Q. I wear dentures now. Any pointers I should know about?

The following are some tips for eating with dentures:

Don't bite with your front teeth or pull your food outward from your mouth.

Chew food on both sides of your mouth simultaneously to stabilize your dentures.

Cut food into small pieces.

When you first eat with your dentures, you should avoid sticky foods, raw vegetables and hard-to-chew meats.

It is more difficult to feel inside your mouth when you wear dentures, so be careful with hot foods and anything with small bones.

And here are some challenges that usually confront denture-wearers:

Speaking is a different experience. You should try speaking slowly at first, and practice by reading aloud.

You may have more saliva in your mouth.

When you sneeze, cough or yawn, your dentures may loosen.

Dentures have to be removed at least once daily to rest the tissue below them. Most denture-wearers remove their plates before bed, and store them a cleaning solution.

After you have been wearing dentures for years, your jaws become smaller, and the dentures don't fit as well. Slippage, gum irritation and odor indicate that your dentures may not fit correctly.

Q. I've been having some difficulty swallowing food. Should I be worried?

You shouldn't worry about occasional difficulty swallowing. Persistent swallowing problems, though, can be a symptom of a serious condition, so it is something to be concerned about. I'd get it checked out by a physician as soon as possible.

Difficulty swallowing, called dysphagia, can occur with aging.

As we get older, the esophagus, the tube that connects your throat to your stomach, loses its ability to move food downward. So, while difficulty swallowing can happen to anyone, it is most common in older adults.

There are a variety of causes for dysphagia. Probably the most common causes for occasional problems are chewing improperly or gobbling food.

Dysphagia can impede nutrition and hydration. And, if food or drinks get into your windpipe when you're trying to swallow, you can suffer from respiratory problems, including pneumonia.

Occasional dysphagia can be prevented by chewing thoroughly and slowing down when you eat.

Q. I may need dialysis. What are my options?

If your kidneys aren't working properly, unwanted substances in the blood can be removed through dialysis. Most people who need dialysis can lead a reasonably normal life.

There are two types of dialysis: hemodialysis or peritoneal dialysis.

In hemodialysis, a patient is connected to an artificial kidney. The mechanical kidney, or dialyzer, filters the blood and then it is returned to the patient. The treatment time typically lasts three to four hours. Most people suffering chronic kidney failure require hemodialysis three times a week. Hemodialysis can be done in a healthcare facility or at home.

In peritoneal dialysis, the filter that is used is the peritoneum, the large, blood-rich membrane lining the abdomen and the organs within it. A fluid is sent into the abdominal cavity via a catheter inserted into the abdominal wall. This fluid (dialysate) is left in the cavity long enough to absorb blood wastes. Then the fluid is drained and replaced.

More than half of those on long-term dialysis are 60 or older. Older people often adapt more easily than younger people to long-term dialysis. However, seniors are more likely to find the treatments tiring.

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