What to do if you are elderly, have a broken tooth and can’t get to the dentist because of physical or cognitive limitations…
There are many reasons why teeth break when you are elderly. At www.GeriatricHouseCallDentistry.com we address this problem daily and will outline the reasons why this may be happening.
The obvious reason that teeth crack or break off entirety (leaving the root behind) is rampant decay. Too often teeth are neglected by the caregivers as they do not realize the importance of a clean thus healthy mouth. No one can deny the link between oral and systemic health and bad bacteria left sitting on the teeth and gums can cause serious damage. Teeth that are swabbed with a lollipop sponge are as dirty as ones where nothing is done. Sponges remove large pieces of leftover food on the teeth which is a good thing, but do nothing to keep the teeth from decaying. When asked why caregivers are not brushing the teeth, we mostly hear that the teeth bleed when they are brushed. The bacteria has engulfed the area at the base of the tooth around the gum line, and when finally brushed bleeding occurs. After proper brushing for a few days, the bleeding will stop.
Another reason we hear from caregivers that they don’t brush their patient/loved one’s teeth is that they clamp their mouth closed when the toothbrush is inserted. The dentists at www.GeriatricHouseCallDentistry.com have special foam anti bite sticks that comfortably keeps the mouth open, so no more excuses. We will tell you where to purchase them and they are extremely affordable.
What do Trees and Teeth have in Common?
Back to the decay issue. Now that you understand the importance of brushing, we can explain why teeth break off at the gumline. Let’s use the analogy of a tree and its roots planted firmly in the ground.
The tree has roots (a tooth has roots) anchoring it securely. And above the roots is the trunk and branches (the crown of the natural tooth or the tooth may have a fabricated crown or “cap”). Imagine that the trunk of that tree gets infested with termites. The termites eat a bit of that tree trunk off in a massive way over weeks or months because it has gone untreated for this infestation. Bit by bit the termites eat at the base of the tree trunk. Eventually, the tree will fall to the ground leaving the roots in the ground only. When decay lays at the base of the tooth and goes untreated, eventually the tooth will break off. And most times especially with those with cognitive issues, the crown of the tooth will be swallowed. We often get calls that a tooth has fallen out, and usually but not always we will guess that the root has been left behind, which may or may not need to be extracted (more on that later). When food lies constantly against the tooth, the sugar that remains will destroy the integrity of the tooth causing it to break in part or all.
In summary, it is extremely important to remove all food and bacteria that lies on the teeth. If you are a caregiver, you are responsible for making sure that all food is removed from the teeth after every meal, especially after eating sugary treats like cookies. A sponge just moves the food and bacteria further into the crevices between and on the teeth.
Our Favorite Oral Care Products
There are special devices that we can recommend for brushing and for those that swallow toothpaste. We recommend a product that we use on, and off label called Elevate AllDay Spray (over the counter on Amazon or on the Elevateoralcare.com website). AllDay Spray has a gel-like consistency that can either be sprayed into the mouth or it can be used as a “toothpaste” and then swallowed. It has xylitol, a natural occurring sugar found in fruits and vegetables that has been shown to reduce the incidence of gum disease and tooth decay. Oral care products high in xylitol have been studied and the reports have shown that it slows the growth of streptococcus mutans on the tooth surfaces, which halts the production of tooth decay causing acid. This in turn neutralizes the pH level in saliva and plaque. With most of our patients having mild to severe dry mouth, we were desperate to find a product to help stop tooth decay because saliva is the oral cavity’s natural defense. AllDay fights to reduce tooth decay as well as helping alleviate dry mouth symptoms.
Learn more about Elevate Oral Care >
So, brush the teeth after every meal paying particular attention at the gum line. Use a small amount of toothpaste if the patient is able to swish and spit and try AllDay Spray (you can use it AllDay) as a great alternative to traditional toothpaste if they swallow everything.
Learn more about our favorite products for Dementia Patients >
Do broken teeth have to be removed?
The root of the tooth that is left in the gum may or may not need to be extracted. A dentist experienced in treating the elderly like the ones at www.GeriatricHouseCallDentistry.com can consult you on the best treatment options.
Another reason teeth may suddenly break is that they may become brittle as we age. Sometimes, an existing large amalgam or white filling and a hard cookie can crack a tooth unexpectedly. For many broken teeth, a simple repair may do the trick but if the patient has cognitive issues such as dementia or Alzheimer’s Disease, a broken tooth may be a difficult situation for all involved.
At www.GeriatricHouseCallDentistry.com we can do fillings without drilling using a technique to ARREST the decay. It’s commonly known as a silver diamine fluoride treatment, but we use a product called Arrest by @Elevateoralcare.com. Unfortunately, this cannot be purchased over the counter and must be done by a qualified dentist. It is most commonly used on patients who cannot tolerate treatment. The only negative side effect is that it stains the decay black (that’s how we know it is working) and two treatments are necessary to ensure the treatment is successful. There are no other negative side effects and patients tolerate this treatment painlessly. Sometimes we can fill the tooth and sometimes this isn’t possible. At least we know that the decayed tooth will not cause pain and will not get worse. The decay has been arrested. If there are any sharp corners, we can easily smooth them to avoid cutting the cheek and tongue.
Call our doctors at www.geriatrichousecalldentistry.com to discuss the best treatment for any type of broken tooth regardless of how it broke. With the newest technology using teledentistry by @Dentulu, we can start the process to discuss what the next steps should be.
About Geriatric House Call Dentistry
Alisa Kauffman and the dentists of Geriatric House Call Dentistry have been providing award winning dental services to the elderly population for over 35 years. The practice is one of a few select options for geriatric senior citizens who need dental work but cannot leave their homes.
Geriatric House Call Dentistry is a national network of highly skilled, compassionate, and exceptional dentists currently serving the following locations:
- Manhattan & The Hamptons
- Queens & Long Island, Nassau & Suffolk County Including The Hamptons
- Chicago
- Brooklyn & Staten Island
- Connecticut
- Philadelphia & Eastern Pennsylvania
- San Francisco & Bay Area
We are expanding to offer more locations, see our website for the updated list of areas offered within our network. Do you, or someone you know interested in joining Geriatric House Call Dentistry? We can help you start, and grow your practice – learn more at: https://join.geriatrichousecalldentistry.com/
