Your Teeth Can Last a Lifetime
May is Older Americans Month, focusing on education about preventative health care and maintaining a healthy lifestyle. As we age, we experience changes to our bodies. It’s a fact of life. Our teeth and gums are also subject to transition, and older adults are prone to significant dental problems. You may wonder why you’re suddenly getting cavities when you haven’t had them in years. Food may be getting caught between your teeth where you never had space before. Many of these problems can be improved with just a simple daily oral hygiene routine and regular preventative dental care exams and cleanings at Alabama Family Dentistry. Our dentists are extremely competent in handling dental problems that arise in later life.
What Kind of Changes Occur as We Age?
As we add on the years, the tissues in your mouth, like other body tissues, begin to transform, and in turn affect other functions in the mouth. As well, your mouth may become irritated more easily and take longer to heal than when you were younger. What kind of changes are typically associated with aging?
Soft Tissues: Fleshy tissues in the cheeks and gums begin to lose its ability to stretch, and muscles become softer and weaker.
Reduced Saliva: The amount of saliva produced by glands in your mouth may decrease, resulting in difficulty chewing. However, dry mouth is not a normal part of aging. It is more commonly a side-effect of medications, particularly those for allergies or asthma, high blood pressure, high cholesterol, pain, anxiety or depression, Parkinson’s disease and Alzheimer’s disease.
Tooth Decay: As we get older, we enter a second round of cavity prone years. Dry mouth contributes to the development of cavities, because the acid causing bacteria and resulting plaque are not naturally washed away. Tooth decay in older adults appears most frequently around the teeth at gum level, exposing the root portion of a tooth, which is especially prone to decay. Decay at the gumline or in the root typically leads to the necessity for a crown or a root canal instead of amalgam filling restoration, because decay often reoccurs around this type of filling soon after it is placed.
Periodontal Disease: This disease, characterized by red and swollen gums that bleed with the slightest irritation, ranges in varying degrees in older adults depending on past quality of oral care. As gums recede from the base of the tooth, pockets can develop between teeth and gums, trapping food debris, leading to even more decay and irritation. If not treated in a timely manner, the destruction to the gums and bone multiplies, and can lead to tooth loss, at which point a dental implant or a bridge may be the remaining option.
Brittle Teeth: In younger years, nerve tissue and blood vessels found in the pulps of teeth are responsive to pain and hot or cold. Through the years, the pulp gradually becomes smaller as the amount of blood vessels and nerve tissue decreases. As fluid content declines, teeth become brittle and can easily break or chip. Pain from a tooth fracture may be diminished due to the reduced nerve tissue, the downside of which is that a person may be unaware that the tooth has chipped if not easily visible. Bonding or a veneer may be required to repair the damage.
Excessive Wear and Tear: Teeth wear because of the grinding action of chewing. Tooth enamel becomes thinner. In severe cases, the hard enamel covering is completely worn away leaving a softer part of the tooth (dentin) exposed. Dentin can be dissolved by acidic oral fluids. Teeth with only a fragile enamel shell may result. These teeth are easily chipped or broken.
Other Types of Age Related Dental Problems
Oral Cancers: The incidence of oral cancer appears to increase with age. About 3% of all identified cancers are found in the jaws, lips, tongue and roof of the mouth. Surgical treatment often results in loss of a portion or all of the jaws, tongue or palate, often resulting in facial disfigurement and serious impairment of chewing ability , particularly with more severe cancers. Radiation therapy, while less invasive, generally results in a reduced amount of saliva, leaving tissues easily irritated and teeth subject to rapid decay. That is why it is so important to schedule exams where our dentists screen for oral cancers.
Systemic Diseases: Evidence of a disease occurring elsewhere in the body is sometimes noted in the mouth. Disorders such as those of the blood system (anemia) or diabetes are sometimes accompanied by inflammation and reduced healing capacity of the gums.
Drug Therapy: Treatment of some diseases (heart disease, high blood pressure, depression, Parkinson’s disease) uses a regimen of many medications. A common side effect of these medications is a decrease in the amount of saliva, which results in a very dry mouth. An increase in the incidence of decay, periodontal disease, and an inability of gums and ridges to tolerate dentures can be expected.
Tolerance to Dentures: It is estimated that nearly half of the dentures worn by elderly persons are ill-fitting and potentially harmful. How well one adapts to dentures depends largely on the ability of the remaining ridges in the mouth to provide the necessary support. Typically, after teeth are removed, the remaining bone (ridge) continuously shrinks to a smaller size, and the gum tissue covering the ridge becomes thinner and more easily irritated. The denture no longer adapts to the contours of the gums. As a result, chewing hurts and you don’t chew as well.
Mature Mouth Care
Accumulation of food debris, plaque or solidified plaque increases the rate of tooth decay and gum disease. Good oral hygiene is perhaps the simplest and most efficient means to promote comfort and help reduce the dental problems associated with aging. However, dexterity may be an issue for many older people, and a little ingenuity can go a long way in fostering good oral care practices. Older adults confined to a bed may seem to have so many health problems that it’s easy to forget about oral health. However, bacteria from the mouth can be inhaled into the lungs and cause pneumonia, so assistance with oral care is critical. Alabama Family Dentistry recommends:
• Brush teeth, gums and tongue at twice a day with a medium soft bristle brush and tartar control toothpaste. If holding the toothbrush is difficult, modifications to the handle can be made with: a rubber strap, a larger handle, or a longer handle.
• Flossing daily is important. However, since flossing takes practice and is difficult if you have limitations in arm and finger movements, pre-strung plastic picks may come in handy to reach those tight spaces.
• Rinsing with warm water helps dislodge food particles that get stuck in teeth, especially if bone loss is an issue and new spaces between teeth have developed, or if difficulty brushing is a problem. Note: this is not an acceptable substitute for brushing.
• Mouthwashes containing alcohol can irritate drier mouth tissues. Substitute with alcohol free products, or dilute the mouthwash with water.
• When it is impossible for older adults to brush or rinse, even with aid, wiping teeth and gums with a wet piece of gauze will remove some of the debris.
• Many mechanical aids have been developed to improve oral hygiene that have a practical application for the elderly, including:
• Electric tooth brushes;
• Water irrigators, used with care to prevent particles from being pushed into pockets between your teeth and gums, can help remove particles from between teeth;
• When gums have receded, the use of interdental cleaners – handles with small changeable brushes – can reach hard to reach spots;
• Oral lubricants or prescription topical medications can ease some of the problems created by a dry mouth and reduce irritation caused by dentures rubbing on the underlying tissue or dry cheeks rubbing on the denture teeth.
What About Dentures?
For many older adults, due to a number of reasons, teeth need to be extracted and dentures fitted to replace them. Wearing dentures requires a proper oral care regimen, because dentures accumulate calculus like the teeth they replace. Not only should they be removed after eating and rinsed with warm water, the mouth should also be thoroughly rinsed before replacing them. At night, dentures should be scrubbed with a stiff brush and commercial denture cleaning cream to remove deposits, then soaked overnight in a cleaning solution. Consult your Alabama Family Dentist to help establish a routine to provide you with the most efficient means of cleaning your dentures and gums.
Why Are Some Older Adults Reluctant to Seek Dental Care?
Statistics indicate that people are living longer, so it follows that teeth and gums need to last longer. Alabama Family Dentistry wants to help you maintain a healthy mouth. Yet as people age, some may start to avoid dental appointments. Why?
Fear of Pain: Dental procedures are often associated with pain. Yet a decrease in nerve fibers renders older adults less susceptible to oral pain. Perhaps the recollection of the sting of anesthesia shots, the feeling of the dentist’s hands in the mouth, or the whine of the drill is the subconscious deterrent.
Why Bother Attitude: The feeling of “since I am old and won’t be around much longer, I do not need dental care” is not uncommon. It may not make sense to spend money on dental procedures. But dental health is important at any age, as neglect can lead to loss of teeth, problems eating, pain, even heart issues. Plus, having a healthy mouth can often improve an older adult’s psychological outlook.
Bottom Line is Cost. Many elderly, because of their fixed income situation, feel that they cannot afford dental care. It is one of the things they may feel is expendable, perhaps because of reduced longevity. However, regular dental visits are important because early stages of oral cancer typically do not cause pain and early detection saves lives, and keeping your teeth healthy is less expensive than waiting until they are damaged to take action.
Alabama Family Dentistry believes that everyone deserves quality dental care – no matter what your age. Caring properly for your teeth helps maintain their appearance, function and comfort at every stage of life. Ensure you are receiving the best care possible and schedule an appointment at one of our four locations, convenient to patients living in Birmingham, Gardendale, Warrior, Sumiton, and surrounding central Alabama communities. We can help you establish a daily routine tailored to your needs and prioritize any dental care issues.