DATE: Aug 17, 2016 
AUTHOR: Sharon Boyd, RDH, BS

For our aging patients it's important to tailor senior dental care treatment to the needs of more mature smiles. Older individuals are more likely to have medical conditions and medications that influence oral health and their oral home care and treatment needs. Here are a few things to consider when caring for your senior patients.

Caries Rates

Due to receding gumlines, exposed dentin and dry mouth, dental caries and especially root caries can quickly get out of hand without adequate preventive care. According to Decisions in Dentistry, research has found that adults over the age of 65 living in urban areas have a root caries rate as high as up to 76 percent, with an overall prevalence of 36 percent in adults age 65 and over.

It's important to help your patient understand the role of fluoride and how it can help prevent dental caries as a key element of the treatment plan. While most patients consider fluoride treatment as just for children, it plays a vital role in senior dental care. It's a best practice for high-risk older adult patients to increase their use of fluoride. An in-office topical fluoride varnish application every three months is recommended for high-risk patients, along with a prescription strength fluoride toothpaste like Colgate(r) Prevident (r) Booster Plus applied twice daily at home. You can find free educational materials and free continuing education resources on this topic at

Xerostomia/Dry Mouth

It should be no surprise that nearly one out of every three seniors experiences dry mouth, often caused by medications used to manage other health conditions. It is one of the most common side effects listed in over-the-counter and prescription medications.

The American Dental Association stresses that palliative care is one of the key aspects of managing dry mouth. To alleviate dry mouth symptoms, recommend a saliva substitute or dry mouth rinse. Sugar-free gum can trigger salivation, provided some salivary gland function is still present. Because dry mouth can lead to more dental caries, it is recommended that patients with dry mouth be placed on a prescription fluoride for daily use.

Educating Caregivers

In senior dental care, we often see individuals who rely on a caregiver or nursing staff to get them to and from their appointments and sometimes also for their oral care needs. Seniors may not always be getting the proper daily oral care that they need unless we educate their caregivers. For example, oral candida infections are fairly common, according to the American Academy of Oral & Maxillofacial Pathology. Educate your patient, along with his or her caregiver and nursing staff as appropriate, on the proper maintenance and disinfection of removable prostheses.

Limited Dexterity

Due to physical restrictions caused by arthritis or other mobility concerns, efficient brushing may be difficult. You may want to recommend that your senior dental care patients trade in their manual toothbrush for an electric one. Or, if dexterity is a concern, suggest that they add a tennis ball or bicycle grip over their manual brush handle for an easier hold. These are simple steps that can greatly increase the ability of seniors to take care of their oral hygiene needs. As the age of our patients increases, so does the likelihood that they may wear a removable prosthesis. Educating patients on proper care of their prosthesis is vitally important to their oral health.

Don't Get Bogged Down

Care plans for seniors have a tendency to become overwhelming for your patients. Start with what's most important for your patients' overall well-being. Is it to eat comfortably so that their nutritional needs can be met? Do they need fewer and longer appointments due to transportation and logistical concerns? Prioritize treatment and take one step at a time. At this life stage, prevention plays a vital role in helping to avoid more complex needs.


  • As your patients age, their smiles may require more and different dental care than when they were younger.
  • Many people see fluoride as a treatment for children, so you must educate your mature patients on how fluoride can benefit their oral health.
  • Senior dental care should also focus on prevention and on the education of the caregivers in the lives of our patients.

Why It's Valuable

As patients age, so may their risk of developing oral health conditions that can impact their overall well-being. Dental hygienists need to relay the most important needs with patients and caregivers, so that complex problems can be avoided.