How to take care of your teeth as you age
People are living longer, and so it’s important that they maintain good oral health. This can be challenging due to side effects of medication, arthritis and irregular dental visits. With more people retaining their natural teeth, rather than dentures, the complexity of their treatment increases.Dr. Michael Hanley, from Hanley Family Dentistry in Chester, Va., works with seniors, and says that one of the biggest changes is the decrease in saliva.
“So many seniors are taking multiple medications that have the side effect of reducing saliva production. Saliva has many functions: it lubricates the oral tissue, helps to digest carbohydrates, has antibacterial properties against microorganisms, flushes out food debris and it maintains a pool rich in phosphates and calcium which help buffer the effects of acid on the teeth. So you take away all of this and plaque has an easy time adhering to the tooth surface,” he says.
Many medications cause dry mouth side effects, including producing less saliva—which can contribute to cavities or decay. Medications that can cause dry mouth include antihistamines, many blood pressure medications, pain medications and chemotherapy.
Dr. Steven Perlman, of Perlman Family Dentistry in Hampton, Va., often works with seniors who attend nearby PACE Centers in Hampton and Newport News.
“Yes, a lot of the medications people are on can cause dry mouth. Most people don’t realize it. They can drink more water to keep their mouths moist, chew sugar-free gum or use xylitol gum or lozenges,” Perlman says.
While drinking more to help with dry mouth is recommended, sipping sugared beverages such as sweet tea, soda or coffee with sugar all day will increase decay and cavities. Water or unsweetened teas are better choices. The American Dental Association recommends using over-the-counter oral moisturizers, such as a spray or mouthwash, and drinking more water. This is another reason to carry a water bottle with you!
Another challenge of aging is osteoarthritis, or joint pain. Arthritis in the wrist or elbow can make grasping a brush difficult. Perlman recommends a powered brush, like a Sonicare or other electronic brush. “It works much more effectively with less effort. It also makes it a bit easier to help someone with it as well,” he says.
A positive result in dentistry today is that preventive care has increased and when today’s youth are seniors, their teeth may be stronger or less susceptible to decay. But today’s seniors are also facing the history of non-fluoridated water, lack of preventive care and irregular dental visits.
“We’ve done a great job with prevention. The decay rate has gone down significantly. Preventive care, fluoridation and orthodontics have helped that. Education is better as well. People used to only go to the dentist when they needed a tooth pulled, and now they know to go regularly,” Perlman adds.
“But, once you create an environment for bacteria, your teeth are more vulnerable to disease and decay. Then the more decay you have, there are more places for bacteria to hide,” Perlman says.
Hanley says that with aging, issues with tooth roots become more common. “Regular checkups need to happen so the problem can be identified early and everyone has increased vigilance for better oral hygiene,” he says.
In nursing homes, dental care can be a challenge. “At the nursing home where I volunteer, we have a program to teach the staff how to care for patients’ teeth, which has been successful. But children of patients need to pitch in, too. After all, they helped you to brush when you were small and couldn’t take care of it yourself,” Hanley says.
Going to see the dentist regularly continues to be a challenge today. Seniors with mobility issues may need assistance transferring from their wheelchair to the dental chair. Also, Medicare does not cover regular dental visits, so people over 65 need to pay out of pocket for their dental care or find supplemental dental insurance through an organization like AARP.
Both dentists agree that prevention is the key. Try to be seen for a cleaning twice a year if possible. Perlman says the maximum amount of time you should let pass between visits is two years.
“You can go to the dentist, and they can take an X-ray, and it can look great. But if there was something that was not evident, by two years later, it could be huge. Never go longer than two years!” he says.
“Many patients have beautiful restorations and healthy teeth that they have taken great care of their entire lives. Then due to physical or mental decline, oral health can decrease rapidly. That’s when we all need to pitch in and help,” Hanley says.