Oral Infection and Systemic Disease in the Elderly

Fayaaz Jaffer
Faculty of Dentistry,
University of Toronto.

David W. Matear
Associate Professor,
Director of Clinics,
Faculty of Dentistry,
University of Toronto.

Introduction
The oral health status of older adults is generally poorer than that of the rest of the population. In particular, those residing in institutions have very poor oral health.^1,2 The prevalence of systemic infection among the elderly is becoming an increasingly important health care issue, especially since age-related demographics show an increase in the numbers of aging and elderly individuals.

One of the primary portals of entry into the body for infectious agents is the oral cavity, which is home to over 500 bacterial species alone.³ Although most oral microbes are non-pathogenic, decreased host resistance and/or environmental factors, such as institutionalization, can increase the risk of systemic infection among the elderly. Furthermore, once a focal infection has been established, it can open the way to colonization by more virulent organisms. Some of the systemic diseases reported to result from oral infections include pneumonia, meningitis, osteomyelitis, bacterial endocarditis, as well as abcesses of the brain, lung, and liver. This article will provide examples of the impact of oral diseases on general health in the elderly.

Healthy Mouth, Healthy Body

Understanding the Importance of Oral Health in the Elderly

David W. Matear, BDS, BMSc, DDPH, MSc, FRSH
Chief of Dentistry, Baycrest
Centre for Geriatric Care and Assistant Professor,
Department of Community Dentistry, University of Toronto

Abstract
Dental professionals in Canada have concerned themselves with the oral health of Canada's population as a whole; unfortunately, strategies and funding have not supported initiatives to address the growing needs of the elderly population. The oral health needs of older adults, and the potentially serious consequences of oral disease in the elderly, present a major challenge not only to members of the dental profession, but to all health care professionals and the general community. We can rise to the challenge successfully only by working together in an integrated and coordinated manner.

Introduction
Despite the advances in oral health care in developed countries, the oral health status of the elderly has not improved to the same extent as that of the younger members of the population.^1,2 This represents a failure on our part; it would seem that we are ill-informed and ill-prepared to meet the oral health needs of our elderly. This lack of preparedness in terms of providing the elderly with appropriate care contrasts sharply with the growing recognition that this is dentistry's fastest growing and most challenging area.