Read the text carefully. Pay attention to words in the bold print

The dental problems of the elderly can be divided into four groups: problems with teeth, gums, dentures and their medical histories.

Teeth Related Problems include tooth decay. Older people are more vulnerable to tooth decay due to a preference for sweeter foods, less care with their oral hygiene and inability or problems to access dental treatment. Tooth decay is preventable by reducing the quantity and frequency of sugar consumption. It must be mentioned here that even fresh fruit eaten in excessive amounts causes tooth decay. Another problem is a tooth ache. Heavily filled teeth, or teeth under crowns and bridges maylook sound, but the nerves in these teeth may die off. Once this happens, the dead nerve tissue may become infected and toothache can follow. The ideal treatment would be root-canal treatment, or possibly extraction. If it is not possible to get to a dentist, then a combination of pain killers and the antibiotic can be taken under advice. Decayed teeth, worn teeth and old fillings do break, often leaving sharp ends that the tongue plays with. This can result in tongue ulceration, which is very sore.Ideally, one should have a dentist smooth off the sharp piece as soon as possible.

Gum Related and Soft Tissue Problems are connected mostly with gingivitis. Gum disease that causes bone loss, tooth loosening, or even tooth loss, does requiretreatment. A dental check-up is the opportunity to assess the level of gum disease. But ninety per cent of gum diseases can be prevented by effective oral hygiene, which should include cleaning in between the teeth with dental floss.

Soft Tissue Problems include lumps, white lines and patches in the mouth. Ulcers are common, but, if they have not healed within two weeks and there is no obvious cause (sharp tooth or filling), the ulcer should be investigated, first of all by a dentist. Any lump or patch in the mouth should be investigated if it bleeds, changes in size, appearance or ulcerates. Mouth cancers account for over two per cent of all cancers and their incidence is increasing. Smokers are at increased risk and if the person has a history of smoking and heavy drinking, the risk of oral cancer increases by sixteen times.

Denture-related Problems: new dentures should be made as a last resort, only if the person is lucid and able to cope with dental appointments. If the previous dentures have never been successful, then it is highly unlikely that further attempts will be. If the previous dentures have been successful, but no longer fit, perhaps because they have broken or because the person has lost a lot of weight, then copying the original denture is the best way.

Denture wearers who develop dry mouth must remember that dentures must be cleaned properly by scrubbing vigorously with a toothbrush. Dentures should not be worn at night and should be soaked in some liquid overnight, otherwise oral fungal infections will occur.

Medical History Problems: old age itself can eventually lead to a reduction in saliva gland function, but anti-psychotic drugs, anti-epileptics, anti-depressants, beta-blockers, and diuretics can all cause a reduced saliva production. Poor saliva production makes it much harder for denture wearers and there is a higher risk of tooth decay and gum disease in people with dry mouth. Using sugar free gum and regular sips of cold water help. Increased tooth paste use is important to prevent tooth decay. Diabetics are more vulnerable to gum infections. In addition, people with dementia must be individually assessed. Whilst there may be a need to do dental treatment, it may be that a general anaesthetic is required. It is unusual for patients with dementia to suffer toothache. This may be due to medication or due to their reduced levels of pain awareness.

GLOSSARY
assess – oszacować 
dementi – demencja 
die off – obumierać 
excessive – nadmierny 
ideally – idealnie 
inability – niezdolność, niemożność 
incidence – zakres, liczba przypadków 
individually – indywidualnie 
last resort – ostateczność 
look sound – (tutaj) wygląda solidnie 
loosening – poluzowanie 
lucid – w pełni świadomy
lump – guzek 
otherwise – w przeciwnym razie 
overnight – w ciągu nocy
scrub – szorować
sharp – ostry
smooth off – wygładzić
soak – moczyć
ulceration – owrzodzenie
vigorously – energicznie
vulnerable – podatny

Match these statements as True or False

1. Tooth decay is not a concern with the elderly patients any more.
2. Sugar intake is mainly responsible for tooth decay problems in the elderly.
3. Gum disease is very dangerous and it requires urgent treatment.
4. Ulcers which do not heal within a few weeks must be checked by a healthcare professional. 
5. The risk of oral cancer is higher in smokes than in heavy drinkers.
6. Dentures are the best option for the elderly.
7. Oral fungal infections occur when proper oral hygiene is denied.
8. Saliva flow may be decreased by the medicines that a patient uses. 
9. Diabetics are less likely to develop various gum diseases. 
10. It’s rare that patients suffering from dementia will complain of toothache.

Match patient’s questions with dentist’s answers

A) If an older person has few or no dental problems or even no teeth, does he or she need to see the dentist?
B) I find it difficult to chew and swallow certain foods
C) My teeth have suddenly become very sensitive to both hot and cold, but my mouth is otherwise healthy. What could cause this?
D) Can braces still be an option for the senior adult?

1) You may be experiencing these difficulties simply because you have tooth decay, ill-fitting dentures, dry mouth, or another condition that is very likely to be treatable. Maintaining proper nutrition is important not only for your oral health but for your overall health too. To maintain overall good nutrition, follow this advice: eat a variety of foods from the five food groups (milk and dairy, breads and cereals, meats and dried beans, fruits, and vegetables),choose a diet with plenty of grain products, fruits and vegetables, low in fat, saturated fat, and cholesterol.
2) There is no age limit for correcting misaligned teeth. The mechanical process used to move teeth is the same at any age. So the benefits of orthodontic treatments such as braces are available to both children and adults who wish to improve their appearance and bite. 
3) it is wise -- especially as you age -- to visit your dentist at least once a year for a comprehensive oral exam. At this visit your dentist can look for signs of oral cancer as well as for any other oral health or medical problems in the mouth, head, and neck areas.
4) Receding gum tissue could be the cause of sensitivity. As gum tissue pulls back away from teeth, the root of the tooth becomes exposed.

Here is a short text which talks about proper oral hygiene in patients having difficulties in cleaning due to arthritis. Read the text and complete it with the words from a table.

There are several 1)_________ you can try that should make caring for your teeth easier to accomplish if you have arthritis. To increase the size of the toothbrush 2)___________, try wrapping the handle with tape or 3)___________the handle into a rubber ball or into a bicycle grip handle. To increase the length of the toothbrush handle, 4)__________two popsicle/ice cream bar sticks, or small plastic or wooden rulers to the toothbrush handle. Another option that might offer assistance is to 5)___________a wide elastic band to the toothbrush under which the person would slide their hand. Finally, a 6)___________- or electric-powered toothbrush might be the most appropriate solution, depending on the dexterity of the person.

Match the words with definitions

DEMENTIA LUMP ULCER SENSITIVITY ARTHRITIS

1._________ inflammation of one or more joints.
2._________ an open sore in the mouth, or rarely a break in the mucous membrane.
3._________ is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior. 
4.________ an abnormal mass or swelling. 
5. ________ the capacity of being vulnerable to hot or cold substances.


Lesson 29 answers