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Can lack of oral care increase your risk of a fall-related injury?

Can lack of oral care increase your risk of a fall-related injury?

By Marguerite Oberle Thomas, RN., BScN.

Seniors need and want to avoid falls and fall-related injuries. Does the condition of our mouths have anything to do with it? If you are someone who has gone through life with good strong teeth, oral health can be taken for granted. One of life’s greatest pleasures is to sit down at the table and comfortably chew meat, fresh fruit, vegetables and breads. Good nutrition is needed all through our lives, especially as we age. It helps us to avoid becoming frail. Older adults who are frail, or have worsening chronic health conditions, are more prone to fall-related injuries.
According to the Surveillance Report on Falls Among Older Adults in Canada:
• Falls are the leading cause of injury-related hospital admissions in Canadian seniors
            • Higher rates among women and those 80+
            • Higher rates among those with less than $20,000 annual income
            • 52 percent of fall-related hospitalizations occur in a household residence
Poor oral health has been linked to many health risks, such as cardiovascular disease, stroke, poor nutrition, glycemic control in people with diabetes and respiratory infection. As we get older, there are more changes in our teeth and gums, meaning they require more care, not less. Common challenges include missing teeth, gum/periodontal disease, root decay and dry mouth often caused by medications. It can be difficult to practice personal good oral care with a reduction in hand dexterity.  
Good nutrition contributes to the health of our teeth and gums, which links to our overall health. Choose water over sugary drinks and nutritious low-sugar snacks. Foods such as apples, raw carrots and hard cheese have a natural cleansing action on teeth but eat applesauce and shredded carrots if you have difficulty chewing.
An international study (Mochida et al.) released in 2018 found that poor oral function, having fewer teeth, and not using dentures are predictors of fall incidents. The study’s authors suggest that further studies are needed to determine whether improving oral health can reduce the risk of falls. While we wait for those studies to be done, we know that the health of your mouth, and your ability to eat nutritious foods, affects your overall health.
Whether due to normal aging, injury or other issues, some people will have to consider dentures or dental implants at some point in their lives. To keep germs and infections away, be sure to brush your new teeth (without toothpaste), rinse them and soak them in denture cleaner according to package instructions. Dental implants are an expensive, but workable alternative to missing teeth.
So, could your mouth affect your risk of a fall-related injury and your overall health? Your best chance of your mouth NOT being a factor in a fall related injury is to give it the best care you can. Get your dental care, do your exercises to gain an appetite, keep eating well and smile.
To learn more about fall prevention or help increase awareness, encourage advocacy for better oral care for older adults, and see the Rapid Review for references, please contact mthomas@parachute.ca.

For further information:

Marguerite Oberle Thomas, RN., BScN.
Consultant - Liaison
Fall Prevention Community of Practice

Marguerite Oberle Thomas, RN., BScN., is the Consultant Liaison for the Fall Prevention Community of Practice sponsored by the national injury prevention charity, Parachute. She is also a senior devoted to preventing fall-related injuries and promoting good oral care for all seniors. To help increase awareness and promote advocacy for better oral care, contact her at mthomas@parachute.ca

Additional Information for Ontario outlets:

Good oral care also includes access to dental care and being able to receive treatment should problems occur. The Ontario Seniors Dental Care Program (OSDCP) is a program that aims to help low-income seniors’ access dental care. To qualify, you must:

  • Be 65 years of age and older and a resident of Ontario
  • Have an income of $22,200 or less for single senior; combined income of $37,100 or less for a couple (Line 236 from your income tax form)
  • No other forms of dental benefits (e.g., private insurance or other government program).

Eligible seniors can also apply to the OSDCP directly online at www.ontario.ca/SeniorsDental, or print a hard-copy form to be mailed. There are a wide range of services available under the program, including both preventive care and treatment services such as: check-ups and cleanings, repairing broken teeth and cavities, x-rays, removing teeth or abnormal tissue, treating infection and pain, and treating gum conditions and diseases. The program will partially cover dental prosthetics and dentures. For a full list of coverage, please visit www.ontario.ca/SeniorsDental.


Websites and Internet Resources

McMaster Optimal Aging Portal. Is it time to brush up on your oral health? [Internet]. Hamilton (ON) McMaster University. [modified 2022 Mar 29]; Hitting the Headlines section. Available from: https://www.mcmasteroptimalaging.org/hitting-the-headlines/detail/hitting-the-headlines/2022/03/29/is-it-time-to-brush-up-on-your-oral-health

McMaster Optimal Aging Portal. Brushing teeth can save lives! The quality of oral health among seniors points to neglect and shows we need to 'brush up' on mouth care [Internet]. Hamilton (ON); McMaster University. [modified 2014 Sep 28]; Blog post. Available from https://www.mcmasteroptimalaging.org/blog/detail/blog/2014/09/28/brushing-teeth-can-save-lives-the-quality-of-oral-health-among-seniors-points-to-neglect-and-shows-we-need-to-brush-up-on-mouth-care?sid=a3a7ac3a-52b7-4eb8-92d6-302a3c0ec034&hl=oral+health

Ontario Dental Hygienists' Association (ODHA). Oral Health Facts. [Internet]. Burlington (ON); ODHA. [n.d.]; Available from: https://odha.on.ca/your-oral-health/oral-health-facts/

Ontario Dental Hygienists' Association (ODHA). Oral Care for Seniors. [Internet]. Burlington (ON); ODHA. [2021 Nov]; Oral Health Information Sheets. Available from: https://odha.on.ca/wp-content/uploads/2016/08/ODHA-Facts-seniors.VFS21.11.pdf

Healthy Populations Institute: Putting 'Oral Health is Health' Into Action Flagship Project. [Internet]. Halifax (NS); Dalhousie University, Faculties of Dentistry and Health. [2022]. Available from: https://www.healthypopulationsinstitute.ca/oralhealth.

Healthy Populations Institute: Oral Health Flagship Project Snapshot. [Internet] Dalhousie University. [2022]. Available from https://www.healthypopulationsinstitute.ca/_files/ugd/6eb48c_4307eb70798a44f5a55bbe2fc2a33202.pdf

Journal Articles

Mochida Y, Yamamoto T, Fuchida S, Aida J, Kondo K. Does poor oral health status increase the risk of falls?: The JAGES Project Longitudinal Study. PLoS One. 2018 Feb 1;13(2):e0192251. doi: 10.1371/journal.pone.0192251. PMID: 29389975; PMCID: PMC5794168.

Eckert CD, Tarleton EK, Pellerin J, Mooney N, Gell NM. Nutrition Risk is Associated With Falls Risk in an Observational Study of Community-Dwelling, Rural, Older Adults. J Aging Health. 2022 Oct;34(6-8):1125-1134. doi: 10.1177/08982643221096944. Epub 2022 Apr 29. PMID: 35487237.