The dental needs of the elderly, like their medical needs, should be constantly evaluated as there are many correlations that exist between the two. The oral cavity, like other parts of the body, is subject to problems of chronic diseases associated with the aging process. In 1967 it was reported that the elderly have the greatest oral health needs of any segment of our population. In another study, it was reported an 81% prevalence of pathology in elderly institutionalized patients who presented no obvious symptoms and were supposedly under “optimal care.” Soft tissues revealed 19 types of problems ranging from innocuous areas of pigmentation to early squamous cell carcinoma.
Oral health is particularly problematic for the elderly partially or completely edentulous patient. Dentures are frequently used well beyond their normal life. Many elderly patients do not seek regular treatment which could enable them to maintain mastication and prevent irritation of denture-bearing tissue. As the fit of the denture deteriorates, the elderly patient will often select a diet that fails to meet their bodily needs, consuming food low in proteins and high in carbohydrates and fats.
Though some problems are a result of the aging process itself, others are related primarily to attitudes toward aging. Many older persons tend to react passively to the effects of aging on both appearance and function. They are also more likely to believe that many preventable losses, illnesses, and pain are an unavoidable part of aging. Consequently, they may have a fatalistic attitude toward their health and be less likely to take steps to guard their physical wellbeing or be concerned with prevention of disease. Although financial restrictions are often the reason for their declining use of dental care, many elderly people do not take advantage of free care even when it is available.
Though there is a correlation between aging and dental disease, the relationship is not necessarily causal. Dental educators and researchers are now attempting to foster a rehabilitative preventative approach to the oral problems of the aged. Problems of diseased and missing teeth, ill-fitting dentures, soft tissue disease, and bone deterioration are amenable to rehabilitation, if not prevention. the consequences of poor oral health in the elderly may lead to inadequate diet and malnutrition, pain, infection, and impaired social functioning.
Providing preventive care to elderly patients is challenging; it is often difficult to motivate them to seek dental care, or to make efforts to correct or prevent problems that they do not believe to be severely handicapping. On the other hand, there is evidence that a behavioral approach can be successfully applied to the elderly in modifying diverse health behaviors.