Oral care for the elderly: Periodontal disease

Linda Postma, RDHAP providing in-home care.

The trend in dental care has evolved to include many strategies for retaining our teeth throughout our lives. Dentists can place crowns, fillings, implants, and bone grafts, in many cases. All of these efforts will be lost if we do not retain our periodontal health.

In other words, the bone that holds each tooth in our mouth must stay healthy in order for us too retain our teeth. The most important strategy for keeping our teeth includes regular dental hygiene care appointments, or dental cleanings. This includes a variety of procedures that the RDHAP can provide, including: prophylaxis. root planing, and periodontal maintenance.

Prophylaxis: Commonly called a "cleaning" or "prophy", this procedure is preventive dental hygiene care. The goal of the prophylaxis is to help the patient prevent periodontal disease from taking hold in their mouth. The RDHAP removes calculus (tartar), plaque, and stain from above and even below the gumlines. These appointments should include:

• measuring pocket depths, a method used to evaluate bone levels around each tooth
• evaluating gum health (healthy gums are generally pink and firm)
• checking for bleeding gums, a sign of infection in the gums
• assessing plaque accumulation (plaque contains the live, disease causing bacteria)
• helping the patient maintain or improve their oral self care - brushing, flossing, or whatever works best for them - in order to prevent disease.

Root planing: Patients who have signs of active periodontal disease need treatment to stop the disease, a procedure called root planing or root debridement. This procedure:

• removes calculus from below the gumlines, allowing the tissues to heal and slow the disease process
• includes local anesthetic or topical anesthetics, for patient comfort
• can be completed in one appointment or several appointments; treating all or only involved teeth.

Periodontal maintenance: Once a patient has had active periodontal disease and has completed treatment, they often require more frequent and involved cleaning appointments. During this appointment, the RDHAP:

• evaluates pockets depths, checking for disease activity
• checks gum health, including bleeding, tissue color, tone, and tenderness
• assesses plaque accumulation
• thoroughly removes calculus and plaque above and below the gumlines, using topical anesthetics as needed
• helps the patient maintain or improve their oral self care - brushing, flossing, or whatever works best for them - in order to prevent disease.
• determines the best interval for future periodontal maintenance appointments in order to prevent further disease activity

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