There are many factors to prevent and treat dental caries, including bacteria and dental plaque, food and dental environment. Due to gingival atrophy and tooth wear, the normal contact relationship between teeth disappears, the gap between teeth becomes larger, food is easily blocked, oral resistance is low, or dental plaque accumulates due to poor cleaning of dentures for many years, leading to dental caries. The main reason is that there are many caries between adjacent teeth, and some of them develop into acute and chronic pulpitis, periapical periodontitis and even rotten roots, and finally they have to be removed. Some elderly people have atrophied gums and exposed roots, and dental caries occur on the surface of the roots, which is called root caries.
Prevention and treatment: master the correct brushing method, use dental floss and interdental brush, maintain good oral hygiene habits, and check your mouth at least once every six months. If you find dental caries, you can find it early and treat it early, and choose the corresponding treatment method according to the situation of the sick teeth. After perfect root canal therapy, that is, "nerve killing" therapy, the diseased teeth become brittle and easy to crack because they lose the nutritional supply of pulp. High inlay or post-core crown (commonly known as braces) should be selected for protection to prolong the service life of patients' teeth as much as possible. Remove the residual roots and crowns that cannot be preserved as soon as possible, and wait until the tooth extraction wound is completely healed (about 3-4 months after tooth extraction) to prevent other oral problems caused by missing teeth.
The causes of periodontal disease include plaque formation, calculus deposition, food impaction, trauma, anatomical factors, bad habits, inappropriate fixed or removable dentures and so on. In addition, genetic factors, low immune function, endocrine disorders, diabetes, mental stress, smoking and other systemic susceptibility factors are also risk factors for periodontal disease. Due to the osteoporosis of jaws in the elderly, the quality of saliva is decreased, and the general resistance is decreased. The incidence of periodontal disease is much higher than that of young people, which is characterized by gingival atrophy, alveolar bone absorption, root exposure, tooth loosening and even falling off.
Prevention and treatment: In addition to maintaining good oral hygiene, you should also wash your teeth once every six months to one year, and follow the doctor's advice when washing your teeth. For the relatively serious periodontal problems that can't be solved by tooth washing, it is necessary to adopt more complicated treatment methods and check them regularly to maintain the health of periodontal tissue. For severely loose and incurable teeth, follow the doctor's advice, pull them out as soon as possible, and then carry out corresponding dental inlay treatment, otherwise, other teeth in the mouth will also get sick. It is worth emphasizing that brushing your teeth and washing your teeth cannot replace each other. Brush your teeth carefully, floss and brush between your teeth, and check your teeth regularly. Both are indispensable.
Wedge-shaped defect refers to the wedge-shaped defect caused by slow consumption of hard tissue in teeth, lips, cheeks and neck. The cause of the disease is that the method of brushing teeth is incorrect and forced to brush horizontally. Coupled with the action of acid, the tooth neck is weak and the stress is concentrated, which easily leads to wedge-shaped defects. Many old people will have this problem in their mouths. Teeth often encounter hot, cold, sweet and sour food to stimulate pain, and even expose pulp to cause pain and swelling, which eventually leads to tooth fracture and affects chewing function.
Prevention and treatment: choose a small-headed high-quality soft-bristled toothbrush, brush it with paper, and brush your teeth evenly. For the teeth that have formed defects, you should go to the hospital for filling treatment in time. Patients with exposed or broken pulp should be treated with post crown restoration according to the doctor's advice, and a few may also face tooth extraction.
Tooth wear refers to the chronic wear of tooth hard tissue caused by pure mechanical action. With the increase of the service life of teeth, the enamel on the chewing surface of teeth becomes flat due to long-term chewing, and it is sensitive due to essential exposure, and even dental pulp exposure causes pain, and the contact relationship between teeth becomes worse, leading to food impaction, followed by dental caries, food pressing on gums, causing gingival atrophy, severe tooth wear, shortening teeth, and a series of problems such as temporomandibular joint diseases, excessively sharp cusp and edge left by uneven wear, which can stimulate buccal and lingual mucosa and cause ulcers.
Prevention and treatment methods: do not eat hard food, correct bad living habits, treat wear and symptoms in time, adjust sharp points and edges to treat traumatic ulcers, and actively treat joint diseases.
Tooth loss refers to the partial tooth loss of single jaw or maxillary and mandibular dentition, which is mostly caused by dental caries, periodontal disease, periapical disease, jaw and alveolar bone trauma, developmental disorder and so on. At present, the common causes of dentition loss in domestic patients are still caries and periodontal disease, and the rate of tooth loss in the elderly is still high at this stage. When tooth loss accounts for 1/4 of the total number of teeth, it will seriously affect the chewing function and is extremely unfavorable to food digestion and absorption.
Prevention and treatment: actively deal with the teeth in the patient's mouth, pull out the teeth that can't be saved, and pull out the teeth in time after the wound is healed. At present, there are three kinds of conventional dental implants: implant, porcelain-fused-to-metal fixed bridge and removable denture, which are divided into many types and price grades due to different materials. When you go to the prosthodontics department of the hospital, the doctor will check the oral condition and give the corresponding dental implant plan, introduce the characteristics of each material, and reach an understanding with the patient. After dental implants, you should also go to the hospital for regular review.
Oral mucosal diseases refer to lesions that occur on oral mucosa, especially oral mucosal leukoplakia, which is an obvious white lesion on oral mucosa and cannot be diagnosed as any other diseases. The reasons are long-term smoking, excessive drinking, spicy food, local physical and chemical stimulation, changes in trace elements and microcirculation, vitamin deficiency, susceptible gene constitution and so on. This disease is easy to occur in middle-aged and elderly people, and has a certain malignant transformation rate.
Prevention and treatment: maintain good oral hygiene, quit smoking and drinking, eat less spicy food, remove residual roots, crowns and bad restorations, supplement vitamins and maintain good living habits. If you have any problems, you should go to the oral mucosa department in time.
Oral diseases and systemic diseases Some systemic diseases are manifested in the oral cavity at an early stage. For example, the oral manifestations of acute leukemia are gingival ulceration and spontaneous bleeding. The oral manifestations of vitamin B2 deficiency are angular stomatitis, cheilitis and glossitis. The oral manifestations of AIDS are hairy oral leukoplakia. Some infectious diseases, such as scarlet fever, have oral manifestations such as strawberry tongue. The oral manifestations of lead poisoning are black lines on the gums. Diabetes patients are mostly middle-aged and elderly people. If blood sugar is not controlled, the typical manifestations of oral cavity are severe periodontal disease, obvious gingival inflammation, easy bleeding, recurrent periodontal abscess and rapid tooth loss. Periodontal disease has been listed as one of the important complications of diabetes. Recent studies have proved that some patients with oral diseases are also prone to heart disease.
Prevention and treatment: treat and control systemic diseases, treat oral diseases symptomatically, and maintain good oral hygiene.
Key points of oral care for the elderly (1) Stick to brushing your teeth and gargling in the morning and evening. Brush your teeth for at least 3 minutes at a time. Pay attention to choose a soft-haired healthy toothbrush that suits you. It is best to use more than two kinds of fluoride toothpaste alternately, and advocate drinking tea or gargling with tea.
(2) Wash your teeth regularly. It can effectively remove dental plaque and calculus, and advocate the correct use of dental care products such as dental floss and interdental brush.
(3) Quit smoking and limit alcohol. It can prevent teeth from yellowing and falling off, and promote blood circulation in gingival area.
(4) Maintain a scientific and healthy lifestyle. From an early age, we should strengthen oral health care through a healthy lifestyle, eat more vegetables and fruits rich in vitamins, and avoid eating cold, overheated and hard food. Adhere to the tooth-tapping exercise and gum massage.
(5) Regular oral examination. The elderly should have/kloc-0 oral examination every year, and dental diseases should be found and treated as soon as possible. Don't wait for a toothache to see a doctor. If you find weakness in oral chewing, bleeding gums, bad breath, etc. , should be timely examination and treatment.
(6) Be cautious about tooth extraction. If one tooth is pulled out, one tooth is missing, so cherish every tooth. Only after careful examination by an experienced dentist can tooth extraction be considered irreparable, preserved or even harmful to health.
The misunderstanding of oral care for the elderly (1) will definitely lead to tooth loss when they get old. "Old-fashioned" is a deep-rooted concept of many people, who think that they can't bite when they are old, which leads many people to ignore oral problems. Experts say that when people get old, their teeth don't necessarily follow "old", and the main reason for tooth loss is unhealthy oral cavity.
(2) It doesn't matter if one tooth is missing. Experts say that many elderly people simply don't realize the impact of tooth loss on oral health. "A tooth is like a combat corps, and each tooth has its own function. For example, the front incisors are as sharp as knives and can bite hard objects; Fangs have a strong ability to tear apart food; Double-sided teeth can chew and grind food like a millstone. " Therefore, losing a tooth not only loses its related function, but also affects the next tooth, leading to problems such as tooth loosening and food residue.
(3) Gum bleeding is a trivial matter. Gum bleeding and gum swelling are the manifestations of early periodontal disease. Experts say that periodontal disease is one of the main causes of tooth loss in middle-aged and elderly people in China. Gums are like soil where teeth live. If the problem is not dealt with in time, inflammation may develop further, destroy periodontal ligament and alveolar bone, and lead to tooth loosening.
(4) Dentures need no maintenance. "When we were investigating in the countryside, we met an elderly woman who had not taken off her false teeth for several years. When we helped her take it off, the denture had fallen into the oral mucosa, and the oral mucosa of the upper jaw had eroded. " Experts say that not caring for dentures in time can easily lead to bacterial growth, which is not conducive to oral health.
Oral cleaning methods for the elderly in bed: nurses prepare: wash hands, wear masks and pick jewelry.
Spare items: put the necessary items on the bedside of the elderly (18 cotton balls, therapeutic bowls, tongue depressors, curved boards, flashlights, mouthwashes, small towels, water cups, straws, etc. ).
Nursing preparation: nurses should first understand the situation of the elderly. With the cooperation of the old man, help the old man turn his head to one side, put a small towel under his chin and put the curved board next to the place where the old man quarreled.
Observe the oral cavity: the nurse wipes the lips of the elderly, lets the elderly gargle (no coma), opens the oral cavity with a tongue depressor, and observes whether there are any symptoms such as bleeding and ulcer in the oral cavity. In case of false teeth, wrap them in gauze and take them out.
Cleaning the mouth: swab mouthwash is scrubbed along the longitudinal direction between teeth, and the scrubbing order is left → right → outside → inside → occlusion; Upper teeth → lower teeth → buccal mucosa → (arc scrubbing); Hard palate → lingual surface → lingual frenulum. Finally, put the used cotton swab in the bending plate.
Observe and then gargle: the nurse opened the old man's mouth with a tongue depressor for observation, let the old man gargle repeatedly, then the nurse dried the old man's face with a small towel and observed whether there was any residue in the old man's mouth.
Medication on demand: If symptoms such as ulcer and fungal infection are found in the oral cavity of the elderly, medication should be taken as needed. If there is ulcer, apply 1% gentian violet, tin powder or boron matte powder as needed; In case of fungal infection, apply 1% gentian and nystatin glycerin; In case of chapped lips, apply a proper amount of paraffin oil.
Key points: When cleaning dentures for the elderly, clean them under running water, and then soak them in cold boiled water. Never soak them in ethanol or hot water. When helping the elderly to clean their oral cavity, the action should not be too heavy, and the cotton swab should not directly contact the oral mucosa of the elderly.
Cleaning method of fixed denture for the elderly (1)
The cleaning method is the same as that of natural teeth, but the dental bridge (the part connecting natural teeth and dentures) should be lightly crossed with coarse floss to remove food residues.
(2) complete removable denture
Take it off and wash it before going to bed every day. There are denture cleaning products on the market now. It is suggested that the elderly who are not flexible in hand movements and worried about incorrect tooth washing should use it more, at least/kloc-0 times a week, to strengthen the sterilization function.
(3) Partial removable dentures
Most elderly people are used to wearing dentures to brush their teeth, so they often ignore the contact surface between dentures and natural teeth. It is suggested that it must be removed and cleaned. Natural teeth should be cleaned with gauze or toothbrush dipped in toothpaste, and dentures should be cleaned with special toothbrush and toothpaste. The special toothbrush for dentures has two brush heads, the large brush head is used to clean teeth, and the small brush head can clean dentures. Special toothpaste for dentures does not add grinding powder like ordinary toothpaste, which does not hurt dentures. Or you can use an ultrasonic cleaning machine in the dental clinic to achieve the cleaning effect by using the decontamination effect of ultrasonic vibration.