Elder Care Dentistry: What Older Adults Need Before Major Surgery

Hi there I’m Dr. Jacquie Sanders, owner dentist at Floss & Fido – Family Dentistry in Fircrest, just down the road from Tacoma and Lakewood.

I see a lot of different kinds of smiles in my chair: tiny toddler teeth, full cosmetic smile makeovers, and – very close to my heart – the smiles of older adults and seniors who have lived a lot of life with those teeth.

Elder care dentistry (sometimes called “senior dentistry” or “geriatric dentistry”) is not just “regular dentistry, but older.” It’s a different world from pediatric dentistry and from Instagram-style cosmetic dentistry – and it matters for far more than just looks. Your mouth is connected to your heart, your blood vessels, your joints, and even how safely you can go through big surgeries like hip replacement.

This article is my way of walking you (or a parent, grandparent, or partner you love) through:

• How senior dental needs are different

• How that differs from pediatric and cosmetic dentistry

• Why good oral health in older age can protect the heart, the brain, and even joint replacements

• What elder care dentistry looks like in my Tacoma/Fircrest practice

What Is Geriatric Dentistry (Senior Dentistry) and Who Is It For?

By the time you’re in your 60s, 70s, 80s and beyond, your mouth has been through:

• Decades of chewing and clenching – Teeth wear down, crack, or have big fillings and crowns.

• Gum recession and bone loss – Gums can pull back, exposing the roots (which are more cavity-prone) and sometimes loosening teeth.

• Dry mouth from medications – Blood pressure meds, antidepressants, allergy medicines and many others can reduce saliva. Saliva is your natural “tooth rinse,” so dry mouth = much higher risk of decay and infections.

• Chronic medical issues – Diabetes, heart disease, autoimmune conditions, and cancer treatments all change how your mouth heals and fights infection. Nature

• Dexterity challenges – Arthritis, tremors, vision changes, or cognitive decline can make brushing and flossing genuinely difficult, even for someone who “knows” what to do.

On top of that, many seniors are living with dentures, partials, implants, or bridges that were placed years ago – which all need maintenance, cleaning, and sometimes updating to keep chewing safe and comfortable.

That mix of factors means senior dentistry is heavily focused on prevention, comfort, and stability – not just “fixing one tooth at a time.”

Elder Care vs Pediatric Dentistry: Different Bodies, Different Brains, Different Risks

I love my kid patients, but pediatrics and senior care are almost opposite ends of the spectrum.

Pediatric dentistry focuses on:

• Growth and development – Are jaws and teeth developing in the right direction?

• Preventing future problems – Fluoride, sealants, and habit coaching (thumb sucking, bottles, sugar).

• Behavior and comfort – Making the dental chair a safe place for future adults.

In kids, the body is still building bone, blood vessels, and enamel. A lot of our work is setting a foundation.

Senior dentistry focuses on:

• Protecting what’s left – Preserving remaining teeth, bone, and gum support as long as possible.

• Managing complex medical histories – Blood thinners, heart conditions, diabetes, joint replacements, cancer history.

• Preventing infection and inflammation – Because infections in the mouth can have a bigger systemic impact in older adults.

• Maintaining function and dignity – Being able to eat real food, speak clearly, smile in photos, and feel like yourself.

So while the tools may look similar (cleanings, fillings, crowns), the risk–benefit decisions are very different. With a healthy 10-year-old, I might recommend a long-term treatment to guide growth. With an 82-year-old on multiple medications, I’m asking:

“What gives you the safest, most comfortable quality of life for the next 5–10 years, without over-treating you?”

Elder Care vs Cosmetic Dentistry: Function First, Vanity Second

I also do cosmetic dentistry – veneers, whitening, esthetic bonding – and those treatments can absolutely be appropriate for older adults. But elder care dentistry is not primarily about creating a “Hollywood smile.”

Cosmetic dentistry (in general) is about:

• Perfect symmetry and color

• Aggressive reshaping of teeth if needed

• Big makeovers in a short time

Senior-focused dentistry is about:

• Function before fashion – Can you chew a steak? Eat salad? Enjoy crunchy foods?

• Conservative choices – We try to preserve tooth structure and avoid putting the body through unnecessary stress.

• Planning around healing capacity – Older bone and soft tissues often heal more slowly, especially with diabetes or blood thinners in the picture.

  
  

I absolutely care about how your teeth look – because confidence and social connection matter at every age. But when I’m treatment-planning for a senior, I’m always asking:

“Will this help you stay healthy, independent, and comfortable – or just make the photos look better?”

Sometimes the answer is both. Sometimes the right answer is a simpler, more stable option.

The Mouth–Heart Connection in Older Adults

This is where my “holistic” brain lights up. Your gums are not isolated from your bloodstream. Long-standing gum disease (periodontitis) is essentially a chronic infection plus chronic inflammation right next to a major blood supply.

Large studies have found that:

• Older adults with multiple oral health problems (tooth loss, gum disease, dry mouth) have higher rates of all-cause mortality, cardiovascular disease, and respiratory deaths. Nature

• Periodontal disease is consistently associated with higher risk of heart disease and stroke, likely through inflammation and bacteria entering the bloodstream. CareQuest Institute+2Harvard Health+2

• Newer clinical trials suggest that treating severe gum disease can improve blood vessel function and slow early artery changes, which are risk markers for cardiovascular disease. Live Science+2ScienceDirect+2

Is gum disease the only cause of heart disease? No. But:

• Gum disease, diabetes, high blood pressure, high cholesterol, and obesity like to travel together. Harvard Health

• Chronic oral infection adds another load of inflammation for your heart, brain, and blood vessels to deal with.

For my senior patients, that means a deep cleaning or gum treatment is not just cosmetic. It’s a way to lighten the inflammatory burden on a body that may already be juggling heart disease, stroke risk, or diabetes.

Oral Health, Nutrition, and Frailty

Another piece we don’t talk about enough:

If your teeth hurt, your dentures don’t fit, or you’re scared of breaking a tooth, you will naturally avoid:

• Crunchy fruits and vegetables

• Nuts, seeds, and high-fiber foods

• Chewy proteins like meat and some plant-based options

Research in older adults has shown that poor oral health is associated with worse

nutrition, weight loss, frailty, and higher overall mortality.

So when I adjust a denture, place implants, or stabilize a broken tooth for a senior, part of my goal is very simple:

“Can we get you back to eating real, nourishing food – not just yogurt, mashed potatoes, and soup?”

Good dentistry here is about muscle, bone, and brain health, not just a nice smile.

Dental Care, Hip Replacements, and Major Surgery

If you’ve had (or are planning) a hip or knee replacement, heart valve surgery, or other major surgery, dentistry becomes part of the pre-op safety plan.

Why your surgeon or cardiologist cares about your mouth

• Dental procedures can briefly let bacteria into the bloodstream (this happens with daily brushing and chewing too).

• In a very small number of cases, those bacteria can lodge on artificial joints or heart valves and contribute to serious infections like prosthetic joint infection (PJI) or infective endocarditis. ADA+3aaos.org+3IDSA+3

Because of this:

• Many orthopedic and cardiac teams ask for dental clearance before major surgery – they want obvious infections, abscesses, or severe gum disease addressed ahead of time.

• Guidelines have evolved: large reviews show routine antibiotics before dental work do not significantly reduce prosthetic joint infection risk for most patient

• Antibiotic prophylaxis is now reserved for specific, higher-risk heart conditions or very high-risk joint situations, and decisions are made case-by-case between your dentist and your medical team.

In my practice, elder care dentistry around surgery looks like:

• Doing a thorough exam and X-rays to identify hidden infections

• Treating active abscesses or severe gum disease before surgery when possible

• Communicating with your orthopedic surgeon or cardiologist about your mouth status

• Deciding together whether antibiotics are appropriate for your specific health picture – not just following a one-size-fits-all rule

The goal isn’t to scare you; it’s to make sure your mouth isn’t the weak link in an otherwise carefully planned surgery.

What Elder Care Dentistry Looks Like at Floss & Fido

Here’s how we try to make senior dentistry feel safer, kinder, and more realistic in our Fircrest/Tacoma office:

1. Longer, calmer visits

We often schedule extra time so we’re not rushing:

• Reviewing medication lists

• Talking through medical history and upcoming surgeries

• Answering questions in plain English, not doctor-speak

2. Gentle, tailored cleanings

For many older adults, “just a regular cleaning” is no longer enough:

• We screen for gum disease and root decay

• We adjust techniques for sensitive gums, dry mouth, and thinner enamel

• If needed, we plan deep cleanings (scaling and root planing) carefully around your health and schedule

3. Focus on “right-sized” treatment

Instead of automatically recommending the most expensive or aggressive option, we:

• Consider your age, health, finances, and goals

• Offer phased treatment plans – prioritizing infection, pain, and function first

• Discuss pros/cons of implants, dentures, partials, and bridges in a realistic way

4. Anxiety & sensory support – at any age

A lot of my senior patients also have dental trauma, anxiety, or sensory sensitivities. Our practice leans on:

• Calming music, nature-inspired design, and art

• Therapy-animal-friendly visits for those who benefit from furry support

• Extra explanation and “tell–show–do” so nothing feels like a surprise

5. Coordination with your medical team

For complex cases, I’m happy to:

• Share X-rays or notes with your physician or surgeon

• Discuss timing of dental treatment around chemotherapy, radiation, joint replacement, or heart procedures

• Help decide when (and if) antibiotic prophylaxis makes sense for dental visits

When Should Seniors See a Dentist?

If you or a loved one is:

• Struggling with loose or painful dentures

• Noticing bleeding gums, bad breath, or loose teeth

• Planning a hip/knee replacement, heart procedure, or major surgery

• Skipping crunchy foods because chewing feels hard or risky

• Feeling embarrassed about smiling in photos

…those are all good reasons to schedule a visit with a dentist who understands elder care.

You don’t have to be “perfectly healthy” to deserve thoughtful dental care. In fact, the more medically complex things get, the more important it is to have a dentist who sees your mouth as part of your whole body, not a separate project.

A Personal Invitation

If you’re in Fircrest, Tacoma, Lakewood, University Place, or the surrounding area and you’re wondering whether your mouth is helping or hurting your overall health, I’d love to meet you.

We’ll sit down, look at your teeth, gums, dentures, and medical history together, and build a plan that fits your season of life – whether that means stabilizing things before surgery, getting you back to eating the foods you love, or simply making sure your smile matches how you feel on the inside.

You’re not “too old” for good dentistry. Your smile is part of your story – and I’d be honored to help you care for it.