Reprinted from the American Academy of Periodontology website.
Oral Health and Older Adults
People are living longer and healthier lives. And, older adults also are more likely to keep their teeth for a lifetime than they were a decade ago. However, studies indicate that older people have the highest rates of periodontal disease and need to do more to maintain good oral health.
Whatever your age, it's important to keep your mouth clean, healthy and feeling good. And it's important to know the state of your periodontal health.
- At least half of non-institutionalized people over age 55 have periodontitis.
- Older people have three times more tooth decay than children.
- Almost one out of four people age 65 and older have lost all of their teeth.
- Receding gum tissue affects the majority of older people.
- Periodontal disease and tooth decay are the leading causes of tooth loss in older adults.
What you may not realize is that oral health is not just important for maintaining a nice-looking smile and being able to eat corn on the cob. Good oral health is essential to quality of life. Consider a few of the reasons:
- Every tooth in your mouth plays an important role in speaking, chewing and in maintaining proper alignment of other teeth.
- A major cause of failure in joint replacements is infection, which can travel to the site of the replacement from the mouth in people with periodontal disease.
- People with dentures or loose and missing teeth often have restricted diets since biting into fresh fruits and vegetables is often not only difficult, but also painful. This likely means they don't get proper nutrition.
- Most men and women age 65 and older report that a smile is very important to a person's appearance.
- And, maybe most importantly, recent research has advanced the idea that periodontal disease is linked to a number of major health concerns such as heart disease, stroke, respiratory disease and diabetes.
While your likelihood of developing periodontal disease increases with age, the good news is that research suggests that these higher rates may be related to risk factors other than age. So, periodontal disease is not an inevitable aspect of aging. Risk factors that may make older people more susceptible include general health status, diminished immune status, medications, depression, worsening memory, diminished salivary flow, functional impairments and change in financial status.
Medications and Oral Side Effects
Older adults are likely to take medications that can impact oral health and affect dental treatment. Hundreds of common medications - including antihistamines, diuretics, pain killers, high blood pressure medications and antidepressants - can cause side effects such as dry mouth, soft tissue changes, taste changes, and gingival overgrowth.
Dry mouth leaves the mouth without enough saliva to wash away food and neutralize plaque, leaving you more susceptible to tooth decay and periodontal disease. In addition, dry mouth can cause sore throat, problems with speaking, difficulty swallowing and hoarseness. Your dentist or periodontist can recommend various methods to restore moisture, including sugarless gum, oral rinses or artificial saliva products. Be sure to tell your periodontist and other dental professionals about any medications that you are taking, including herbal remedies and over-the-counter medications.
Special Concerns for Older Women
Women who are menopausal or post-menopausal may experience changes in their mouths. Recent studies suggest that estrogen deficiency could place post-menopausal women at higher risk for severe periodontal disease and tooth loss.
In addition, hormonal changes in older women may result in discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour. In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition.
Most women find that estrogen supplements help to relieve these symptoms.
Bone loss is associated with both periodontal disease and osteoporosis. Osteoporosis could lead to tooth loss because the density of the bone that supports the teeth may be decreased. More research is being done to determine if and how a relationship between osteoporosis and periodontal disease exists. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth as well as other parts of the body.
More and more older people are selecting dental implants over dentures as a replacement option for lost teeth. Whether you have lost one or all of your teeth, dental implants allow you to have teeth that look and feel just like your own.
Older adults have similar success rate with implants compared with younger people. As long as you're in good health and your periodontist can restore healthy gums and adequate bone to support the implant, you're never too old to receive a dental implant.
A dental implant is an artificial tooth root placed into your jaw to hold a replacement tooth or bridge in place. While high-tech in nature, dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support.
In addition, dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Therefore, they prevent the bone loss and gum recession that often accompanies bridgework and dentures and preserve the integrity of facial features. When teeth are missing, the bone which previously supported these teeth begins to deteriorate. This can result in dramatic changes in your appearance, such as increased wrinkles around the mouth and lips that cave in and lose their natural shape.
Since periodontists are the dental experts who specialize in precisely these areas, they are ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own.
Talk with your periodontist to find out if dental implants are an option for you.
Denture wearers need to avoid plaque buildup that can irritate the tissues under the dentures. Thoroughly clean dentures daily and remove dentures at night to avoid bacteria growth. If you wear dentures, you need to continue to see a dental professional regularly. Because mouths continually change, dentures need to be checked for proper fit to avoid irritation, increased bone loss and infections. A change in the fit of partial dentures could indicate periodontal disease.
Perfecting Your Smile
Cosmetic periodontal procedures are not just for people in their 20s and 30s. You can have the smile you desire at any age.
A study by the American Dental Association and Oral-B in 1998 found that nearly half of survey respondents age 65 and older selected a smile as the first thing they notice about people. Almost 80 percent in this age group also reported that a smile is very important to a person's appearance.
Preventing Periodontal Disease
Even if you've managed to avoid periodontal disease until now, it is especially important to practice a meticulous oral care routine as you age. Receding gum tissue affects a large percentage of older people. This condition exposes the roots of teeth and makes them more vulnerable to decay and periodontal infection.
To keep your teeth for a lifetime, you must remove the plaque from your teeth and gums every day with proper brushing and flossing. Regular dental visits are also important. Daily cleaning will help keep calculus formation to a minimum, but it won't completely prevent it. A professional cleaning at least twice a year is necessary to remove calculus from places your toothbrush and floss may have missed.
If you have dexterity problems or a physical disability, you may find it difficult to use your toothbrush or dental floss. Your dentist or periodontist can suggest options such as an electric toothbrush or floss holder or a toothbrush with a larger handle.
Treating Periodontal Disease
In the earlier stages of periodontal disease, most of the treatment involves scaling and root planing, which means removing plaque and calculus in the pockets around the tooth and smoothing the root surfaces. In most cases of early periodontal disease, scaling and root planing and proper daily home care are all that are required for a satisfactory result. More advanced cases may require surgical treatment.
Once you've been treated for periodontal disease, periodontal maintenance procedures or supportive periodontal therapy enables you to gain control of the disease and increase your chances of keeping your natural teeth. In additional to a dental examination, a thorough periodontal evaluation is performed. Harmful bacterial plaque and calculus are then removed from above and below the gum line. If necessary, root planing may be used to smooth root surfaces that are infected. In addition, your periodontist or other dental professional will review your at-home oral hygiene routine and may suggest modifications tailored for your condition.