It pays to make a dentist your friend

Press, 21 July 1986, Page 5

It pays to make a dentist your friend

Word of Mouth

By

DESMOND SMITH,

8.D.5., D.D.P.H.

A generation, ago, dentistry for anyone over the age of 50 years consisted almost entirely in providing a new upper and lower denture. Not so now though, because many people retain their natural teeth for a lifetime, just the way we were meant to. That poses a few new problems which warrant time and thought.

The difficulties which afflict the oral tissues as we get older have a pattern of their own and often require the attentions of a dentist who is attuned to treating these conditions. That does not mean we need geriatric dentists to treat geriatric patients, but we do need professional people with the ability to listen, the patience to understand and the empathy to act accordingly*. If it is possible, make a friend of your dentist, and thus your treatment of each other will be harmonious.

It is important to realise that dental decay can occur at any age, and it is particularly liable to start near the necks of the teeth where shrinkage of the gums has taken place. It is much more likely to start in several places, and even become rampant in type, where the person has had radiotherapy for any malignant condition round the head and neck.

We tend to place older people in the same category as very young children when we forget the need both classes of people have for a continuing ability to chew, if their general health is to be maintained. The result

is, just as some preschoolers gradually lose several first teeth through abscessing and breakdown, so many senior citizens lose their permanent teeth over the years and fail to realise that they are trying to carry out all the functions of chewing without much of the necessary mechanism. We would not dream of trying to make do on half an arm or without several toes but the progressive destruction of our chewing apparatus is often accepted quite philosophically. Not by the stomach and digestive system though, because they have to work that much harder to compensate for the lack of teeth.

Dry mouth can be a most upsetting factor in the lives of older patients. Its cause may be certain long-term medication, some types of therapy or simply an age change. Whatever the origin, the effects can be devastating, as anyone who has had to suffer the disability can testify. However, help can be made available through a prescription for artificial saliva and a mouthwash containing fluoride. A discerning and knowledgeable dentist will provide either or both.

Other conditions which have a particular relationship to the mature years of life are problems with

the gums, stiffening of the joints of the jaw and changes in the linings of the lips and cheeks. Although complete cure may not be possible considerable, help with symptoms is often available if the patient keeks out a competent dentist. No older patient should ever be satisfied with a cursory examination when he or she attends for a dental appointment. The ethical practitioner will start by obtaining a complete medical and dental history and then follow that up by examining both hard and soft tissues of the mouth for any abnormality. Suspicious areas will be subjected to further testing, including biopsy if required. So your next check-up should not merely patch up the odd broken filling, but give you some assurance that all the parts of your oral mechanism are in reasonable working order. As they progress in years, people will sometimes find it expedient to get a nose job done, to spend continuing sums on hair-dos, to outlay large amounts for wardrobe overhauls; but never consider it prudent to have a thorough mouth job carried out. Dental knowledge and techniques have expanded vastly over the last 10 years and senior citizens should make sure they take advantage of them all, whether they have natural teeth or dentures.

Just in passing a tip for all denture wearers is to put water in the hand basin before you clean your plates. Then, if you accidentally drop them, they are much less likely to break.