smiles life - California Dental Association

smiles life - California Dental Association
FOR
SMILES LIFE
FOR
SMILES LIFE
Smiles for Life is a program developed
in response to the need for education
and awareness on the importance of
continued good oral health for older
adults. This program serves older adults
living independently at home and semidependent older adults who need partial
or full assistance from a family member or
other care giver.
This program is not copyrighted and
duplication of all materials is encouraged.
Posting the materials on Web sites is
also recommended. Through duplication
of the program, the information can be
disseminated to the populations listed
above, as well as to those who work with
older adults in a professional and/or
personal caregiver capacity.
Continued good oral health care – from
daily brushing and flossing to regular
dental visits is important to keep the
older adult healthy. The link between
oral health and overall health is strong.
The U.S. Surgeon General and numerous
health associations continue to spread
the message that “oral health is essential to
general health and well-being…”
The following fact sheets cover issues
related to oral health and the daily
oral care of the semi-dependent and
independent older adult. A list of other
helpful resource materials is located at the
end of this packet.
To learn more about good oral health, visit:
www.cda.org/public-resources
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
INFORMATION
CONTAINED WITHIN
Smiles for life
– Causes or contributions to tooth decay
in an older adult
– Common signs of dental disease
– Health conditions that can make
brushing or flossing difficult
– Dry mouth
– Possible side effects of drugs on oral
health
– Daily oral hygiene routine
– Dentures
– Nutrition and the older adult
– Tobacco use and tooth decay
– Oral cancer
– Oral health care for the cancer patient
– Resource materials
ACKNOWLEDGEMENTS
Information contained in these fact
sheets has been compiled from numerous
sources, including geriatric dentistry
experts Dr. Marsha Pyle, Case School of
Dental Medicine and Dr. Abdel Rahim
Mohammad, The Ohio State University
College of Dentistry. Other sources
of information and assistance are the
American Dental Association, National
Institutes of Health – National Institute of
Dental and Craniofacial Research (NIDCR),
the Ohio Dental Association Council on
Access to Care and Public Service, U.S.
Dept. of Agriculture, the American Cancer
Society, GlaxoSmithKline Consumer
Healthcare, and Laclede, Inc.
Photos and graphics are used with
permission/courtesy of Microsoft Office
Clipart, the U.S. Dept. of Agriculture,
NIDCR, Case School of Dental Medicine,
The Ohio State University Section of
Periodontology, and iStockphoto.com.
For the Dental Patient copied with
permission of the American Dental
Association.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
WHAT CAN CAUSE OR CONTRIBUTE
TO TOOTH DECAY IN AN OLDER ADULT
Unable to hold the toothbrush? A lack of strength due to arthritis, stroke, or other
such illness can make holding the handle of a toothbrush difficult.
SOLUTION: Stick the toothbrush handle into a tennis ball, slide it in a bicycle handlebar grip
or put the toothbrush in a Velcro strap.
You can also carefully wrap the handle of the
toothbrush with aluminum foil to make it bulky
and easier to hold.
Unable to squeeze a tube of toothpaste? Lack of strength because of arthritis,
stroke, loss of dexterity or other physical limitation can turn this usually simple task into a
chore.
SOLUTION: Place the opened tube of toothpaste on the sink, slightly over the edge of the
basin. Hold or place the toothbrush in the sink underneath, and using fingers or the side of
the hand, gently press the tube to squeeze out the toothpaste.
Toothpaste squeezers are available at local drugstores.
Place one on the end of the toothpaste tube and slide
it up to dispense the toothpaste.
Some toothpaste products are available in a pump
dispenser which may assist older adults who are unable
to remove the cap from the tube of toothpaste. They can be
purchased at most retail supermarkets or drugstores.
Also, toothpaste dispensers that easily put the correct amount of toothpaste on
the brush are available online. Simply do a search for “toothpaste dispensers.”
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Difficulty flossing? Holding and using floss can be a
problem for an individual who has lost dexterity in the hands
and fingers.
SOLUTION: Use a floss holder similar to that pictured. Ask
the caregiver for assistance with this part of the daily oral care
routine if necessary.
Forgetting to brush the teeth … An illness such as
Alzheimer's or other form of dementia or frailty may be the
reason patients are not doing their daily hygiene, including
brushing teeth. This adult will most likely need daily assistance
and supervision with oral hygiene.
Be aware that a wet toothbrush doesn’t mean the teeth were
brushed – the patient may be brushing the same tooth over and
over, using the wrong end of the toothbrush, or just wetting it.
SOLUTION: A family member or other caregiver can help the patient with daily oral
hygiene care. Some helpful tips to keep in mind are:
• The caregiver and the patient should be seated or standing comfortably. The caregiver
should be slightly higher than the patient.
• Use a location where it is easy to do the oral hygiene routine – this could be the bathroom,
kitchen, at a table or with the patient reclining in a chair or bed.
• Have the oral care products, water and a towel easily within reach.
• Use a room with good lighting.
• Wear protective gloves (and face mask if needed).
• Explain and show each step to the patient before you do it.
• Keep to a daily routine: same time, same place.
• Be patient and caring and give positive feedback.
• Don’t rush.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
resistant patient … Is the person resisting because of pain from tooth
decay or gum disease? Is the patient uncomfortable? Does the patient
recognize or know you? Is there a language barrier?
These are common issues to consider with an individual that is resisting the
oral hygiene routine.
SOLUTION: Make sure the surroundings are comfortable, familiar and pleasing to the
patient. Create a calm routine that is easy to follow.
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Consult with the family if the patient is resistant.
Discuss the use of mouth props.
Take time to create a “bond” with the person.
Respect privacy. Always ask permission to enter the room and brush teeth.
Explain the routine step by step.
Keep the routine the same each day – make it familiar.
Use a quiet and soothing voice.
Don’t rush the person or the procedure.
Provide the patient with a distraction, if it would be welcomed: favorite music, turn on the
television, let the person hold something special, etc.
• When possible, let the patient help – hold and guide the patient’s hand holding the
toothbrush.
• If there is a language barrier, find someone to interpret.
Other causes for dental decay can include:
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History of cavities
Not visiting the dentist
Dry mouth
Some physical illnesses
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Common Signs of Dental Disease
If the older adult is not brushing or flossing, and there seems to be no physical limitation to
prevent this, perhaps there is tooth decay or gum disease present. If the individual is able to
cognitively understand your questions, ask if they have mouth pain.
Some indications of tooth or gum disease:
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Verbal complaints or visible expressions of pain
Visible tooth decay
Persistent bad breath
Stained teeth
Filmy or dull looking teeth
Bleeding gums
Swelling in the mouth
Difficulty chewing
Not eating
Dentures are not in the mouth
Dentures that don’t appear to fit
Loose teeth
Picture of periodontal
disease and bone loss
If the person has Alzheimer’s or another form of dementia, he or she may not be able to tell
you there is pain. Caregivers – wearing protective gloves and if necessary, a surgical mask –
should carefully examine the individual’s mouth for signs of disease.
Overgrowth of tissue and decay
Decay
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Health CONDITIONS THAT CAN MAKE
BRUSHING OR FLOSSING DIFFICULT
Tremors can be caused by Parkinson’s disease, cerebral palsy
or Huntington’s disease.
Unable to grip a toothbrush, floss or tube of
toothpaste … a possible result of paralysis from stroke,
MS, Parkinson’s, brain or spinal cord injury, frailty or other
debilitating condition or illness.
This could also be caused by muscle weakness and lack of
strength, loss of coordination, or from limited range of motion
caused by arthritis or other crippling illness.
Cannot keep the mouth open … a possible result of
paralysis or weakness from illness. This could also be caused
by temporomandibular joint disease (TMJ), mouth infection,
jaw clenching or teeth grinding.
Assistance with daily
oral hygiene is often
needed for older adults
with loss of strength,
mobility or dexterity, or
other functional loss.
Dementia or cognitive impairments … Alzheimer's, other forms of dementia, and
the after effects of a stroke, often cause the patient to forget to brush or forget how to
brush.
Visual impairments … vision problems such as glaucoma, total blindness, and macular
degeneration can make a simple oral hygiene routine challenging.
Difficulty swallowing … can cause choking or a sensation of choking; older adults may
be afraid to brush their teeth for fear of choking. Parkinson’s disease or stroke patients may
have difficulty swallowing.
History of poor oral hygiene … if the individual did not take proper care of their
teeth and gums when young, including daily brushing and flossing, it probably won’t be
important as an older adult.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
DRY MOUTH
Xerostomia (
) is the medical term for a dry mouth due to lack of saliva. Dry
mouth can cause difficulty eating and talking and can also lead to halitosis (bad breath).
Without saliva to lubricate the mouth, wash away food particles, balance the acidity of the
mouth, and remineralize the teeth, cavities and other infections can easily form.
Seniors are particularly susceptible to dry mouth because they often take multiple
medications to control diseases they have developed throughout their lifetime. Seniors
are also more likely to have teeth with exposed roots due to a number of factors including,
but not limited to, their age, tobacco use, and oral hygiene habits. Root surfaces become
exposed when the bone around the teeth is lost, usually caused by gum disease. Root
surfaces are more prone to cavities because they do not have enamel to protect them. The
combination of exposed root surfaces and dry mouth increases the likelihood of cavities
forming.
Causes of Dry Mouth
Medication: Medication is the most common cause of dry mouth; over 400 common
prescriptions and over-the-counter drugs are known to cause dry mouth.
Radiation and Chemotherapy: Individuals who undergo radiation or chemotherapy for head and neck cancers experience xerostomia. The salivary glands can be
permanently damaged and saliva can be reduced and/or its consistency changed.
Disease: Dry mouth may be a sign of an underlying disease such as diabetes or Sjögren’s
syndrome, a disorder in which immune cells attack and destroy the tear and saliva glands.
Substance Abuse: Dry mouth is a common symptom of substance abuse as many
drugs reduce saliva production.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Solution: Although there is no cure for xerostomia, there are steps you can take to
help manage this condition. Drink plenty of water and/or sugar free beverages. Chew sugar
free gum containing xylitol; gum stimulates saliva production and xylitol helps protect teeth
against cavities. Avoid tobacco, caffeine, and alcohol. If you use mouthwash, be sure it is
alcohol free. Use a saliva replacement gel to help lubricate your mouth; they are available
at drug stores. Talk to your physician about changing your medications to ones that do not
cause dry mouth.
Finally, be sure to visit your CDA member dentist regularly so he or she can provide
protective fluoride treatments and other care essential to keeping your teeth and mouth
healthy.
Cavities on exposed roots
Tongue affected by dry mouth
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
OTHER POSSIBLE SIDE EFFECTS
OF DRUGS ON ORAL HEALTH
Medications often have side effects, besides dry mouth, that can effect other parts of the
body, including the mouth.
These side effects can include:
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Swollen or bleeding gums
Overgrowth of gum tissue
Fungal infections, such as thrush – some oral inhalers may cause this type of infection
Weakness and tiredness – the adult could become too tired to care about hygiene
Confusion
Tardive dyskinesia – a condition causing unusual and repetitive mouth movement
Tooth decay – many medications have added sugar or are syrupy – which can contribute
to tooth decay
It is important to remember that tobacco and alcohol are also considered drugs – both
can have harmful and drying effects on the mouth, teeth and gums. Using tobacco and/or
alcohol can result in oral cancer.
Before the dental appointment … The older
adult or caregiver should advise the dentist about any
medications, supplements and herbals being taken,
especially before oral surgery or treatment for gum
disease. Additionally, aspirin and anticoagulants can
reduce blood clotting capability which could cause
bleeding problems during these types of procedures.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
DAILY ORAL HYGIENE ROUTINE
Brushing … At every age, regular daily care of the mouth and
gums is important. The daily oral health care routine for an older
adult who has all or some of his or her own teeth should include:
• Brush at least twice a day.
• Use a regular or electric (or spin) toothbrush with soft bristles.
Be sure to replace it regularly.
• Use a small amount of toothpaste, about the size of a pea.
The best toothpaste has fluoride and the American Dental
Association’s Seal of Acceptance.
• If toothpaste causes problems such as swallowing, try using a
toothpaste made for sensitive teeth, alcohol free mouthwash or
just water.
• Brush each tooth gently, front and back using small circles.
• Brush the tongue. Rinse the mouth.
• Let the toothbrush air dry.
Flossing … Older adults may have difficulty flossing their own
teeth. A family member/caregiver can help by doing the following:
Caregivers may wish
to wear surgical gloves
and a face mask when
assisting with another
person’s daily oral
hygiene routine.
• Use a string of floss 18-24 inches long. Wrap it around the
middle finger of each hand.
• Grip the floss between the thumb and index finger of each
hand.
• Start with the lower front teeth, then floss the upper front teeth.
Floss through all the teeth.
• Work the floss gently between the teeth to the gumline. Curve
the floss around each tooth and slip it under the gum. Slide the
floss up and down.
• Adjust the string of floss for each tooth.
• Some older adults may be able to floss on their own by using a
floss holder.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Rinses … The older adult may need additional fluoride, often
available as a fluoride rinse or gel. Some products are available overthe-counter while others are in prescription concentrations. Ask the
dentist if a fluoride product would be helpful.
A chlorhexidine rinse, available by prescription, can fight germs that
cause gum disease. Ask the dentist if chlorhexidine rinse should be
part of the daily oral hygiene routine.
Mouthwash (choose an alcohol-free product to help prevent dry
mouth) will also help keep breath fresh – and help reduce bacteria in the
mouth.
These rinses should not be swallowed. For patients with swallowing
problems, talk to a dentist.
Fluoride rinses
and alcohol-free
mouthwashes are
available at area
drugstores and
supermarkets.
Regular visits to the dentist ... Older adults should visit
the dentist at least twice a year for a professional cleaning and
examination. Those without any remaining natural teeth should also
have their gums and oral tissues examined once each year. For an
adult who cannot communicate well, family members and caregivers
should provide the following information to the dentist at each visit:
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Is there pain?
Is there difficulty eating, chewing or swallowing?
The older adult’s dental history.
The older adult’s medical history, including a list of medications,
history of tobacco use, known allergies, and illness/surgical history.
• Insurance, billing and legal information, such as who can legally give
consent for treatment.
• If the patient wears dentures, bring them to the appointment.
See Resource Materials (Finding Dental Care) for information on finding a
dentist, including reduced or no-fee dental care for those in need.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
Regular dental
exams help keep
the mouth healthy
and identify dental
disease – and
can often detect
early signs of oral
cancer.
FOR
SMILES LIFE
DENTURES
GlaxoSmithKline Consumer Healthcare,
Wearing dentures may take some getting
use to. Ensuring dentures fit properly will
help lessen the adjustment period.
recommends the following for denture
makers of Polident® and Poligrip® products,
A new denture wearer may notice:
• Dentures feel large or bulky in the
mouth
• Lips feel pushed forward
• A gag reflex
• Increased saliva
• Change in speech pattern (especially
with words starting with F or S)
• Sore spots in the mouth
Dentures, when
cared for properly,
generally last five
to ten years
These are normal reactions and generally
disappear as soon as the person (and
mouth) becomes used to the new dentures.
This could be a few hours or a few days.
wearers:
• Eat soft foods the first day
• Avoid sticky foods (like caramels)
• Continue to wear the dentures – this will
help you adjust to having them
• Use a denture adhesive if needed to
help keep the dentures stable in the
mouth
• Weight loss can affect the fit of dentures
– see the dentist if the fit has changed
• Using an adhesive can help the fit until
the dentist can check the dentures
• Clean dentures after each meal – and
use a low abrasive denture cleaner so
the acrylic surface of the denture is not
scratched
• Use an overnight soaking product on
a regular basis to help remove tough
stains and keep dentures fresh
• See the dentist once a year to check
dentures and make sure they fit properly
Call the dentist if:
Well-fitted dentures should not interfere with
normal functions, including talking, eating, and
chewing.
• Sore spots develop
• The denture needs an adjustment,
rebasing or relining
• There are any chips or breaks in the
dentures
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Caring for the dentures … The following daily routine can help keep dentures (full or
partial) clean and the mouth healthy:
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Rest your mouth – remove dentures at night.
Soak them in a denture cleaning solution while you sleep.
Rinse dentures in water to remove food particles after meals or snacks.
Do not use hot water to clean dentures.
Rinse over a sink filled with water to prevent breakage if they are dropped. Placing a
washcloth at the bottom of the sink will provide padding in case they are dropped.
• Clean dentures by brushing daily and soaking. Use a soft-bristled toothbrush or one made
for dentures.
• Never try to repair a broken denture yourself – call the dentist.
Putting dentures in … Always insert dentures that are clean and dry:
• Apply adhesive if necessary – it may take a few days of trial and error for
you to find the amount of adhesive that works best.
• Rinse the mouth.
• Press the denture firmly in place, hold and bite down.
To remove the dentures:
• For upper dentures, place the thumbs or fingers at the top of the denture, along the top
area of the cheeks where they meet the gum tissues. Push down gently until the denture
is loosened and it can be easily removed.
• For lower dentures, place fingers on each side of the denture, slowly pull on the denture
while rocking it gently side to side.
Assisting an older adult with denture care … Caregivers should follow the
steps outlined above to help a dependent or semi-dependent adult with dentures. This is
an important part of the oral hygiene routine. A mouth that feels fresh will help provide
comfort and confidence. Remember, a yearly exam with a dentist is still necessary even for
those with full dentures. The dentist will check the fit of the denture, look for and relieve
sore spots, assess bone loss and examine the mouth for early signs of cancer.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
NUTRITION AND THE OLDER ADULT
To help maintain proper nutrition and keep teeth and gums healthy, the older adult should
continue to eat a diet containing the recommended daily allowances of vitamins, minerals
and other essential nutrients such as calcium and protein. A healthy diet can help keep the
mouth healthy.
Visit www.MyPyramid.gov for more information on nutritional guidelines. The USDA’s
recommendations for a healthy diet are below.
Meat & Bean Group
Grain Group
Milk Group
5 ounces daily
Low-fat or lean meats
& fish: broil or grill
5 to 6 ounces daily
Make half your
grains whole
3 cups daily
Low-fat, fat-free, or
lactose-free
Fruit Group
Vegetable Group
1 ½ to 2 cups daily
Eat a variety: fresh,
canned, frozen or
dried
2 to 2 ½ cups daily
Eat dark green, leafy
& orange-colored veggies;
also dry beans, peas and lentils
Your family physician may also recommend a daily multi-vitamin or mineral supplement.
Avoid or limit foods and beverages high in sugar and starch, and low in nutritional value. Limit
diet soft drinks – the acid in these drinks can contribute to tooth decay and gum disease.
Consume alcoholic drinks in moderation, if at all.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Is the older adult
eating regularly?
At every age, good
nutrition is an
important part of
good oral health. Older adults, however,
may not get a balanced diet for many
reasons. In fact, they may not eat regular
meals, and that too, can hurt their oral
and overall health. Some of the reasons an
older adult may not eat much or regularly
could be:
• Ill-fitting dentures, or no dentures
• Tooth and/or mouth pain
• Depression and/or loneliness
• Alcoholism
• Very limited income
• Illness (cancer treatment, for example,
often changes eating habits and what
can be eaten, and can decrease desire
for food)
• Stomach pain
• Alzheimer’s or other form of dementia –
this type of patient may forget to eat
What can be done?
For oral disease or other illness, the
appropriate health professional; e.g.,
dentist or physician, should be consulted.
The family or caregiver should be advised
of any suspicion that the older adult is not
eating regularly or is not eating enough
to maintain his or her health. Every effort
should be made to provide regular,
nutritious meals to the individual.
Your city or county may have a homedelivery meals program serving homebound adults or those on limited incomes.
The California Area Agencies on Aging or
the California Department of Aging can
provide information and eligibility criteria
for other elder assistance programs.
See Resource Materials (Aging Programs/
Services in California).
For those with limited financial resources
and no dental insurance, there are
professional care giving services that
offer in-home assistance in areas such
as grocery shopping, meal preparation,
assisting with the daily hygiene routine,
and other services.
• Sense of taste is weakened or gone
• Unable to shop or cook on their own
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
TOBACCO USE AND TOOTH DECAY
Tobacco use … Smoking cigarettes, cigars or pipes, or using smokeless tobacco products
increases the risk of many cancers, including oral cancer.
Use of tobacco products can cause or contribute to a number of oral health conditions:
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Receding gums
Bleeding gums
Severe gum disease
Bad breath
Stained teeth and tongue
Reduced sense of taste and smell
Delayed healing after surgery
Leukoplakia (white patches – can be an early sign of oral cancer)
Oral cancer
SOLUTION: Quit smoking and/or using tobacco products. Ask your dentist or physician
about tobacco cessation programs and/or products. Numerous other resources exist to help
you quit smoking:
• Quitline at 1-800-QUIT-NOW (784-8669). This is a free program and
telephone counseling service providing personalized guidance and
assistance.
• Associations such as the American Cancer Society or American Lung
Association have tobacco cessation programs and helpful information.
(See Resource Materials, “Kicking the Habit,” for more information on
tobacco use and cessation.)
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
ORAL CANCER
The risk for oral cancer increases with age. The American Cancer Society (ACS) reports that
more than half of oral cancer patients are 65 years of age or older and that oral cancer is
twice as likely in men as women. The ACS also reports the following:
The two primary risk factors for oral cancer are:
1. Tobacco use:
• An estimated 90 percent of oral cancer patients use
tobacco.
• A smoker is six times more likely to develop oral cancer
than a non-smoker.
• Smokeless tobacco users are 50 times more likely to
develop cancer of the cheek, gums and inner surface of
the lips.
2. Alcohol use:
• Heavy drinkers are at higher risk for oral cancer.
• Over 75 percent of oral cancer patients drink alcohol
more than occasionally.
• Drinking and smoking can be a deadly combination.
Leukoplakia (in center of
picture) is often an early
indicator of oral cancer.
(Picture courtesy of the Case
School of Dental Medicine)
A dentist can often identify early signs of oral cancer or precancerous lesions. The American Dental Association provides the
following information about oral cancer:
A squamous cell
carcinoma of the
tongue.
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Oral cancer often starts as a tiny, unnoticed white or red spot
or sore somewhere in the mouth.
It can affect any area of the oral cavity including the lips,
gums, cheek lining, tongue and the hard or soft palate.
Lesions are often painless.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Other signs of oral cancer can include:
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A sore that bleeds easily or does not heal
A change in color of the oral tissues
A lump, thickening, rough spot, crust or small eroded area
Pain, tenderness, or numbness anywhere in the mouth or on the lips
Difficulty chewing, swallowing, speaking or moving the jaw or tongue
A change in the way the teeth fit together
Prolonged exposure to the sun increases the risk of lip cancer.
SOLUTION: Take precautions to help reduce the risk for oral cancer:
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Don't smoke, dip or chew tobacco
Drink alcohol in moderation, if at all
Use lip balm with sunscreen
Eat plenty of fruits and vegetables
Have regular dental exams including an oral cancer screening
The National Institute for Dental and Craniofacial Research (NIDCR) states most oral cancer
is preventable, and encourages making the oral cancer exam a routine part of the regular
dental check-up. Prevention is the best defense.
(See Resource Materials: “Oral Cancer – are you at risk”)
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
ORAL HEALTH CARE FOR THE CANCER PATIENT
Cancer treatment has a number of side effects; some may affect oral
health:
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Swelling and ulcers of the mucous membranes
Painful mouth and gums
Increased risk for oral infections
Dry mouth
Tooth decay
Problems with the tongue, burning, swelling, peeling
Jaw stiffness
Difficulty eating and swallowing
Visit your dentist before beginning cancer treatment. When
possible, cancer patients should have a dental exam two
weeks before treatment begins to help identify and rule out
any infections in the mouth.
It is helpful to see the
dentist before beginning
cancer treatment.
(See Resource Materials: “Oral care for cancer patients”)
Some side effects of chemotherapy can cause oral health
problems (such as infection) which may stop or delay cancer
treatment temporarily. If the mouth is unhealthy before
chemotherapy starts, the person may be at higher risk for
other health problems.
(See Resource Materials: “Chemotherapy and your mouth”)
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
To keep the mouth healthy during cancer treatment:
It is important to discuss the best oral disease preventive strategies with your dental
professional. Ask if a prescription fluoride gel or rinse may be helpful in preventing the
development of cavities. Other suggestions are:
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Drink plenty of water or suck on ice chips
Use a saliva substitute that contains fluoride if dry mouth is a problem
Choose sugarless gum or candy
Avoid sugary foods and beverages that could cause tooth decay
Continue to brush teeth, gums and tongue regularly, and use a super soft brush if needed
Use only alcohol-free mouth rinses
Floss gently, avoiding areas that are sore or bleeding
If dentures are uncomfortable or loose, see the dentist
Watch what you eat and drink if the mouth is sore
Avoid spicy, acidic and crunchy foods
Do not drink alcoholic beverages
Do not use tobacco products
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
RESOURCE MATERIALS
Smiles for Life fact sheets can be downloaded from the CDA Web site: cda.org.
Finding Dental Care
California Dental Association “Find a Dentist” cda.org/finddentist
American Dental Association Find an ADA Member Dentist service
ada.org/public/directory/index.asp
California has 32 dental societies that can provide information about area dentists.
cda.org/about_cda/component_dental_societies
For those with limited financial resources and no private dental insurance, there is a
statewide listing of reduced fee/sliding fee scale dental clinics in California counties.
Safety Net Dental Clinics in California: cda.org/clinics
You can get Medi-cal (including dental benefits) if you are:
• 65 or older
• Blind
• Disabled
• In a skilled nursing or intermediate care home
Or if you are enrolled in one of the following programs:
• SSI/SSP
• CalWorks (AFDC)
• Refugee Assistance
• In-Home Supportive Services (IHSS)
California Department of Health Care Services: www.dhcs.ca.gov
Medi-Cal (medical and dental insurance):
www.dhcs.ca.gov/services/medi-cal/Pages/Medi-CalEligibility.aspx
Denti-Cal: www.denti-cal.ca.gov
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
For the Dental Patient … These materials are provided by the American Dental
Association as an educational resource on various oral health issues and conditions. The
following link has a list of nearly 50 oral health topics: www.ada.org/goto/patientpage.
Of special interest for the older adult and caregiver are the following articles:
• How medications can affect your oral health
• Do you have dry mouth?
• Dealing with dry mouth
• Oral care for cancer patients
• Kicking the habit … keeping your smile healthy
The ADA encourages printing, distribution and use of these materials in hard copy handout
format only for educational and informational purposes. However, For the Dental Patient
materials may not be posted to any other Web site other than the ADA’s, nor reprinted in
another print or electronic publication.
Helpful Chart of Drugs Causing Dry Mouth … This useful chart contains a list of
common drugs with indicated side affects of dry mouth, and a listing of diseases that also
cause a reduction of saliva. Provided by Laclede, Inc. For information on Biotene products
that help restore saliva, visit www.laclede.com or phone (800) 922-5856.
Dry Mouth … A booklet of the National Institutes of Health, National Institute of Dental
and Craniofacial Research. This booklet is free; 50 copies can be ordered from the NIDCR
on the web link below. The booklet is also available as a PDF file to download and print out.
These materials are not copyrighted and duplication is encouraged.
www.nidcr.nih.gov/HealthInformation/DiseasesAndConditions/DryMouthXerostomia/
DryMouth.htm
Oral Cancer – are you at risk? … A brochure of the National Institutes of Health,
National Institute of Dental and Craniofacial Research. This brochure is free; 50 copies can
be ordered from the NIDCR on the web link below. These materials are not copyrighted and
duplication is encouraged.
www.nidcr.nih.gov/HealthInformation/DiseasesAndConditions/OralCancer/OralCancer.htm
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Chemotherapy and Your Mouth … A booklet of the National Institutes of Health,
National Institute of Dental and Craniofacial Research. This booklet is free; 50 copies can be
ordered from the NIDCR on the web link below. These materials are not copyrighted and
duplication is encouraged.
www.nidcr.nih.gov/HealthInformation/DiseasesAndConditions/CancerTreatment
AndOralHealth/ChemotherapyandYourMouth.htm
Aging Programs/Services in California
The California Department of Aging contracts with and provides leadership and direction to
Area Agencies on Aging (AAA) that coordinate a wide array of services to seniors and adults
with disabilities. To locate an AAA in your area call 1-800-510-2020 or locate your county at
http://www.aging.ca.gov/local_aaa/AAA_listing.asp
Senior Information Line: For information on services in your area for seniors and adults
with disabilities within California, call 1-800-510-2020.
For information on services outside California for seniors or adults with disabilities, call
1‑800‑677‑1116
Meal Program: Information on the Congregate Meal program and how to qualify and
receive services can be obtained by calling the statewide toll free line at 1-800-510-2020
Long-Term Care Ombudsman CRISISline: CRISISline is available 24 hours a day, 7
days a week, to receive complaints from residents, call 1-800-231-4024.
HICAP Information Line: Health Insurance Counseling and Advocacy Program serves
current Medicare beneficiaries and those planning for future health and long term care
needs. HICAP counseling is confidential and free of charge. If you would like to set up an
appointment in your local community or have questions, call your local HICAP at
1-800-434-0222.
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
FOR
SMILES LIFE
Report Domestic Elder Abuse: call 1-888-436-3600
U.S. Dept. of Agriculture Nutrition Guidelines: New Dietary Guidelines for
Americans were released in 2005. These and other useful information are online at
www.mypyramid.gov/guidelines/index.html
To learn more about dental care for healthy aging, visit cda.org.
Materials developed in 2005 by the Ohio Dental Association
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