Good Dental Care is Key to Overall Health as We Age

Dental professionals typically focus on different issues across the lifespan. In mid-life (ages 35-55), it is important to check the teeth and gums for common issues such as fractured molars, decay, and gum disease. More mature adults (ages 55-75) often find that their existing dental restorations, like fillings, crowns, or bridges, start to wear down or become less effective. By age 75, several dental health challenges become more common, such as dry mouth, taste changes, decay on root surfaces, and tooth loss. We’ll take a look at each of these stages here.

 

Ages 35-55

Molars, especially the back teeth, are prone to fractures as we age due to wear and tear from chewing and grinding. Fillings, crowns, or even root canals may be necessary if a fracture occurs. 

Tooth decay can still be an issue in adulthood, especially in areas that are harder to clean, like between the teeth or around fillings. Daily brushing and flossing are essential preventive measures to help avoid decay. Regular check-ups help identify cavities before they cause serious damage. 

Gum disease becomes more common in this stage of life, often due to a combination of factors like poor oral hygiene, tobacco use, and hormonal changes. Left untreated, gum disease can lead to tooth loss. Periodontists, who specialize in the prevention, diagnosis, and treatment of gum disease, as well as dental implants, may be involved in treating more advanced cases of gum disease. 

Ages 55-75

This age is crucial for restorative care. Over time, fillings and crowns can wear down due to chewing forces, grinding, or even natural aging of materials. This can lead to compromised restorations that no longer protect teeth effectively. You may notice changes in tooth shape, wear patterns, or saliva production. Replacing worn restorations can prevent potential problems like decay underneath old fillings, fractures, or gum diseases, and ensure your teeth remain functional for eating, speaking, and maintaining a natural smile. 

A dentist may recommend upgrading old restorations with more durable materials like porcelain or composite resin to ensure that they last longer and provide better protection, which helps you keep your smile healthy and functional in your later years. Regular dental visits during this time will help ensure you’re maintaining optimal oral health.

Age 75 and Beyond

At this stage of life there are several dental health challenges that become more common. Many of these are influenced by the medications people are taking and the natural changes in the body that occur with age. For example:

• Dry mouth (Xerostomia): Medications commonly taken by older adults, such as those for high blood pressure, depression, or diabetes, can reduce saliva flow. Saliva has a protective effect and is key for washing away food particles and neutralizing acids, so a lack of it can lead to increased risk of decay, gum disease, and discomfort in the mouth. A dry mouth can also make it more difficult to chew and swallow.
• Taste changes: Medications, along with aging, can alter your sense of taste and reduce the function of your taste buds. This can affect appetite, nutrition, and breath freshness, and it can also make oral care less comfortable. 
• Decay on root surfaces: Aging gums naturally recede, exposing the root surfaces of teeth, which are softer and more vulnerable to decay than the enamel-covered parts of teeth. Plus, difficulty cleaning those exposed areas properly (due to physical limitations or dry mouth) can increase the risk of root decay. This issue can be harder to spot early on, and it can progress quickly once it starts. Proper brushing with a fluoride toothpaste and regular dental visits are key to addressing this concern.
• Tooth loss due to gum disease and/or decay: Gum (periodontal) disease and decay are two leading causes of tooth loss in older adults. Gum disease can lead to loosening of teeth, especially if untreated, and root decay can cause the breakdown of tooth structure. Both conditions are often made worse by dry mouth and poor oral hygiene. As teeth loosen or decay, tooth loss becomes more likely. 

So, how can seniors and their care partners manage oral health in later life? Here are a few tips:

• Drink plenty of water to help lessen dry mouth.
• Use a humidifier to keep air moist and help with dryness in the mouth. 
• Use over-the-counter saliva substitutes that help mimic saliva.
• Get regular dental check-ups for early detection of oral health issues with teeth and gums.
• Take special care to clean around the gumline and roots of the teeth. If you have trouble reaching certain areas, consider a electric/powered toothbrush or water flosser to help.
• Use fluoride toothpaste and mouth rinse to strengthen teeth and protect against decay.

How care partners (caregivers) can help:

• Pay attention to when dental appointments are scheduled. If none are made, gently offer to make one for your loved one and offer a ride, if needed.
  • Check to see whether your loved one has dental insurance. If not, offer to work with the dental office, as needed, to figure out payment options. Many offices offer CareCredit or other payment methods to ease the burden of sometimes costly dental work. 
  • Some communities have resources to assist with oral health care for those who cannot afford it otherwise. Contact your local Area Agency on Aging or other community ministries to inquire, as needed. 
• Pay attention to complaints about a dry mouth, pain when eating, sore gums, sensitive areas in the mouth, and other potential oral health issues. Gently ask questions to determine whether a dental visit might be needed. 
• If possible, notice oral hygiene habits. Can your loved one brush their teeth? Is it difficult for them? Would an electric toothbrush or water flosser make dental hygiene easier? Consider a softer bristle to protect sensitive gums, as well as alcohol-free mouthwash to reduce dry mouth and freshen breath.
• Stay alert to darkening teeth when your loved one smiles. This could be a sign that teeth are decayed and in need of care. 

Remember, where oral health is concerned, an ounce of prevention really is worth a pound of cure. Practicing good oral hygiene across the lifespan helps keep teeth and gums in good shape and can prevent the need for painful and expensive treatments in later life. 

 

ACAPcommunity wishes to thank Dr. Joshua Millsaps and Ms. Molly Cline, Registered Dental Hygienist (RDH), of Joshua M. Millsaps, DDS, PA in Hickory, NC, for their research and considerable contributions to this article.