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Post 69…An oral health overview in the elderly, including dry mouth.

Posted on 7th April 2025 at 07:00
 
Introduction 
 
As The Care Whisperer continues to engage and work with industry experts, we are pleased to announce a new relationship with Penny Priddy, Dental Hygienist and Educator, to bring you this latest post on oral health in the elderly. This post will mark the beginning of an ongoing piece of work about the importance of oral health as we age, offering solutions to problems and top tips on how to keep you're mouth clean and infection free. 
 
Our oral health to our general health, an important partnership 
 
Our oral health influences our general health, thus making it a major part of our personal health regime. Our mouth is the gateway to our well-being and it is known that poor oral health can contribute to heart disease, stroke (potentially causing vascular dementia), and other underlying health conditions. There are times that may dictate that some people need a ‘helping hand’, and why not. 
 
For carers, offering this important help assists in maintaining the optimum level of oral health care, and promotes the all-important independence to those that are in need, restoring a person’s self-esteem and dignity. 
 
Due to various physical and mental health conditions, dexterity and sensory obstacles may arise. If an individual is living with a condition such as dementia, or they have lost the physical capability to hold a toothbrush, it is of the upmost importance that the persons carer remains vigilant with their oral health. 
 
For some folks who live with dementia, looking into a mirror can be confusing and cause behavioural changes or anxiety. The reason for this is because the person may believe they are younger than they are, and therefore seeing the reflection of an elderly person in a mirror can be confusing to them. If this is happening, it is again important that carers continue to support a person to maintain their oral well-being as much as possible. 
 
There are a variety of tooth brushes, and other oral health aids that help achieve comfortable care in the mouth, they just need to be tailored to the individual’s needs. 
 
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XEROSTOMIA (Dry mouth) 
 
One in four of us may suffer from a dry mouth, and even put up with it for a long but unnecessary time. Older people are already naturally at risk of dehydration because we begin to lose our sense of thirst as we age, this can increase the risk of falls, injury, UTI’s and hospital admissions. 
 
If untreated, dry mouth can also lead to further oral health problems and subsequently effect our general health and well-being. Less able-bodied people, or those living with dementia, are not always able to alert carers and friends of this so awareness from us all is of paramount importance. 
 
If untreated, a dry mouth can lead to difficulty in speech & swallowing, discomfort and sometimes pain, lack of appetite and therefore weight loss, decline in socialising, lack of self-esteem and the inability to wear dentures. For older people, weight loss can also happen naturally and can increase the risk of falls or decline in mobility, it is therefore vital that other factors such as dry mouth do not prevent an older person from being able to eat and drink normally. 
 
Causes of dry mouth 
 
MEDICATIONS – There are over 500 medications that contribute to a dry mouth, including certain incorrect use of mouthwashes. 
 
MEDICAL PROCEDURES - Radiotherapy and chemotherapy can damage our salivary glands, resulting in a dry mouth. 
 
SMOKING – Smoking long term can contribute to a dry mouth, even if a person has ceased in recent years the damage remains. 
 
HORMONES – Hormonal imbalances can contribute to a dry mouth, screening is advised. 
 
STRESS – We are only human, and everyone is prone to stress at some time during our lives. However, the very elderly and those living with dementia and other debilitating conditions may well suffer with bouts of stress thus triggering our parasympathetic system to cause a dry mouth. 
 
MOUTH BREATHERS – As we approach advanced years, there is a tendency to sleep with our mouths open, known as a mouth breather. This results in a dry mouth, but the good news here is that medications can alleviate the discomfort. 
 
DEHYDRATION – Dehydration is a big cause of dry mouth in people of all ages, but this is an acute problem for the elderly. Carers need to be aware of a person’s medical history to understand if any of these other factors could be causing dry mouth, due to the additional risks that dehydration poses to older people. 
 
How you can help: 
 
• Look and listen with sensitivity 
• Take medical history, sometimes with help from family and friends. 
• Request some blood screening. 
• Manage stress 
 
MEDICATIONS AND MANAGEMENT 
 
There are several medications in the form of sprays and gels. Sprays do need supervision in certain cases. Most of these are sensitive free, tasteless, and vegan friendly. 
 
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End of life mouth care 
 
Sometimes, circumstances require extra specialised care during the period of advanced illnesses, palliative care, and end of life care. This can be a daunting and a frightening time for carers, entering the unknown. We (Penny) provide specialist instruction and guidance into applying the most suitable techniques using the appropriate oral health aids. 
 
In the stages of end-of-life care, the last senses to pass are hearing and touch, so to feel some comfort in the mouth, along with words of reassurance are so beneficial and important. At this time, saliva flow reduces, and becomes viscous, along with bacterial changes, releasing toxins. 
 
It is essential to use specialised oral health aids to maintain a comfortable mouth and reduce further infections, such as Aspiration Pneumonia. 
All these items are available, but only to use them following professional guidance. 
 
Conclusion 
 
We all know that oral health is important at any age, and this doesn’t change as we age, if anything it becomes even more important. Over the coming posts, we look forward to working with Penny to investigate different areas of oral health, whilst looking at ways to solve any mouth related issues. 
 
Tagged as: Carers, Collaboration, Oral Health Care
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