Aging doesn’t have to be a march toward tooth decline

People tend to accept, albeit grudgingly, that bodies deteriorate with age and become more susceptible to disease.

Yet when it comes to cavities, many people think they’re home free once they’ve passed a certain age.

“It’s a misconception that we stop getting cavities after the teenage years; in fact, we get more tooth decay as we age due to decreased saliva,” says Dr. David Villarreal, a dentist at BioDental Healing in Newbury Park, Calif.

Another misconception, which seems to contradict the first, is that we’re bound to lose a tooth – or several – if we live long enough, just as we’re bound to get cataracts. But tooth loss and denture use “are not inevitable,” says Dr. Dan Marut, a dentist and founder of Quality Dental Plan, headquartered in Reno, Nev.

However, there are oral care challenges specific to seniors, which can later become cause for concern for their caregivers.

1. Breaks and Stains

“Unfortunately, dental work doesn’t last forever and usually needs to be replaced over time,” Marut says. “Just think about how much wear and tear you subject your teeth to on a daily basis.”

Sleeping with a night guard “makes restorations last longer,” Villarreal says, but routine checkups are advised to monitor oral health including the condition of fillings, crowns and other restorations.

Dentures can irritate oral tissues – a problem made worse by sleeping in them. A dentist should check these tissues, as well as the fit of the dentures, at least once a year as dentures tend to loosen. “Then, you’re not able to chew as well,” Villarreal says, which can lead to digestive problems or even choking.

Discolored teeth at an older age “most of the time occurs because lots of us drink coffee, we eat blueberries, we drink wine,” Marut says. However, discoloration in a single tooth could signify a dead nerve and should be checked.

Depending on seniors’ oral health, the dentist might prescribe a different oral care regimen or special products. When it comes to care and cleaning, “use only what the dentist recommends, and don’t cut corners,” Marut says. “I hear stories of people using Comet, the kitchen scrub, not just on their dentures but on their real teeth to brighten them.”

2. Mouth Like Mojave

One of the most common and problematic changes to oral health as people age is dry mouth, or xerostomia. Medications are the most common cause.

Dry mouth can lead to tooth and root decay, gum disease, bad breath and a host of other oral health problems, says Dr. Chris Kirby, a dentist at Vaca & Kirby Dental Group in Longview, Texas. That’s because saliva lubricates oral tissues, washes away food particles and bacteria, and neutralizes acids that cause tooth decay. Decreased salivary flow allows harmful organisms to flourish in the mouth.

But that’s not all. Dry mouth can also cause difficulty speaking, chewing and swallowing, Kirby says.

The American Dental Association recommends that dry mouth sufferers sip water throughout the day and with meals; use sugarless gums or mints to stimulate salivary flow; and try alcohol-free oral rinses, sometimes called saliva substitutes or artificial saliva.

If medication is the suspected cause of dry mouth, seniors should not discontinue its use but address the concern with their doctor or pharmacist.

3. Get a Grip

Many seniors develop dexterity problems that make basic oral hygiene a daily frustration. “My best advice for patients with dexterity issues or debilitating arthritis is to use an electric toothbrush,” says Kirby, adding that an oral irrigator or floss picks for gum care as well as an antimicrobial rinse “as an adjunct” can round out an effective regimen.

“For patients who are unable to brush at a sink, there are products such as Colgate Wisp disposable brushes that do not require water or rinsing,’ Kirby says.

To better manage a manual toothbrush, the American Dental Hygienists’ Association recommends wrapping the handle in tape or inserting it into a sponge curler or tennis ball with a slit.

For many seniors, “There comes a time when caregivers play a critical role in oral health care,” Kirby says. “The most important thing is to remove plaque and food debris effectively.”

A dental hygienist can demonstrate how to administer care to a compliant individual.

Providing care to someone with dementia is considerably more challenging, so the Washington Dental Service Foundation partnered with the Alzheimer’s Association to develop illustrated “Oral Care Cards for Caregivers,” available at SeniorsOralHealth.org.

– Dawn Klingensmith