Keep Your Teeth and Keep On Smiling
True or false? You'll ultimately lose some or all of your teeth, and there's nothing you can do about it.
The answer is false, even though ]]>tooth decay]]> in later life is likely even with ongoing dental care. However, with good oral hygiene and proper dental care, seniors can retain all or most of their teeth. But the trick is that taking care of the gums is just as important as taking care of the teeth!
Proper Dental Care
Most tooth loss is caused not by cavities, but by ]]>gum disease]]> (periodontal disease). Gum disease results when bacteria enter the crevices between teeth and gums, where they create plaque. The presence of plaque causes an immune reaction that causes the gums to become inflamed. The inflammatory process eventually eats away at the structures that hold teeth in place.
Gum disease can be prevented by thoroughly brushing your teeth regularly (at least twice each day, and preferably after each meal and snack), and also flossing regularly. Evidence suggests that electric toothbrushes are more effective than manual ones. If you do use a manual toothbrush, use a soft bristled toothbrush held at a 45° angle. Be sure to brush the back, front, and bottom of all teeth. Also brush your tongue and the roof of your mouth. And replace your toothbrush every two to three months.
If you have a physical disability that makes grasping a toothbrush difficult, you may find an electric toothbrush easier to handle. But here are some low-budget fixes as well:
- Attaching the brush to your hand with an elastic band.
- Lengthening the handle by attaching a Popsicle stick or tongue depressor.
- Attaching a sponge or small rubber ball to the handle to make it easier to grasp.
If you don't want to create your own special handle, there are companies that make manual toothbrushes for people with grasping problems.
In addition to brushing, flossing at least once per day is necessary to remove plaque that forms between the teeth and below the gum line. When flossing, be sure to gently ease the floss between the teeth, and rub the floss gently along the side of each tooth and below the gum line. Don't forget to floss behind the back of the rear teeth! If you have extremely tight teeth, or extensive fillings—on which floss can catch and tear—try using waxed dental floss or dental tape.
If you have trouble handling the floss, you can tie the dental floss in loops to make it easier to handle or try using a commercial floss holder.
Mouthwashes containing essence of thyme (thymol), such as Listerine, can help reduce bacteria levels that cause periodontal disease.
Getting Regular Exams and Cleanings
Although brushing and flossing help greatly, they do not remove all of the plaque—especially the hardened plaque that is the main component of tartar. For this reason, you need to see the dentist at least once, preferably twice, per year for a cleaning to completely remove the plaque and to check for tooth decay and gum disease.
The risk of serious mouth diseases, such as cancer of the mouth, increases with age. Therefore, it's important to have your dentist closely examine any swellings, sores, or discoloration you notice anywhere in your mouth, jaw, cheeks, throat, tongue, or lips.
Though not as effective as when used in childhood, drinking fluoridated water and brushing with fluoride toothpaste (and using fluoride mouthwash) as an adult may help maintain healthy teeth and prevent tooth decay. The topic of ]]>fluoridated drinking water]]> is controversial, since some researchers believe it may negatively affect bone health.
Many seniors experience decreased saliva flow as a result of certain medical conditions or as a side effect of various medications. In addition to causing problems such as difficulty swallowing and eating, persistent hoarseness or sore throat and a dry, sensitive nasal passage, dry mouth can also lead to tooth decay. To alleviate the dryness, try sucking on sugar-free candy or chewing sugar-free gum—both of which help increase saliva flow. If that doesn't work, ask your dentist about the use of artificial saliva and oral rinses to help the problem.
Although starting proper tooth care later is better than never, it may not fully prevent the loss of teeth due to earlier poor dental and periodontal hygiene. In those cases where you do lose one or more teeth, it's very important to replace them in order to prevent misalignment and problems with your remaining teeth. Depending on which and how many teeth are lost, tooth replacement can come in one of the following forms:
- Bridges —Bridges are artificial teeth that attach to remaining healthy teeth adjacent to where a tooth or teeth have been lost or extracted. Bridges can either be attached permanently (via a crown placed over adjacent remaining teeth) or are removable (attaching via a small metal clasp or other attachment device).
—Dentures are artificial teeth that attach to gums via an adhesive. They are used when most or all of your teeth are lost or must be removed. While certainly not preferable to healthy, natural teeth, today's dentures are much more effective, comfortable, and cosmetically appealing than in the past.
- If you do wear dentures, be sure to practice proper denture care. This includes brushing and soaking your dentures daily, brushing and rinsing the gums thoroughly before inserting your dentures, and using a strong denture adhesive. And you should still have regular dental examinations, even if you have a full set of dentures.
- Implants —For patients with minimal tooth loss who are in good health and have adequate remaining bone (below where a tooth or teeth are lost), artificial tooth implants may be a viable option. Implants, which attach directly to the jawbone, are generally much more secure than bridges or dentures, and are maintained like natural teeth.
As we get older, teeth tend to become discolored and stained. To improve the appearance of your teeth, you may consider having your teeth professionally bleached or using a commercial tooth whitening product. For severely discolored or stained teeth, ask your dentist about veneer (tooth-colored material that is bonded to the teeth) or bonding, which paints a tooth-colored material onto your teeth.
Time for Your Teeth
Although you may be preoccupied with taking care of other parts of your body, don't neglect good dental care. After all, paying attention to your teeth is a very small price to pay for a healthy smile.
Academy of General Dentistry
American Dental Association
Canadian Dental Association
The Canadian Dental Hygienists Association
Dental health information for mature adults. American Dental Association website. Available at: http://www.ada.org/public/topics/mature/index.html .
A guide to oral health for seniors. California Dental Association website. Available at: http://www.dentalaccess.com/seniors.htm .
Senior oral health. American Dental Hygienists' Association website. Available at: http://www.adha.org/oralhealth/seniors.htm .
Last reviewed November 2009 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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