Top 10 Things You Need to Know About Dentures for a Loved One in Assisted Living

Dr. Stu Rubin, Dr. Lindsay Rubin and their team of dentists at Dental Home Services have over 50 years of combined experience providing dental care for patients in assisted living facilities across New Jersey.  Accordingly, we’ve compiled a list of the top 10 facts you should be aware of  if you have a loved one who wears dentures and resides in assisted living.

1. Choking. Some people assume that if a loved one doesn’t have dentures or has dentures that don’t fit, then it’s ok for that person “gum it” to chew their food. And while this might seem like a reasonable alternative to wearing dentures that are uncomfortable, eating food without properly breaking it down into smaller pieces is a significant choking hazard. Add the fact that seniors likely have a weaker cough reflex compared to when they were younger, and you have the potential for a serious choking and airway blockage incident. 

2. Alzheimer’s patients.  Patients with Alzheimer’s disease face significant challenges, including the inability to communicate properly or effectively if something is hurting them.  They may have sore spots from their dentures or painful ulcerations from dentures that don’t fit well, and are no able to express their pain.  Thus, a dental exam is necessary in order to find and relieve sore spots or areas of discomfort.

3. Pneumonia hospitalization. The leading cause of hospitalizations in seniors is pneumonia.  Research has found that much of this pneumonia was initiated from inhalation of dental plaque/bacteria from natural teeth and from dentures.  What this means for someone who lives in an assisted living facility is that keeping up with dental care must be paramount. Regular cleanings with a traveling dentist or hygienist can greatly reduce the risk of pneumonia as well as other oral infections.

4. Weight loss due to ill fitting dentures. When someone has a denture that doesn’t fit, hurts when they bite, or moves when they try to talk or eat, they understandably don’t wear them. And when someone who is accustomed to chewing with dentures no longer has them, by necessity, they often have to move to a very soft or liquid-based diet. Obviously there are situations where a soft or liquid-diet is indicated, but having a liquid diet over a long period of time in seniors who should otherwise be eating solid foods can be dangerous. One of the most significant problems we see in older adults is lack of nutrition directly related to weight loss, which in turn can lead to a dampened immune response and increased susceptibility to infections.

5. Denture sores and irritations. Anyone who takes multiple daily medications is likely aware of the dreaded side effect of many of these medications, alone or in combination – dry mouth.  Technically known as xerostomia, dry mouth is a significant dental problem for two main reasons.

The first reason that xerostomia can be so damaging is because lack of saliva and moisture in the mouth can lead to an increased risk of cavities.  Saliva acts as a natural lubricant and keeps the surfaces of the teeth relatively moist so that plaque and bacteria don’t stick to the teeth as easily. When a patient has xerostomia, however, this lack of lubricant and salivary flow cause plaque, bacteria and food debris to accumulate and stick to the tooth surfaces, leading to the formation of dental caries (cavities).  

While one of the best ways to combat dry mouth is for a patient to be even more vigilant about home care, so the amount of debris on the teeth is reduced, many elderly patients can’t take advantage of this approach because suffer from arthritis and other issues with dexterity, which make otherwise routine oral hygiene home care a challenge. 
The second reason we are concerned about xerostomia, and the reason that it is especially devastating in the elderly population, is because dry oral tissues make the mouth more susceptible to cuts and infections. For example, if you  try to clean a baked-on stain off of your kitchen counter with a dry paper towel, you won’t be able to remove the stain and your paper towel will likely rip. But if you wet the paper towel, you’ll be able to easily remove the stain and keep the paper towel in one piece.  The mouth is the same in that small insults to dry tissues can lead to irritations and cuts. Thus, if a patient has an ill-fitting denture and suffers with dry mouth, denture sores and cuts that might otherwise resolve quickly and on their own, can lead to complications including infections, or discomfort to the point where the patient no longer wears their dentures and starts to lose weight.

6. Broken dentures. A denture may have a chip on it with a sharp edge, on a broken section that a patient has gotten used to. And while this damage to the denture may not be causing an acute problem, the roughness and poor fit of these areas may cause a long term problem.  The same concerns exist for dentures that don’t fit well and rub against the gum tissues, causing sores and irritation.

7. Fungal infections. You can sometimes think of dentures or partials as you would with clothes – you can wear them all day but they do need to  go into the washing machine to be thoroughly cleaned.  Because dentures are made of acrylic, are kept in the warm environment of the mouth for hours, and tend to accumulate food debris, patients who wear dentures and have a limited ability to keep them clean are at a risk for thrush.  Thrush is an infection caused by the Candida fungus, and it often presents as a white rash in the mouth. We all have a baseline level of Candida in our bodies, but in people with weaker immune systems such as infants and the elderly, the amount of fungus can increase to a point where it causes a rash that if untreated, can spread and lead to problems with taste and swallowing.

8. Problems with speech. If dentures don’t fit well or if they move around too much in the mouth, speaking can be very difficult for the person.  Combine this problem with the fact that many older patients already have problems with speech due to stroke, dementia, or Alzheimer’s disease, and the issue becomes more significant.   If a patient can’t speak well, they may become introverted because they are embarrassed about their speech, or frustrated because it’s difficult for other people to understand them (especially if many of the people who surround them every day are also elderly and likely have difficulty hearing).

9. Appearance.  Just because someone is elderly or lives in an assisted living facility, it does not mean that they no longer care about their appearance or that they are immune to feelings of embarrassment and depression. Depression is common in older people because so many of them are lonely, suffer with multiple medical conditions including memory and hearing loss, and find that daily life is often a struggle compared to what it was when they were younger.  These negative feelings are understandably exacerbated in people who have dentures that don’t fit or that can’t be worn, as nobody wants to walk around among their friends or fellow residents without teeth.  Having dentures with a smile they are proud of, even if only for social situations, can be an uplifting emotional boost for people in this situation.

10. Dementia. As with Alzheimer’s patients discussed earlier, patients with Dementia may have difficulty expressing that they are having mouth pain, and may have emotional responses to their discomfort that is less pronounced – or more pronounced – than a similar person who does suffer from Dementia. Thus, it’s important to have dentists such as those at Dental Home Services who work with patients and families in this situation every day.

If you have any questions or would like more information, please contact us and we’ll be happy to help.

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