Table 4.

Oral hygiene protocol for the elderly with polypharmacy.

Protocol for the Long-Term Use of Chlorhexidine in the Elderly
Concentration and Frequency: -Use a lower concentration of chlorhexidine (e.g., 0.12%) to minimise side effects. -Limit the use of chlorhexidine to a short period, such as two weeks, with periodic breaks to prevent staining of the teeth and other side effects. -If prolonged use is necessary, consider using chlorhexidine on a maintenance schedule, such as a few times per week.
Oral Health Assessment: -Regularly assess the patient’s oral health to determine the continued need for chlorhexidine. -Monitor for any signs of adverse effects, such as tooth staining or changes in taste sensation.
Patient Education: -Educate the patient on the proper use of chlorhexidine, emphasising adherence to recommended concentrations and application frequency. -Highlight the importance of reporting any unusual side effects promptly.
Protocol for the Long-Term Use of Fluoride in the Elderly
Fluoride Toothpaste: -Encourage the use of fluoride-containing toothpaste with at least 1000 ppm (parts per million) of fluoride. -Ensure that patients are aware of the correct toothbrushing technique and the amount of toothpaste to be used.
Fluoride Mouthwash: -Recommend a fluoride mouthwash with a lower fluoride concentration for daily use. -In cases where a higher concentration is necessary, use should be intermittent to prevent potential side effects.
Professional Application: -Consider professional fluoride applications during dental visits, especially for individuals with a higher risk of dental caries. -Assess the patient’s overall fluoride exposure, including drinking water fluoridation, to avoid excessive fluoride intake.
Regular Monitoring: -Monitor the patient’s oral health regularly, including assessing the fluoride levels in drinking water, to adjust fluoride recommendations accordingly.
Patient Compliance: -Emphasise the importance of compliance with the prescribed fluoride regimen. -Address any concerns or issues related to the taste or discomfort associated with fluoride use.
Protocol for Xerostomia Management in the Elderly
-Stay hydrated by drinking water regularly. -Use saliva substitutes or artificial saliva products to alleviate dry mouth symptoms. -Use sugar-free chewing gum or lozenges that can stimulate saliva production. -Avoid caffeinated and alcoholic beverages, as they can contribute to dry mouth. -Choose mild, alcohol-free mouthwashes to prevent irritation. -Consider antimicrobial mouthwashes if prescribed by a healthcare professional. -Schedule routine dental check-ups to monitor oral health and address any emerging issues promptly.