Senior Dental Care – Oral Changes With Age
Gordon Dentistry has found that senior dental care has increased steadily since dental care for seniors now focuses more on natural teeth. Although the nature of tooth decay changes somewhat as people age, senior dental care has greatly improved. Seniors wearing dentures or dental implants have realized the value of proper denture care and how to deal with age-related maladies such as xerostomia.
Isn’t tooth loss inevitable in the later years?
No! Today, older adults are keeping their natural teeth longer because of scientific developments and the preventive emphasis in dentistry. This improvement was seen in the results of a survey released by the National Institute of Dental and Craniofacial Research. They showed that among persons aged 55 to 64, the rate of toothlessness dropped 60 percent since 1960.
Good oral hygiene and regular dental care are important throughout your life, whatever your age. By practicing good oral hygiene at home and visiting your dentist regularly, you will prevent dental problems and save time and money as well. In the process, you can save your teeth and gums.
Thorough daily brushing and flossing of your natural teeth are essential to keep them in good condition—especially as you age. Plaque, the sticky, colorless layer of bacteria that causes tooth decay and periodontal (gum) disease, can build up quickly on the teeth of older adults, particularly when they neglect oral hygiene. This can increase your risk for tooth decay and periodontal disease.
A few simple steps can help you maintain good oral health throughout your life. Brush your teeth twice a day with a fluoride toothpaste, and clean between your teeth daily with floss or interdental cleaners. Choose products that carry the ADA Seal of Acceptance, your assurance that the products have met the ADA’s standards for safety and effectiveness. Be sure to see your dentist regularly for exams and professional teeth cleaning.
Tooth decay is not just a child’s problem. Adults of all ages can have cavities. The causes for tooth decay are the same for everyone, regardless of age. Decay results when the bacteria in plaque feed on the carbohydrates (sugar) in our diet to produce acids that can cause cavities.
However, the nature of the decay problem does change somewhat as people grow older. Adults are more likely to have decay around older fillings, and because many adults grew up without the benefits of fluoride, they may have many more fillings. Decay of the tooth root is also common among older adults. Root caries (decay) occur when the gums recede, exposing the softer root surface, which decays more easily than tooth enamel.
Tooth decay is also promoted by dry mouth. This condition—called xerostomia—occurs when the supply of saliva is greatly reduced. It can be caused by many types of medications (such as antihistamines, anti-hypertensives and anti-depressants) or radiation therapy to the head or neck. Saliva is needed to lubricate the mouth, wash foods away and neutralize the acids produced by plaque. If allowed to continue, dry mouth can lead to rampant tooth decay. If you think you have this problem, be sure to discuss it with your dentist or physician. They may recommend artificial saliva and fluoride products to help prevent decay.
I understand that periodontal disease is a major cause of tooth loss in adults, but is there anything I can do about it?
Gum disease—periodontal disease—often progresses slowly, without pain, over a long period of time. This is one reason why it is common among older adults. The longer the disease goes undetected and uncontrolled, the more damage it causes to gums and other supporting tissues. Although periodontal disease is caused by plaque, other factors can increase the risk or severity of the condition. These include food left between the teeth, smoking, smokeless (spit) tobacco use, badly aligned teeth, ill-fitting bridges or partial dentures, poor diets and systemic diseases such as anemia.
Although periodontal disease is common, it can be controlled or arrested. In its early stages, it can be reversed. Treatment of advanced cases may require surgery. Look for these warning signs and see your dentist if you notice any of them: bleeding gums when you brush; red, tender or swollen gums; gums that have pulled away from the teeth; pus between your teeth and gums when the gums are pressed; loose teeth or teeth that are moving apart; any change in your bite; any change in the fit of your partial dentures; constant bad breath or bad taste.
My dentures don’t feel as comfortable as they once did. Before I see the dentist, should I try some different products myself to try to improve them?
Your dentures were made to fit precisely. If they are cared for properly, they do not change shape. They can become loose due to natural changes in the gums and bone supporting them. As the jawbone begins to shrink, so do the gums. When your dentures do not fit properly, see your dentist as soon as possible so adjustments can be made. Do not try to change the fit of your dentures yourself. This can damage them and make them non-repairable. It could be a costly experiment! Ill-fitting dentures repaired at home can irritate the gums, tongue and cheeks. In emergencies, denture adhesives can be used to keep the dentures stable until you see the dentist. If your denture is loose, have your dentist check it.
Even if you no longer have your natural teeth, you should see your dentist regularly for an oral examination. The dentist will examine your mouth to check for any problem with the gum ridges, the tongue and the joints of the jaw, as well as screen for oral cancer. For a variety of reasons, many older adults are more susceptible to oral diseases, including oral cancer. About 95 percent of all cancers are found in people over age 40. However, many of these cancers are treatable if detected early. Oral tissues are also checked for signs of other diseases that can first manifest themselves in the mouth.
I find that some foods have become difficult to chew and swallow. Do I really need to eat the same amount or variety of food that I did when I was younger?
Maintaining proper nutrition is important for everyone of all ages. Many older adults do not eat balanced diets and avoid meats, raw vegetables and fresh fruits because they have trouble chewing or swallowing. These problems can be caused by painful teeth, ill-fitting dentures, dry mouth or changes in facial muscles. Others find their sense of taste has changed, sometimes due to a disease or certain medications. Because of these and other factors, the diets of older adults are often lacking in calcium, protein and other nutrients essential to dental and overall health. You need a balanced diet based on the five food groups—milk and dairy products; breads and cereals; meats and dried beans; fruits and vegetables. You may need a multi-vitamin or mineral supplement, but do not be your own doctor. Use these supplements only after discussion with your physician.
Anxiety over dental treatment is not unusual. People of any age can experience it. Older patients may be less able to cope with the stress due to certain physical conditions such as vision or hearing loss. Communication between you and your dentist is an important aspect of a comfortable dental visit. You should share your feelings with your dentist and the staff. Let them know that you are anxious so that they can adjust their treatment and their pace to meet your needs. Advances in pain and anxiety control, including many behavioral therapy techniques borrowed from psychology, have made dental visits relatively anxiety and pain-free.
I am currently taking medication that my physician prescribed for me. Can this affect my dental treatment?
When your dentist asks for your medical history, be sure to provide complete, up-to-date information on your health. Inform your dentist if you have experienced recent hospitalization or surgery, or if you have recently been ill. Also, tell the dentist the names, doses and frequency of any medications you are taking—whether prescription or over-the-counter products—and the name of your physician. Inform the dentist of any changes in your health or medications. This information will help the dentist to select the most safe and effective method of treatment for you.
Dental implants may offer solutions for patients who cannot function adequately with conventional dentures. However, not every patient is a candidate for implants. The decision can be made only after careful examination by your dentist, and discussion of the relative benefits and risks, and what the procedure involves. Ask your dentist if implants may be an option for you.
I’ve heard of some new cosmetic techniques that can improve smiles. Are they appropriate for older adults?
Older adults can benefit from many of the options available today for improving the look of a smile. Your dentist can describe and discuss with you the range of treatments that would be right for you. Part of older adulthood is the acceptance of aging and the development of realistic expectations for appearance. In that context, dental treatment for older adults can be a healthy and adaptive way of maintaining dental health and emotional well-being. Our teeth and mouth play a critical role in psychological development and well-being throughout our lives. Modern dentistry has expanded esthetic options for people of all ages. Coupled with good oral hygiene and regular dental visits, cosmetic techniques can help improve the appearance of your smile.
I’m on a limited, fixed income and can’t really afford regular dental treatment. Are there any resources available to help me?
Even if you cannot pay for senior dental care, you don’t need to live without it. Thousands of dentists across the country assist the elderly on fixed incomes by offering their services at reduced fees through dental society-sponsored assistance programs. The availability of such aid varies from one community to another, so call your local dental society for information about where you can find the nearest assistance programs and low-cost senior dental care locations, such as public health and dental school clinics. Other sources of such information are local social service organizations.
Dentists are experiencing a quiet revolution in their offices as the number of older patients increases steadily and their treatment centers more on natural teeth. The profession knows that this burgeoning population group is wearing fewer dentures and is keeping natural teeth longer. Also, we know that some patients in this group require special consideration because reduced mobility and dexterity may make daily oral hygiene difficult. In addition, medical conditions and impairment are factors that dentists take into account for certain patients. Sometimes, lack of awareness about available treatments and techniques leads older patients to make false assumptions about their dental health and tolerate conditions such as toothaches, bleeding gums and clicking dentures. Dentists are gaining practical information on how to effectively manage the treatment needs of older patients. Many dental societies have set up access programs to assist older adults, individuals with physical or mental disabilities and indigent persons to receive care.
Dentists are increasingly sensitive to the special needs and the importance of dental health in the older patient. Older adults are more health-conscious as a group than ever before. Their oral health is an important part of their overall health and the dental profession is committed to providing the treatment and guidance older adults need to maintain it.
One of the changes you may notice as you grow older is that it’s harder to keep your teeth clean and white. This is because the sticky, colorless layer of bacteria, called plaque, can build up faster and in greater amounts as we age. Changes in dentin, the bone-like tissue that is under your enamel, may also cause your teeth to appear slightly darker.
Reduced saliva flow that results in a dry mouth is a common problem among older adults. It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics. Some of the common problems associated with dry mouth include a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages. Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive cavities can form.
Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.
You may find that you are losing your appetite due to a change in your sense of taste. Several factors can cause this change. Besides an age-related decrease in the sense of taste and smell, certain diseases, medications and dentures can contribute to a decrease in your sense of taste.
Additional senior dental care topics which may be of interest to you: