A healthy smile is a bonus at any age. Too often older people, especially those who wear false teeth (dentures), feel they no longer need dental checkups. If you haven't learned the basics of oral health care, it is not too late to start. And even if you have, it's a good time to review.
Tooth Decay (Cavities)
Tooth decay is not just a children's disease; it can happen as long as natural teeth are in the mouth. Tooth decay is caused by bacteria that normally live in the mouth. The bacteria cling to teeth and form a sticky, colorless film called dental plaque. The bacteria in plaque live on sugars and produce decay causing acids that dissolve minerals on tooth surfaces. Tooth decay can also develop on the exposed roots of the teeth if you have gum disease or receding gums (where gums pull away from the teeth, exposing the roots). Decay is most prevalent in the grooves and pits on the biting surfaces of back teeth and the surfaces in between the teeth.
Just as with children, fluoride is important for adult teeth. Research has shown that adding fluoride to the water supply is the best and least costly way to prevent tooth decay. In addition, using fluoride toothpastes and mouth rinses can add protection. Fluoride for daily rinses can be bought at most drug stores without a prescription. If you have a special problem with cavities, your dentist or dental hygienist may give you a fluoride treatment during the office visit. The dentist may prescribe a fluoride gel or mouth rinse for you to use at home.
Gum (Periodontal) Disease
A common cause of tooth loss after age 35 is gum (periodontal) disease. These are infections of the gum and underlying bone that hold the teeth in place. Gum diseases are also caused by the bacteria in dental plaque. The bacteria produce an acid or enzymes that cause the gums to become inflamed and bleed easily. If left untreated, the disease gets worse as pockets of infection form between the teeth and gums, causing the supporting bone to dissolve away. If left unchecked you may lose enough bone to cause your teeth to become loose, and eventually require extraction.
You can prevent gum disease by routinely removing plaque. Thoroughly brush and floss your teeth each day. Carefully check your mouth for early signs of disease, such as red, swollen, or bleeding gums. See your dentist regularly every 6-12 months - or at once if these signs are present.
Cleaning Your Teeth and Gums
An important part of good oral health is knowing how to brush and floss correctly. Thorough brushing each day removes plaque. Gently brush the teeth on all sides using fluoride toothpaste. Circular and short back-and-forth strokes work best. Take the time to brush carefully along the gum line. Lightly brushing your tongue also helps to remove plaque and food debris and makes your mouth feel fresh.
In addition to brushing, using dental floss is necessary to keep the gums healthy. Proper flossing is important because it removes plaque and leftover food that a toothbrush cannot reach. Your dentist or dental hygienist can show
An antibacterial mouth rinse, approved for the control of plaque and swollen gums, may be prescribed by your dentist. The mouth rinse is used in addition to careful daily brushing and flossing.
Some people (with arthritis or other conditions that limit motion) may find it hard to hold a toothbrush. To overcome this, the toothbrush handle can be attached to the hand with a wide elastic band or may be enlarged by attaching it to a sponge, styrofoam ball, or similar object. People with limited shoulder movement may find brushing easier if the handle of the brush is lengthened by attaching a long piece of wood or plastic. Electric toothbrushes are very effective and helpful to many.
Other Conditions of the Mouth
Dry mouth (xerostomia) is common in many adults and may make it hard to eat, swallow, taste, and speak. The condition happens when salivary glands fail to work properly as a result of various diseases or medical treatments, such as chemotherapy or radiation therapy to the head and neck area. Dry mouth is also a side effect of more than 400 commonly used medicines, including drugs for high blood pressure, antidepressants, and antihistamines. Dry mouth can affect oral health by increasing the risk of tooth decay and infection.
Until recently, dry mouth was regarded as a normal part of aging. We now know that healthy older adults produce as much saliva as younger adults. If you think you have dry mouth, talk with your dentist or doctor. To relieve the dryness, drink extra water and avoid sugary snacks, beverages with caffeine, tobacco, and alcohol - all of which increase dryness in the mouth. There are certain perscription drugs which can help the mouth produce as much saliva as possible from damaged salivary glands.
Cancer therapies, such as radiation to the head and neck, or chemotherapy can cause oral problems, including dry mouth, resulting in tooth decay, painful mouth sores, and cracked and peeling lips. Before starting cancer treatment, it is important to see a dentist and take care of any necessary dental work. Your dentist will also show you how to care for your teeth and mouth before, during, and after your cancer treatment to prevent or reduce the oral problems that can occur. Flouride rinses are a good idea if dry mouth occurs.
Oral cancer (mouth cancer) most often occurs in people over age 40. The disease frequently goes unnoticed in its early, curable stages. This is true in part because many older people, particularly those wearing full dentures, do not visit their dentists often enough and because pain is usually not an early symptom of the disease. People who smoke cigarettes or use other tobacco products are at increased risk for oral cancer.
It is important to spot oral cancer as early as possible, since treatment works best before the disease has spread. If you notice any red or white patches on the gums, cheeks, or tongue, sores that do not heal within two weeks, or if you have difficulty chewing or swallowing, be sure to see a dentist.
A head and neck exam, which should be a part of every dental check-up, will allow your dentist to detect early signs of oral cancer. A tongue exam is also important, focusing on the back and the sides of the tongue.
If you wear false teeth (dentures), keep them clean and free from food that can cause stains, bad breath, and gum irritation. Once a day, brush all surfaces of the dentures with a denture care product. Remove your dentures from your mouth and place them in water or a denture cleansing liquid while you sleep. It is also helpful to rinse your mouth with a warm salt water solution in the morning, after meals, and at bedtime.
Partial dentures should be cared for in the same way as full dentures. Because bacteria tend to collect under the clasps of partial dentures, it is especially important to clean this area. Also, pay particular attention to brushing the gums of the anchor teeth.
Dentures will seem awkward at first. When learning to eat with false teeth, select soft non-sticky food, cut food into small pieces, and chew slowly using both sides of the mouth. Dentures may make your mouth less sensitive to taste, hot foods and liquids, and lower your ability to detect harmful objects such as bones. If problems in eating, talking, or simply wearing dentures continue after the first few weeks, see your dentist about making adjustments.
In time, dentures need to be replaced, adjusted or realigned because of changes that occur in tissues of your mouth. Do not try to repair dentures at home. This may damage the dentures, which in turn may further hurt your mouth or the dentist's ability to repair them.
Dental implants are anchors that permanently hold replacement teeth. There are several different types of implants, but the most popular are metal screws surgically placed into the jaw bones. These are called asseointergrated implants and are usually made of titanium oxide material. If there isn't enough bone to hold the imbedded implant, a separate surgical procedure to add bone may be needed. Because bone heals slowly, treatment with implants can often take longer (4 months to 1 year or more) than bridges or dentures. If you are considering dental implants, it is important to select an experienced dentist with whom you can discuss your concerns frankly to be certain the procedure is right for you. Cost may be an important factor for you so a thorough understanding is vital to your satisfaction.
In addition to practicing good oral hygiene, it is important to have regular check-ups by the dentist whether you have natural teeth or dentures. It is also important to follow through with any special treatments that are necessary to ensure good oral health. For instance, if you have sensitive teeth caused by receding gums, your dentist may suggest using a special toothpaste or a desensitizing gel for a few months. Teeth are meant to last a lifetime. By taking good care of your teeth and gums, you can protect them for years to come.
The National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057