Medical Conditions Affecting Your Dental Care

Your medical conditions can affect your dental care. Your dentist needs to know your health history to prevent potential complications and provide you with the best care. These include diabetes, multiple drug interactions, cardiac conditions, and infectious disease. For example, medications that you are prescribed for a medical condition might produce a problem during the administration of a local anesthetic, or it could interact with pain medication prescribed post-intervention. Some types of dental care for certain medical conditions should only be performed in a hospital. For example, procedures like tooth extractions should be done in an in-patient setting for patients with significant bleeding problems or thrombocytopenia arising as a primary condition or secondary to medication, radiation, or leukemia where replacement of platelets can be provided before the procedure or afterwards if spontaneous bleeding occurs.

Diabetes: Seniors with diabetes are more prone to cavities and gum disease. With diabetes, you may produce less salvia, causing dry mouth. Dry mouth is a major cause of cavities because saliva protects your teeth. For those with diabetes, periodontal disease is the most common dental disease, affecting more than 20% of those diagnosed. Poor blood sugar control increases the risk for gum problems. Gums may develop gingivitis where they become inflamed and bleed. In turn, serious gum disease, as with all infections, can cause blood sugar levels to rise, making diabetes harder to control. For diabetics, regular dental visits are extremely important. Practicing good oral hygiene, having professional cleanings, and treating gum disease will help you control your blood sugar levels and decrease the progression of the disease. Likewise, controlling your blood sugar levels by being compliant with your medications, eating healthily, not smoking, and exercising more will improve your overall health, and your oral health in particular. Keeping blood sugar levels under control will help your body fight infections in your mouth and relieve dry mouth.

Medications Affecting Your Dental Care

Senior dental problems can also be caused or exacerbated by medications. Older adults are likely to take medications that can impact oral health and affect dental treatment. There are literally hundreds of common medications – including antihistamines, diuretics, painkillers, high blood pressure medications and antidepressants – that can cause dental health side effects. These include dry mouth (lack of saliva in the mouth), abnormal bleeding, soft tissue changes (oral thrush), taste changes, and gingival overgrowth (overgrown or enlarged gums). It is important to let your dentist know what medications you are taking, even if you think they have nothing to do with your teeth.

Dry Mouth: There are hundreds of prescription and over-the-counter medications in which dry mouth is a common side effect. You can experience dry mouth when taking medications for everything from colds and stuffy noses (antihistamines and decongestants) to medications for serious chronic conditions like depression, anxiety, pain, hypertension (diuretics), asthma (certain bronchodilators), and Parkinson’s Disease, just to name a few.

Abnormal Bleeding: Many medications, including plain old aspirin, have anticoagulant properties. Medications like warfarin and heparin are used to help prevent blood clotting in individuals with a risk of heart attack or stroke. Your dentist needs to be made aware of these medications, especially when your treatment may involve some bleeding. Your dentist may consult with your physician before initiating treatment.

Soft-Tissue Changes: Some medications have been linked to the development or oral sores, thrush, or inflammation or discoloration of the mouth’s soft tissues. These include medications for blood pressure control and immunosuppressive agents.

Taste Changes: Some medications can cause a bitter or metallic taste or even affect the ability to taste. These include certain cardiovascular drugs, stimulants, anti-inflammatory drugs, and even nicotine skin patches to stop smoking.

Gingival Overgrowth: Overgrown or enlarged gums have been associated with certain anti-seizure medications as well as calcium-channel blockers taken by some heart patients. Meticulous attention to cleaning teeth and gums is important for patients with this condition.

Dry Mouth (Xerostomia)

Dry mouth is a common, and often overlooked, source of dental problems with seniors. Our bodies so not produce saliva so that we can lick envelopes. Saliva is our body’s natural rinse to keep bacteria and food washed away from teeth and gums. An underproduction of saliva leaves you more susceptible to tooth decay and periodontal disease. Dry mouth can cause sore throat, problems with speaking, difficulty swallowing and hoarseness

As we get older, we enter a second round of cavity-prone years, decades after our childhood cavity experiences of eating too much candy, drinking too much sugar-laden beverages, and not having the best brushing and flossing routines. Round Two of cavities later on in life is often the result of dry mouth. It’s not a normal part of aging. Rather, dry mouth is often a side-effect of hundreds of medications commonly taken by seniors, including those for allergies or asthma, high blood pressure, high cholesterol, pain, anxiety or depression, Parkinson’s and Alzheimer’s diseases. Often, patients wonder why their dentist should be concerned about what medications they are on. This is just one reason. If your dry mouth is chronic and severe, you should consult with your physician about the medication or the dosage. There may be alternatives that will help reduce this serious side effect.

Your dentist can make recommendations to help relieve your dry mouth symptoms and prevent cavities, and can apply a fluoride gel or varnish to protect your teeth from cavities. Ways to help with dry mouth include using over-the-counter oral moisturizers, such as a spray or mouthwash drinking more water throughout the day to provide constant lubrication, using sugar-free gum or lozenges to stimulate saliva production, keeping more moisture in your home’s air with a humidifier, and avoiding foods and beverages that irritate dry mouths, like coffee, alcohol, carbonated soft drinks, and acidic fruit juices.

Oral Thrush (Oral Candidiasis)

Another mouth problem found disproportionately among seniors is oral thrush, a fungal infection of the mouth. A fungus, Candida albicans, accumulates on the lining of mouth, causing creamy white lesions, usually on your tongue and inner cheeks. Candida is a normal organism in your mouth, but sometimes it can overgrow and cause symptoms.

We often think of thrush as only affecting newborns. However, older adults and people with weakened immune systems can also be affected, especially those with dentures, diabetes, dry mouth, undergoing chemotherapy, or on steroid medication. Thrush can make the mouth so sensitive, that is is difficult to eat or swallow, and becomes almost impossible to perform regular oral hygiene. If you have lesions and sensitivity in your mouth or other symptoms like cracking and redness at the corners of your mouth, or a cottony feel in your mouth, your dentist can readily diagnose and treat this condition with antifungal medications.

Loss of Manual Dexterity

For seniors with arthritis or a medical condition that limits manual dexterity, brushing and flossing is often easier said than done. There are various ways to make brushing easier that your dentist may recommend. An electric toothbrush can makes brushing easier, and many find them fun to use. If you don’t like powered toothbrushes, you can elongate your toothbrush with a tongue depressor and even rig a tennis ball at the end of your toothbrush for a better grip. Even using a soft washcloth or gauze as well as frequent rinsing helps. Finally, if need be, a family member or friend should assist you. Don’t be embarrassed to ask for help. Helping someone preserve their teeth, in the words of Cervantes, is the equivalent of giving a gift of diamonds.

Take Control of Your Oral Health by Recognizing When It’s Time to See Your Dentist

You are the best and most passionate advocate for your own health. Seniors need to recognize the signs and signals when their mouth, teeth, or gums are crying out for dental treatment. They include tooth sensitivity, teeth grinding, pain, mouth sores, bumps, swelling, loose teeth, jaw popping or clicking, and the symptoms associated with dry mouth – difficulty quenching thirst, swallowing, and chewing. Most dental problems do not self-resolve, and they won’t go away by ignoring them. By going to the dentist at the earliest signs of a problem, you’ll make it easier for the dentist to treat. Early treatment is often faster, less invasive, and easier on your wallet.

Good dental care requires good nutrition, daily oral hygiene, regular dental checkups, maintaining dental appliances such as dentures and dental bridges, and telling your dentist about any medications you are taking or changes to medication. These are the keys that will keep you smiling in your golden years!