Elderly care is an important matter for loved ones in the family, since their aging is accompanied by some health problems. Dental care for the elderly is very necessary to develop a treatment plan after examining oral hygiene and supportive tissues and gum conditions. Given its difficulty and complications, the care and treatment of the elderly’s mouth is a branch of dentistry branches, it depends on the presence of qualified specialists to treat this category of patients in particular.

Dental procedures for the elderly include diagnosis, prevention, and treatment of problems related to aging, such as accompanying oral changes, loss of oral mucosa elasticity, decreased salivation resulting in dry mouth, gingival recession, gradual loss of the enamel surface with an increase in teeth yellowing due to increased formation of secondary dentin, erosion of the tooth surface, increased rate of caries in the root zone due to receded gums, problems with chewing and the TMJ, and others.

The most prominent dental problems in the elderly are:
- Oral hygiene: As a result of limited mobility or poor general health, difficulty arises in cleaning teeth and mouth properly.
- Gum disease: it results from contamination of the supporting tissues of the teeth that leads to gums bleeding, bad smell in the mouth, the appearance of tooth roots, loose and lost teeth. In addition to the intertwining effects of gum disease with chronic diseases such as heart disease, stroke, and diabetes.
- Tooth decay: The risk of caries increases in the elderly as a result of the appearance of the roots due to the erosion of the gums, the large number of incorrect old restorations and the dry mouth due to taking medicines or after chemotherapy and radiation.
- Fungi: They appear as a result of the continuous use of antibiotics or steroids, diabetes, suppression of the immune system, dry mouth, unregulated feeding, and partially or completely artificial teeth.
- Soft tissue injuries: They mainly appear as an ulcer (wound) or an additional tissue growth, due to partial or complete placement of the artificial teeth in an unstable manner as a result of the friction of the moving tooth structures with the oral tissues.
- Oral cavity cancer: The risk of developing oral cavity cancer in the elderly increases if a person smokes and/or consumes alcohol or if exposed to sunlight for very long periods.





The importance of visiting the dentist:
The doctor accurately diagnoses the patient's condition before starting treatment, as most cases require dental replacements using movable or fixed fixtures or implants. To determine the most appropriate treatment, a precise treatment plan is developed, including:
1- Dental replacement, as aging does not mean the absence of dental replacement treatment, regardless of its type, simple or advanced. It is the right of the elderly to obtain aesthetic and functional compensation at the same time.
2- The patient may come with teeth missing a long time ago, which may have caused an exacerbation of the mismatch of the teeth with each other, as a result of the movement of the adjacent and opposite teeth in terms of space. Here the difficulty lies in choosing and making the appropriate formula, as it depends on the presence of sloping teeth, as well as the absence of problems in the gums due to the accumulation of food residues, in this case the role of the specialist in cooperation with the technician in planning the appropriate composition.
3- A number of patients prefer fixed compensation with implants more than moving ones, whether complete or partial, due to problems related to chewing or its cosmetic and even psychological role.
4- Gum care, where many factors affect the health of the gums and the supportive tissues. Gum disease in old age is more difficult because it is chronic, and it occurs due to the accumulation of harmful factors in the gums.
5- Local factors, which are the "plaque and tartar" layer, as the majority neglects oral and dental hygiene and thus leads to severe receding gums, and then erosion of the bone surrounding the teeth and the supportive tissues. This leads to tooth sensitivity when drinking hot or cold liquids, and with the progression of the disease it leads to teeth loosening, or difficulty of treating them, and not considering them as a support for a dental replacement, so the specialist may have to remove them.
6- Smoking has a role in gum disease, as it causes discoloration in the surface of the teeth and gums together, in addition to the poorly moving structures that put pressure on the gums and oral tissues, causing ulcers and accumulation of bacteria and fungi.
7- Organic factors such as diseases that affect the body, for example diabetes, so diabetics are always advised to take care of the mouth and periodically visit the dentist to avoid disease effects on the tissues supporting the teeth, which leads to its loosening.
8- Treating gums begins with taking care of it through regular visits to the dentist, as it may be advised to use mouth washes and special toothpaste for sensitive teeth. In some cases the treatment may require gum restoration operations that have receded from the teeth, especially in the front teeth because of their aesthetic importance. This, of course, is done after examining the situation by a specialist in periodontal surgery to determine the possibility of this type of treatment.
9- There are also operations to increase the thickness of the jawbone in the event that there is severe erosion in the bone, which limits the work of the mobile structure or implant.
10- Caries, as most decay in the elderly occurs in the root caries and in the cervical caries due to the receding gums that expose these two layers, and thus become vulnerable to the accumulation of bacteria and food remnants, and then to decay.
11- Dry mouth and a lack of saliva production are among the factors affecting the occurrence of caries, as it is known saliva is important in moisturizing the mouth and providing protection against bacteria. With age and exposure to several diseases, this problem increases, as well as there are many medicines that cause mouth dryness, we mention drugs for pressure, depression and anxiety, or radiation therapy for cancer patients.

Tips for maintaining oral and dental health in the elderly:
- Maintaining oral hygiene using cleaning tools twice a day, using a soft brush and toothpaste that contains fluoride, and in case of limited movement, an electric brush can be used.
- Maintenance of artificial teeth, as they must be cleaned daily because of germs, it is also preferable to remove them during the night. In each case they must be taken out of the mouth for at least 4 hours a day, soaked in a special sterilizing solution in order to maintain their cleanliness, and they must be rubbed using a special brush designated for that.
- Stop harmful habits such as smoking and alcohol consumption because they increase the risk of oral cavity cancer.
- Treating dry mouth by consulting a dentist to determine the cause of the problem in certain cases. Likewise, enough water should be drunk daily, and alternatives to saliva such as sugar free gums can be used.
- Regular visit to the dentist for a routine check-up at least once every six months, it is also important to inform the dentist with every change in the health status and in the medications used because these details can have a decisive effect on dental treatment.


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