The Tribune

By Dr Andre Clarke

April 7 was World Health Day and it has been celebrated every year since 1948. Every year, as is the custom, the World Health Organisation (WHO) selects a theme to be highlighted. The theme they usually choose reflects a priority area of focus for the WHO. This year the theme was "Ageing and Health: Good health adds life to years".

It was the intention of the WHO to focus on emerging health issues and catapult collective action to protect the health and well being of the aged. Older men and women can lead full and productive lives. They can remain an asset to their families and communities. Ageing spares no creed or stratum of society. It affects the young and the old; male and female; and the rich and poor.

The Bahamas Association of Primary Care Physicians (BAPCP) launched two weeks of promotions, early in April, to alert the public to the importance of health and aging. Their efforts must be commended. Public forums and educational drives are important.

It is my belief that the WHO's theme for 2012 also speaks to the inherent connection between the mouth and the body. "Good health adds life to years," just as easily could have read, "Good mouth health adds life to years." Mouth health is of utmost importance especially for the ageing.

The dentist is important not only in managing the many mouth problems of the elderly, but also in keeping their morale high. There is a crucial role in ensuring that the elderly have strong teeth and chewing muscles so that they can maintain adequate nutrition.

Functionally independent elderly patients, with no serious medical problems, can easily be managed in a general dental practice. However, elderly functionally dependent persons may need domiciliary dental care, with portable dental equipment. The other option of seeing the elderly would be in a hospital environment. The hospital setting is usually reserved for those persons with significant medical problems who require dental treatment.

It is common in the Bahamas to see many elderly persons who have a few or no remaining teeth. There is an even larger number who have disease of the gums (gingivitis) and disease of the teeth's supporting structures (periodontitis). Of interest, as persons age, there is a natural decrease in saliva production and once this occurs, it usually contributes to a high level of cavities, especially root cavities.

Cavities on the top part of teeth often occur in the mouths of the elderly, but these types of cavities are also commonly seen in the wider population. Cavities on the root, however, are more common in the elderly than in the wider population, because in the elderly, gums tend to pull away from the teeth (as a result of gum disease).

The softer root surface then becomes exposed and the softer surface is more susceptible to bacteria assault. The bacteria use food debris in the mouth, and they produce acid over time and dissolve the teeth away.

In addition to causing cavities, impaired saliva production predisposes to fungal mouth infections. This often times is a nuisance to the elderly patient; those who are hospitalised and those who are not.

The medications used to treat mouth fungi may be rubbed on or swallowed. Taking the medication is distressful to the elderly person, because they are usually taking many other medications and do not want to take more.

In addition to medications for hypertension (pressha) and diabetes (sugar), it is common for the elderly to be taking prescribed medications like antipsychotics and antidepressants. The antipsychotics and antidepressants are used to manage mental disorders associated with old age.

Of note, all of these medications often time add to the decreased production of saliva and therefore worsen or create dry mouths and intensifies the associated problems of dry mouth.

Despite the possible mouth problems as we age, it does not have to be all gloomy in the mouth as we age. It is important to keep a high level of mouth hygiene in order to delay or prevent the possible mouth problems. Mouth health is very important. We need to maintain it. When the pangs of age come upon us, we want to still have a smile that is very much alive.

Ageing is something we cannot avoid and it is only through death that we loosen the bonds of ageing. Do not loosen your bonds yet and endeavor to age gracefully; live life to the fullest; and remember that "Good health adds life to years."

This article is for informational purposes only. It is not intended and may not be treated as, a substitute for professional medical/dental advice, diagnosis, or treatment. Always seek the advice of a physician or dental professional with any questions you may have regarding a medical/dental condition. Never disregard professional medical/dental advice or delay in seeking it because of a purely informational publication.

If you have questions, please send email to dr_andreclarke@hotmail.com.