How oral health changes with age

Created date

April 19th, 2018
Just like our bodies, our teeth change over time.

Just like our bodies, our teeth change over time.

The American Dental Association recommends that most people see a dentist every six months—not only to have cleanings, but because your dentist can spot problems before they progress too far. As you get older, these dental visits become especially important.

Age matters

“Changes can occur in your mouth as you age,” says June M. Sadowsky, D.D.S., M.P.H., dentist geriatrician and associate professor in the Department of General Dentistry and Dental Public Health, UTHealth School of Dentistry in Houston, Tex. “Your teeth may shift because of tooth loss, and you may lose gum tissue due to periodontal disease. The greatest rate of oral cancer is in seniors, so oral screening exams are necessary on a regular basis.”

Chronic illnesses can have a negative effect on your mouth tissue. “Cardiac conditions and arthritis affect oral health because these diseases are associated with inflammation, and the inflammatory response affects the oral cavity,” Sadowsky explains.

“Diabetes is a special concern,” Sadowsky adds. “This condition has a poor healing component, and the inability to fight bacterial infection in your gums is devastating to the tissue surrounding the teeth.”

Taking medications for chronic conditions puts you at risk of oral health problems because a common side effect is dry mouth.  “Your saliva contains protective elements and a lack of it can lead to increases in decay-causing plaque and decreases in the ability to talk and swallow food,” Sadowsky says.

“Medications for allergies, pain, inflammation, urinary incontinence, and Parkinson’s disease, as well as antidepressants and heart and blood pressure medications are just a few examples of medications that can cause dry mouth,” says Vrinda Suneja, M.D., medical director at Fox Run, an Erickson Living community in Novi, Mich.

“Ask your physician if there is another drug in the same class that you might take that may lessen dry mouth or if your dose can be modified,” Sadowsky says. “Sometimes taking the drug at a different time, such as at night, can help because symptoms aren’t as bothersome when you are sleeping.”

“Check with your doctor about the best time of day to take medications,” Suneja adds.

Special mouthwashes and lozenges can ease dry mouth. Drinking plenty of liquids also helps. “Artificial saliva in a spray form is very easy to use,” Sadowsky says. “Symptoms may stay away for hours.”

Periodontal disease

Any gum infection, no matter how mild, is considered periodontal disease. According to the National Institute of Dental and Craniofacial Research, about 17% of adults over 65 in the U.S. have some form of periodontal disease, and over 10% have moderate to severe forms. Periodontitis, the most advanced form, can lead to tooth loss and cause tissue and bones supporting the teeth to break down.

“Periodontal disease may not cause pain until there is mobility or tenderness in the teeth,” Sadowsky says. “Frequently, the first sign of periodontal disease is bleeding gums or spitting out blood when brushing your teeth. You must visit the dentist at this point to find the best way to take care of the problem.”

Oral prosthetics and dental care

Plaque forms on all surfaces of your mouth, whether you have your natural teeth or not. “The mouth is aging just as the entire body is,” Sadowsky says. “Those changes affect the fit of dentures and the health of mouth tissue.”

“Too often, seniors neglect their oral health, especially if they no longer have their natural teeth,” says Carl Driscoll, D.M.D., chief of prosthodontics at University of Maryland Dental School in Baltimore, Md. “People who have dentures or have had teeth restored or replaced still need to see a dentist, no matter how old they are.”

Dentures or other oral prosthetics can take time to get accustomed to, and they need meticulous care. Dentists recommend that you remove dentures once a day and clean them thoroughly with a product designed for denture care. Brush all surfaces of your mouth including gums, tongue, insides of your cheeks, and roof of the mouth with a soft-bristled brush.

People who have implants need to care for them as if they were natural teeth, except they may need a special type of brush.

Keep it clean

Older adults need to rethink their at-home mouth care routine. “Think of the process as cleaning your teeth, not just brushing them,” Sadowsky says. “Think of each tooth as having five sides and all sides need to be cleaned, not just brushed. Ask the dentist or hygienist if you are doing a sufficient job and how can you do better.”

Cleaning your mouth includes using floss and mouth rinses. “Use interproximal brushes if spaces are too big for floss,” Sadowsky recommends. “Use a fluoride rinse as well as fluoride containing toothpaste to prevent cavities. It has been shown that fluoride is very good for the teeth of seniors.”

Dental problems are preventable and curable. “Prevention is most economical,” Sadowsky says. “Remember what George Burns said, ‘If I knew I was going to live this long, I would have taken better care of myself.’ You may live 10 to 15 more years than you think. You need to keep your mouth healthy.”

Did you know?

Research shows that people with rheumatoid arthritis are more likely to have periodontal disease, and people treated for periodontal disease have a greater chance of having arthritis.