Improving oral health in older people – six ways to reduce the risk

Some medicines used by frail older people reduce saliva – the body’s own protection against dental problems. The more of these medicines that are used, the greater the risk. In an article in the October edition of Australian Prescriber, geriatric dental experts Drs Alan Deutsch and Emma Jay look at the effect of medicines on oral health and provide six ways to reduce the risk.

Poor oral health can lead to poor general health. Some bacteria that cause gum disease have been linked to Alzheimer’s disease. Improved oral hygiene can reduce the risk of breathing illnesses and pneumonia.

“Saliva is important for speech, digestion and swallowing,” says Dr Deutsch.

“It also kills bacteria in the mouth and prevents decay and tooth wear.

“Many people may not be aware that there are medicines that are often used by frail older people that reduce saliva production and can cause a dry mouth, which can accelerate dental problems.

“Indeed, over half of people taking more than 5 medicines have a dry mouth,” he says.

Medicines that have this effect include medicines for urinary incontinence, antidepressants and antipsychotic medicines.

“To reduce the risk from these medicines, doctors should review, switch, reduce, time, divide and check.

1. Review the medicines a person is taking and consider stopping some when appropriate
2. Switch to medicines without this saliva reducing effect
3. Reduce the doses of these medicines if possible
4. Time the dosings during the day when saliva production is higher
5. Divide the doses into smaller doses throughout the day
6. Check for adverse medicine reactions that mean that cause these medicines to stay in the body longer.

“It is important for doctors to remember oral health and to look into the mouths of their older, frail patients. Oral health is so important for general health,” he says.

The Australian Prescriber article also reviews other medicines that can affect oral health including asthma inhalers, blood thinners, blood pressure medicines and pain medicines. The article also references an Oral Health Assessment Tool that can be used by health professionals to assess oral health.

Read the article in Australian Prescriber