Prevention and Disease Management for Older Adults( Article 2 of 4)

The rapid growth of population that is 65 and older will profoundly affect dental care in a number of ways.
Risk assessment for this vulnerable group  will help develop the most appropriate prevention plan and treatment strategy.

 Prevention:

Majority of older patients suffer from hyposalivation or Drymouth

Simple preventative remedies  to alleviate drymouth include-

Regular sips of water throughout the day
Limiting number of alcoholic beverages and beverages
Limiting beverages high in sugar and caffeine particularly sodas,juices and sweetened coffee and tea
Avoid spicy and salty foods
Caution using mouth washes containing alcohol
Using  salivary substitutes  such as Oralbalance gel, Biotene Moisturing spray, liquid mouthspray etc
.
In extreme cases, a salivary stimulant may be prescribed which does require consulting with patient's physician. 
Discussion with physician and or pharmacist regarding substitution of medicines causing dry mouth can also be an option.

Caries:
For patients with an increased risk of caries or dental decay, an oscillating tooth brush is best.  Automated toothbrushes remove more plaque than manual brushing alone. It is particularly helpful for patients with limited dexterity and arthritis.

Use floridated toothpaste daily and floride rinses
 Periodic topical application of 5% sodium floride varnish in severe cases of caries.
  This mode is inexpensive, non invasive and shown to reduce decay.

As the old adage goes " an ounce of prevention is worth more than a pound of...."

Visit www.mydentistchino.com or Call 909 627 6699 to contact our office. We are more than happy to help you with your question.

Blood Thinners and Dental Procedures

Do you take medications like aspirin, warfarin (Coumadin, Jantoven, Marfarin), clopidogril (Plavix), or ticlopidine (Ticlid) to prevent heart attack or stroke, resulting from a blood clot?

These medications make it more difficult for your blood to clot and because of this, you may have trouble with bleeding after certain dental procedures.  It may take longer than you would expect for any bleeding to stop.  In light of this, you might consider reducing your dosage or stop taking the medications entirely before receiving dental care.  However, it is generally agreed that anticoagulant drug regimens should not be altered prior to dental treatment.  If you stop taking, or take less of, the anticoagulant medication, you increase your chance for blood clot development, which could result in thromboembolism, stroke or heart attack.  The risks of stopping or reducing this medication routine outweigh the consequences of prolonged bleeding, which can be controlled with local measures.  For example, you may be asked to bite down on sponges treated with a liquid that helps control bleeding.

Some patients who are taking these anticoagulant medications have additional medical problems that increase the risk of prolonged bleeding after dental treatment.¹  If you have one of these conditions, your dentist may want to refer you to a hospital dental clinic.  These medical conditions include:

• liver impairment or alcoholism
• kidney failure
• certain blood disorders.

Talk to your dentist if you are curious about these medications and how they may affect your dental treatment.

“In our office, we routinely work with physicians to arrive at the best protocols for achieving ideal dental outcomes for our patients” assures Dr. Cherukuri from her Chino, California dental practice.