Oasis Resource: Periodontal Disease in the Elderly Patient

Dr. Aviv Ouanounou discusses the prevalence and etiology of periodontal disease in the elderly and gives insights on how to manage the condition in the elderly patient who is taking various other medications to manage other medical issues.

Periodontal disease is a very common condition amongst the elderly. In North America, studies have shown the prevalence or periodontal disease to be approximately 50% and the prevalence of gingivitis to be as high as 70 or 80%.

There are several factors which impact the periodontal status of our elderly patients.

• Socioeconomic status which impacts the affordability of oral care
• Alcohol abuse and/or smoking
• Depression
• Cardiovascular health
• Other chronic disorders – diabetes, osteoporosis, osteoarthritis, hypertension
• Medications which have side-effects such as gingival hyperplasia and xerostomia
• Oral pathogens

When treating the elderly patient, the dentist must assess the patient’s cognitive abilities, risk factors, and medical and medication history. Scaling and root planing is still a first line of defense with oral hygiene instruction and hygiene aids (involving the caregivers, when required). Additionally, extraction of hopeless teeth with appropriate prosthodontic options should be considered. When necessary, antibiotic therapy may be prescribed as an adjunct to the treatment of periodontal disease.