Effects of aging on your oral health
Growing older brings both rewards and challenges. For many, the biggest rewards include time – to play, partake in creative, cerebral and athletic passions, spend time with grandchildren. Increasingly, retirees are embracing exercise and fitness, leading to longer and healthier lives.
Maintaining good oral health requires a different sort of routine (which, regrettably, doesn’t have quite the allure of golf or pickleball). Since your oral health is deeply connected to your overall health, good dental habits are increasingly important as you grow older. Use time as your advocate to do everything you can from a prevention standpoint.
Dry mouth and its impact on your smile
The most significant factor in diminished oral health among older dental patients, dry mouth is more than just an uncomfortable annoyance. Dry mouth can cause bad breath and contribute to periodontal disease. And even more important, because dry mouth is a leading cause of tooth decay, it can be very detrimental to both oral and overall health.
Dry mouth is a common side effect of many medications, including those that treat high blood pressure or anxiety, as well as antihistamines, decongestants and pain relievers. Certain medical conditions, including diabetes, cancer, and many autoimmune disorders can also cause dry mouth. These medical conditions (or medications that treat them) can interfere with the signals that stimulate saliva production. Saliva provides protection for the teeth both by naturally flushing away plaque and food debris, and also neutralizing acidic food and drinks.
A lack of saliva greatly increases the incidence of tooth decay. One area that is particularly susceptible is along the gumline. Plaque accumulates naturally along the gumline area, and if not cleaned sufficiently (or frequently enough), will lead to tooth decay. Many older adults also have gum recession which causes the root surface of the tooth to be exposed, a part of the tooth that is much weaker than enamel and decays much more rapidly. This effect is exacerbated with dry mouth, since the natural flushing and neutralizing effects of the saliva are absent.
The primary remedies for dry mouth are preventative measures. Vigilant homecare is the first step: Increase brushing to three times daily and rinse vigorously with water after snacks and meals. High fluoride (prescription) toothpastes are also recommended, as are fluoride applications during hygiene appointments.
Not surprisingly, a key goal should be to drink more fluids – water, especially. Other recommendations include limiting alcoholic beverages, as well as drinks high in sugar or caffeine, and choosing alcohol-free mouthwash. While over-the-counter saliva substitutes or sugar-free gum can provide some relief, their effects tend to be temporary.
Lost teeth cause more than just lost confidence
Tooth loss can be attributed to various factors, including smoking, gum disease, cavities, medications, poor nutrition and trauma. Aside from the obvious inconvenience of difficulty chewing and trapped food associated with missing teeth, tooth loss poses other — and more weighty — health risks.
Without the ability to chew effectively, your diet will likely include primarily processed foods, which are softer and easier to chew, but also less healthy than whole foods. Because much of the fiber is lost during the processing, eating a diet high in processed foods can affect your gut and lead to other health and digestive problems. Processed foods tend to be lower in protein, vitamins and minerals and higher in sodium and fat. Perhaps not surprisingly, there is a correlation between tooth loss and a higher risk of cardiovascular disease.
Absent teeth are more than an unattractive annoyance; they can cause bite problems or pain resulting from the missing tooth. Even worse, because the functionality of your jawbone is supported by the pressure and stimulus of chewing, your jawbone can start to deteriorate if you lose a tooth and don’t replace it.
The importance of preventative action: Dental implants help restore the overall functionality of your mouth, including a healthy and functional bite, and can aid in the prevention of bone loss in the jaw. In some cases, implants can be handled within our office. For more complicated cases, we have strong relationships with specialists with whom we work closely.
Gum recession – a stealthy retreat
While some recession of the gums is a natural result of aging, it can also be caused by other factors, including vitamin deficiencies and smoking. Receded areas are essentially exposed root surface. The surface of the root is significantly weaker than the enamel, and is more prone to decay. In advanced cases, gaps will open up, and food debris can collect, furthering the likelihood of decay.
Physical challenges presented by symptoms of rheumatoid arthritis or Parkinson’s disease can limit the dexterity necessary for proper oral care; similarly, cognitive deterioration from Alzheimer’s or dementia can interfere with self-care, contributing to gum disease and recession. Aggressive brushing and bad home hygiene can also play a role in gum recession; however, generally, clenching or poorly positioned teeth are the primary cause.
Preventative actions: If not advanced, gum recession can often be kept in check by practicing proper oral hygiene at home. Twice daily, position a soft bristle toothbrush at a 45 degree angle to your teeth and brush gently using a non-abrasive toothpaste with fluoride. Follow with floss once daily. Use of an electric toothbrush and Waterpik can help avoid further deterioration.
In patients with advanced gum recession, we typically recommend fluoride treatments during hygiene visits.
No more pearly whites? Darkened or yellowed teeth
The most common cause of discolored teeth in older adults is simply aging. A significant percentage of those over 65 or 70 have some discoloration of the teeth. Contributing factors include certain medications, tobacco use, enamel erosion from coffee, tea, red wine or soda, as well as certain health conditions and poor oral hygiene. Over time, old silver fillings can contribute to a darkened appearance.
Steps you can take: While limiting the offending beverages will help minimize additional discoloration, darkened teeth won’t improve without treatment of some sort. Over-the-counter options including whitening toothpaste, over-the-counter whitening strips and whitening mouthwash can provide some mild improvement. However, to make any appreciable change, in-office professional whitening works much better.
Sad and sore: Your mouth with periodontal disease
Red, tender and swollen gums, pain when chewing, and tooth sensitivity can all present as symptoms of periodontal (gum) disease. Periodontal disease can be caused by multiple factors including certain medical conditions, smoking, poor diet, high sugar diet (which builds plaque) and a genetic predisposition to periodontal disease. However, poor oral hygiene is the most significant risk factor.
Certain systemic diseases link can increase an individual’s risk for periodontal disease. Among these are people with diabetes; in fact, periodontal disease is often considered a complication of diabetes, especially if the diabetes is not under control. Studies have shown that periodontal disease can increase risk of heart disease as well as pancreatic, kidney and blood cancers.
In a case of the chicken-or-the-egg, some research also suggests that it is the periodontal disease that contributes to the progression of other diseases — even more reasons to keep it at bay.
Avoiding or mitigating symptoms of advanced gum disease is straightforward. First, amp up your oral hygiene routine at home: Brush two to three times daily, floss daily, replace your toothbrush every three months, and use a fluoride rinse and antibacterial mouthwash regularly. Devices such as Waterpik and an electric toothbrush can produce better results.
Dental hygiene appointments at least twice yearly can help manage periodontal disease more effectively. When active periodontal disease is present, typical treatment involves scaling and root planing to remove dental plaque and tartar from beneath the gums; ultrasonic instruments may also be used to penetrate the deepest areas under the gums.
Healthy teeth, check. Get on with that happy life.
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