Maintaining good oral hygiene and oral health is paramount for overall well-being. When it comes to older individuals, proper dental care goes beyond just addressing oral issues; it also plays a critical role in managing underlying health conditions.

Periodontal disease (periodontitis) affects up to two thirds of people over 65. The condition is even more common in people with diabetes.

- Clean mouths, teeth and dentures are a priority in the oral care of older people, as they prevent both decay and various types of oral infections. Inflammation of the gums is thought to be linked to the risk of heart attack, among other things, says Tommi Pätilä, a cardiac and organ transplant surgeon at the New Children's Hospital in Helsinki.

Oral health is known to predispose to more than 200 chronic diseases, including lung disease and rheumatic diseases. According to researchers, severe gum disease, periodontitis, can increase the risk of developing even dementia or milder form of memory loss. The results of a study published in the Journal of the American Geriatrics Society show that the risk was about a fifth higher if a patient had poor dental health.

- Simple measures, such as regular brushing and cleaning of gaps between teeth and regular dental check-ups, can help prevent the onset of gum disease while minimising the risk of oral bacteria or their structures entering the bloodstream and spreading to other parts of the body, says Pätilä.

A healthy mouth is a prerequisite for well-being

Looking after your teeth and oral health is particularly important if you have an underlying disease such as diabetes or cardiovascular disease. Preventing and treating oral infections is also necessary before surgery, Pätilä points out.

For instance, prior to prosthetic joint or flap surgery, it is imperative for a dentist to confirm the absence of asymptomatic infections within the oral cavity. Such infections could potentially serve as entry points for bacteria into the surgical site, leading to post-operative complications.

Thorough oral hygiene is the basis for the prevention and treatment of gum diseases such as periodontitis. However, effective mechanical tooth brushing and extractions are not always enough.

As we get older, oral hygiene can also become more difficult to maintain as vision, memory or hand motor skills deteriorate. Finnish researchers have developed Lumoral, a method that acts as a precision weapon against microscopic plaque in the mouth. Lumoral kills both Streptococcus mutans, the bacteria that cause tooth decay, and gingivitis bacteria.

- Lumoral retards plaque formation and significantly reduces problem-causing bacteria in the mouth. Notably, older people align well into the product's user profile, as thorough oral hygiene is so important in this age group, says Pätilä.

Tested in the treatment of peri-implantitis

Lumoral is a Finnish innovation for maintaining oral health and treating and preventing oral diseases at home. It is recommended by many dentists and the Finnish Association of Oral Hygienists.

- The device is intended primarily for people whose conventional oral hygiene does not produce desirable results. This is often the case, for example, with patients suffering from chronic periodontitis.

Lumoral has also been tested in the treatment of peri-implantitis.  Peri-implantitis is characterised by inflammation of the soft and hard tissues around the implant. It affects both the mucosa and the bone supporting the implant, leading to the gradual destruction of the skeletal structure holding the implant in place.

The pilot study involved patients diagnosed with peri-implantitis or a milder form of it. Lumoral was used by the patients as part of their dental self-care routine.

The amount of plaque and gingival bleeding around the inflamed implant was significantly reduced compared to baseline, the study found. In four out of seven patients, the inflammatory markers in the implant pocket fell to normal levels.

According to the researchers, the pilot study shows that regular, repeated antibacterial Lumoral treatment can prevent and cure inflammation of the tissue around dental implants, while promoting overall oral health.

Inflammatory bowel disease is linked to an increased risk of periodontitis, i.e. periodontal disease. This is according to new publications from a European research project that explored the link between the two diseases.

How does inflammatory bowel disease affect oral health? And how does the mouth affect our gut? It is already well known that periodontitis can be linked to diabetes and cardiovascular disease. But the link between periodontitis and inflammatory bowel disease (IBD) has not so far been explored on a large scale in a European context.

Now, two publications from a large research project involving Danish patients show that there is a strong link between the diseases. 

– The study shows that patients with IBD have more periodontitis and fewer teeth compared to people without IBD. We also see that patients with both IBD and periodontitis have worsened bowel disease with higher activity than patients with IBD who have a healthy mouth, says Andreas Stavropoulos, professor, and senior dentist at the Faculty of Dentistry at Malmö University, and one of the researchers behind the study.

– Both diseases can be described as creating a strong overreaction of the immune system to a bacterial trigger. You could say that the immune system is attacking your own body.

Oral health more affected in patients with Crohn's

In the study, around 1,100 patients answered questions in an online survey. Around half of the participants had Crohn's disease and the other half had ulcerative colitis. The study also included about 3,400 people without IBD, who were randomly selected but also matched for certain criteria to the patients with inflammatory bowel disease.

– The study showed not only that patients with inflammatory bowel disease had poorer oral health than people without IBD, but also that the oral health of patients with Crohn's disease was more affected. They lost more teeth than patients with ulcerative colitis, says Kristina Bertl, lecturer and dentist at the Faculty of Dentistry.

"Patients with IBD should be followed up better"

Through contacts with the Danish crohn's disease and ulcerative colitis patient association Colitis-Crohn Foreningen (CCF), the researchers were able to find participants for the study. Within the association, it was well known that many patients had recurring problems with their teeth and infections and ulcers in their mouths. At the same time, they felt that this was not really addressed in their contact with the health care system.

– The Association was therefore very keen to help. The survey confirms this picture. Participants reported that they were not informed about the possible link between the two diseases, and in general that problems with the teeth and mouth were under-prioritized, says Andreas Stavropoulos.

Periodontitis initially causes relatively mild symptoms, such as bleeding gums when brushing, but can lead to tooth loss if not treated in time.

– Overall, the studies show that the oral health of patients with IBD should be better monitored to prevent the development of periodontitis and tooth loss in this patient group, concludes Kristina Bertl.