Older patients may have difficulty in removing plaque due to interproximal and furcal concavities, open gingival embrasures, and use of fixed and removable prostheses. In addition to anatomical barriers to plaque removal, some older patients may not be able to tell whether the mouth is clean.
Oral stereognosis - the ability to manipulate and identify objects and textures in the mouth - may be compromised in advanced age and is certainly diminished by xerostomia and/or denture use. This contributes further to food retention and promotes oral disease. Patients should perform oral care procedures and oral self exams more frequently; more frequent recall visits may be advisable as well.