Management of post-operative sensitivity following periodontal treatment

Abstract

In my 15 plus years working as a dental hygienist in long term care facilities, I have seen the most reprehensible oral care imaginable. I have witnessed dentures that had not been removed or cleaned in years. I have seen tube-fed residents who had not had their teeth brushed in months because of the staff ’s failure to see the necessity of providing oral homecare. I recently treated a patient who had so much tartar build up on his lower anterior teeth that he could not close his mouth or properly chew his food. I have listened to the countless, heart-wrenching accounts of elders so embarrassed by their dental condition that they were ashamed to smile or even let me examine their mouths. Dental health plays a significant role in mental and emotional health and well-being. Therefore, caregiver provision of proper oral homecare helps maintain the dignity of the geriatric community. Whether the neglect is due to caregivers’ lack of knowledge or lack of compassion, the result is detrimental to the systemic health of the elderly. Uncontrolled oral bacteria can lead to pneumonia, diabetes, strokes, and heart attacks. It has even been linked to Alzheimer’s Disease. Frequently, cognitive impairment intensifies preexisting oral problems. For instance, elders with Alzheimer’s typically have poor oral care and a higher incidence of oral diseases. The most deplorable aspect of this situation is the fact that it is readily preventable. The quality of life and systemic health of residents in long term care facilities can be significantly improved by simple, consistent, and effective oral care practices. 31 Open Journal of Geriatrics V1 . I1 . 2018 Solh 2011) Death rates vary from 1 to 48% and are associated with age, comorbidities, and the severity of the disease (Welte et al. 2012). Clinically, residents feel sick and present with cough, purulent sputum, fever, sweats, pain, and suffocation hazard. Very old residents lack these classic symptoms and rather present with disorientation and some may even fall (Janssens and Krause 2004). Silent aspiration of treacherous oral microorganisms resulting from poor oral hygiene is a major contributing factor to nursing home pneumonia. It can be found in places we would never suspect. There is evidence for the first time that denture wearing during sleep doubles the risk of pneumonia in very old people (Iinuma et al. 2014). Microorganisms of denture plaque associated with periodontal disease were found in the lungs of patients who were denture wearers. (Imsand et al. 2002). The tongue is another place that harmful oral microorganisms populate. A study was conducted on seventy-one edentulous residents of long term care facilities age 65 years and older. The study evaluated the quantity of tongue-coating and found that elderly residents whose tongues were coated had “significantly higher salivary bacterial counts” than those whose tongues were not coated. The study also revealed that the risk of developing pneumonia was higher for elderly patients with poor oral hygiene, “suggesting that tongue-coating is a risk indicator of aspiration pneumonia in edentate subjects.”(Abe et al. 2008).