Common Dental and Oral Health Issues
One of the most frequent reasons for involuntary mouth movements in the elderly is related to dental and oral health. Years of wear and tear, coupled with common age-related changes, can lead to muscle weakness, ill-fitting prosthetics, and dryness, all of which contribute to unusual chewing or mouth motions.
Dentures and Tooth Loss
For many seniors, dentures are a necessary part of daily life. However, ill-fitting or uncomfortable dentures can cause a person to subconsciously make chewing motions to try and adjust them. The loss of natural teeth, a condition known as edentulism, can also trigger abnormal movements. The loss of sensory feedback from the ligaments that once surrounded the teeth can affect a person's proprioception, or awareness of their jaw position, leading to aimless, repetitive movements. This condition is specifically known as edentulous dyskinesia.
Dry Mouth (Xerostomia)
Dry mouth, or xerostomia, is a common issue in older adults, often caused by medication side effects or dehydration. When the mouth is dry, an individual may chew or move their mouth to try and stimulate saliva production. In severe cases, this can lead to discomfort and further dental problems. Addressing the underlying cause of dry mouth is critical for relief and improved oral health.
Weakened Facial Muscles
As we age, facial muscles can weaken and atrophy, much like other muscles in the body. This weakening can lead to subconscious chewing motions as the body attempts to keep the muscles active and maintain some level of function. This is often an unconscious effort to combat the natural effects of aging on muscle tone.
Neurological and Medical Explanations
Involuntary oral movements can also be a symptom of more complex neurological disorders or a side effect of medication. It is important to distinguish these causes, as their management can differ significantly.
Tardive Dyskinesia
Tardive dyskinesia (TD) is a neurological disorder characterized by repetitive, involuntary movements of the face, tongue, and limbs. It is most commonly a side effect of long-term use of antipsychotic medications, which are often prescribed for conditions like schizophrenia, bipolar disorder, and severe depression. Symptoms of TD often include lip-smacking, puckering, grimacing, and tongue protrusions. TD can be distressing and stigmatizing, and it's crucial for caregivers to recognize these symptoms and seek professional medical help.
Parkinson's Disease
Parkinson's disease (PD) affects the central nervous system and can cause involuntary movements, including tremors in the jaw and face. While facial tremors are less common than limb tremors, they can still occur and are more prevalent in older individuals and those who have had PD for a longer duration. Additionally, some medications used to treat PD, such as levodopa, can cause or worsen involuntary mouth movements.
Dementia and Perseveration
In some cases of dementia, patients may exhibit a behavior called perseveration, which is the repetition of a particular action, gesture, or phrase. This can manifest as constant chewing or mouth movements. The brain's failure to send the correct signals can also lead to the mouth hanging open. Caregivers may notice this behavior alongside other cognitive decline symptoms.
Other Movement Disorders
Several other, less common, movement disorders can cause involuntary mouth movements. These can be related to genetic factors, other medical conditions, or drug use. Conditions like Tourette syndrome, various dystonias, and even essential tremor can present with oral-facial movements, although they typically appear at a younger age or alongside other symptoms.
Addressing the Issue: What Can Be Done?
Because the causes are so varied, a proper diagnosis is the first and most critical step. A healthcare provider can help determine the underlying issue and develop an appropriate treatment plan. For caregivers, observation is a key tool for gathering information to present to a medical professional.
How Caregivers Can Help
- Monitor and Document: Keep a log of when the movements occur, what the person was doing beforehand, and any other correlating factors. This can help a doctor make a more accurate diagnosis.
- Oral Hygiene: Ensure proper and regular oral hygiene. For individuals with dementia or limited mobility, a caregiver may need to assist with brushing, flossing, and cleaning dentures.
- Encourage Hydration: If dry mouth is a factor, encourage regular sips of water throughout the day. Using sugar-free gums or candies can also help stimulate saliva production.
- Dental Check-ups: Regular dental visits are essential for checking the fit of dentures and addressing any other oral health problems. An older adult may not complain about a dental issue, so these visits are vital.
Medical Interventions
- Medication Adjustments: If the movements are a side effect of a drug, a doctor may be able to adjust the dosage or switch to a different medication. For TD caused by antipsychotics, some new medications are available that can help control the movements.
- Dental Correction: A dentist can refit or replace dentures to ensure a proper, comfortable fit, which may resolve movements related to edentulous dyskinesia.
- Specialist Referrals: Depending on the diagnosis, a doctor may recommend seeing a neurologist or other specialist for further treatment and management of neurological conditions.
Comparison of Common Causes
| Feature | Dental Issues | Tardive Dyskinesia | Parkinson's Disease |
|---|---|---|---|
| Primary Trigger | Ill-fitting dentures, tooth loss, dry mouth | Long-term use of certain medications (antipsychotics) | Neurodegeneration affecting dopamine |
| Movement Type | Chewing, adjusting motions, smacking | Lip-smacking, puckering, grimacing, tongue protrusion | Resting jaw/mouth tremor |
| Awareness | Often subconscious but may be aware of discomfort | Usually involuntary and often unaware of movements | Often aware of tremors |
| Onset | Gradual with dental changes or denture use | Delayed onset, appearing months or years after starting medication | Gradual onset and progression |
| Treatment Focus | Dental adjustments, improved oral hygiene, hydration | Medication changes, specialized drugs | Dopaminergic medications, other therapies |
Understanding and Empathy: The Caregiver's Role
Beyond medical and dental considerations, understanding the emotional and social impact is vital. Involuntary mouth movements can cause social embarrassment and distress for the senior, potentially leading to social withdrawal and isolation. Caregivers can offer reassurance, understanding, and a supportive environment. Simply acknowledging the issue and reassuring the person that it's a medical condition, not a personal failing, can make a significant difference.
For more in-depth information on movement disorders and how they affect the elderly, the American Parkinson Disease Association provides excellent resources on its website: https://www.apdaparkinson.org/.
Conclusion: A Multifaceted Issue Requiring a Comprehensive Approach
Answering the question of why do elderly move their mouths? requires a look at a range of possible causes, from simple dental problems to complex neurological disorders. It is rarely a single issue and often involves a combination of factors. By observing the behavior, consulting medical and dental professionals, and providing compassionate support, caregivers can help improve the comfort and quality of life for the seniors in their care. A proactive and informed approach ensures that the underlying causes are addressed effectively, leading to better outcomes for all involved.
