The Silent Impact of Dental Neglect on the Elderly

"Do you visit the dentist often, sir?"

"Well, you see... it's all about money. You need money to go. Visiting the dentist costs an arm and a leg."

I met Mr. Park (84 years old, male), who resides in A, Gwangsan-gu, Gwangju Metropolitan City, at his home last month, where he served pumpkin stew. With few remaining teeth, Mr. Park mentioned that he only eats soft foods. Despite being soft pumpkin and tofu, he struggled to eat them even with a spoon.

For elderly individuals who receive basic living assistance, visiting the hospital poses a significant burden. While the government provides support, it often falls short of covering all medical expenses. Moreover, the infrequent bus services to the city center make travel time-consuming. Furthermore, Mr. Park, the elderly individual in question, currently suffers from conditions such as diabetes and hypertension, requiring him to take multiple medications daily. Despite brushing his teeth twice daily, he complains that his teeth feel loose every time.

Oral health is crucial for the elderly. However, it often gets overlooked compared to conditions like stroke and dementia. Decreased tooth count and impaired chewing function significantly reduce quality of life. Additionally, reduced chewing function can lead to decreased blood flow to the brain, affecting cerebral metabolism and causing decreased neural activity, systemic malnutrition, and other related issues.

■ Dental Health Linked to Depression and Dementia

Research has repeatedly shown that neglecting oral health in the elderly can worsen other conditions, particularly those related to brain health, such as dementia.

Last year, a research team led by Satoshi Yamaguchi at the University of Tohoku Dental School in Japan revealed that deteriorating dental health in the elderly is associated with dementia.

The team conducted a study on 172 elderly individuals aged 55 and above with normal cognitive function. The results showed that elderly individuals with mild periodontal disease and few healthy teeth experienced rapid shrinkage of the hippocampus, a memory center in the left brain. Similar findings have been reported multiple times in the United States, Norway, and other countries.

According to a study by the Korea Institute for Health and Social Affairs on the association between elderly oral health and depression levels, oral health tends to deteriorate with age, and poor oral health in older people can lead to depression.

Dr. Yoon Hong-cheol, the chief dentist at Best Dental Clinic, emphasized the importance of dental care in old age, as it directly affects nutrition intake. He explained, "Proper brushing and regular flossing to remove plaque and tartar promptly are the first steps in managing oral health in old age.

■ Economic Burden Primary Cause... Prevention is the Only Solution

According to the National Health Statistics from the Korea Disease Control and Prevention Agency, as of 2021, the prevalence rates of complaints of masticatory discomfort and oral functional limitation among those aged 65 and older were 35.9% and 37.5%, respectively. This means that more than one in three individuals in this age group experience discomfort due to teeth, dentures, or gum issues.

In response, the government provides dental treatment support for financially disadvantaged seniors. The beneficiaries are those on essential living assistance, and for implants, individuals aged 65 and older are supported for up to two implants per person as a one-time assistance. However, there have been criticisms that the support for dentures, provided once every seven years, is insufficient.

Ultimately, prevention is the key. Proper brushing is the most effective preventive measure for dental health. Neglecting brushing can lead to the formation of dental plaque, which, when hardened, becomes tartar. This can eventually lead to cavities, gingivitis, periodontitis, and other related diseases.

The Korean Dental Hygienists Association currently emphasizes the importance of the "Standard Gum Brushing Method." This involves placing the toothbrush bristles at a 45-degree angle to the gumline, gently vibrating the brush in place 5-10 times, and then rotating the wrist to sweep the brush outward. However, excessive force may irritate the gums and lead to gum disease.

Especially for those with diabetes, paying extra attention to brushing is crucial. According to research by teams from Yongin Severance Hospital and Ewha Womans University Medical Center (involving 10,009 diabetic patients), patients who brushed their teeth twice or more a day had a significantly lower adjusted hazard ratio for cerebrovascular diseases compared to those who brushed once a day or less

Director Yoon Hong-Cheol emphasized, "Nowadays, all aspects of health are shifting from 'treatment' to 'prevention,'" adding, "While policies to enhance the guarantee of dentures and implants are beneficial, preventive measures to preserve natural teeth are necessary.