keep in mind are:

A resistant patient

Is the person resisting because of pain from tooth decay or gum disease? Is the patient uncomfortable? Does the patient recognize or know you? Is there a language barrier? These are common issues to consider with an individual that is resisting the oral hygiene routine.

To help with the problem, make sure the surroundings are comfortable, familiar and pleasing to the patient. Create a routine that is calm and easy to do.

Other causes for dental decay

Other causes for dental decay can include a previous history of cavities, not visiting the dentist, dry mouth, and some physical illnesses.

Published with permission from Smiles For Seniors ... an oral health initiative of the Ohio Dental Association.

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Last Reviewed: Jun 27, 2014