“Older teeth are more fragile, making them more prone to fracture and wear,” says Olivia Sheridan, professor of preventive and restorative clinical sciences at the University of Pennsylvania School of Dentistry. Illnesses that are more common with age, such as type 2 diabetes, may also play a role.
While dental problems can certainly cause pain, they can also have other negative effects. Loose or missing teeth can make chewing more difficult, especially foods such as produce with a hard consistency, says Athanasios Zavras, director of the department of public health and community services at Tufts University School of Dentistry. in Boston.
Dental problems can even harm your heart. A study published in the Journal of Periodontology in 2021, for example, found that people with inflamed gums were more likely to have inflammation of the arteries, which increases the risk of vascular disease. “Gum disease creates pockets where anaerobic bacteria can grow and travel to vulnerable sites in your body, like your heart,” Zavras says.
All of this makes it important to get good dental care as we age. But this can be difficult. Traditional Medicare does not cover most dental services (although some Medicare Advantage plans offer some coverage). Here, experts explain how to manage three common dental problems, including what you can do and why you need a dentist’s help.
When you have a toothache:
Cavities – which occur when plaque bacteria convert dietary sugars and starch into acid that eats away tooth enamel – are one of the most common causes of dental discomfort.
Receding gums are often part of the problem. “When the gums recede, the root of the tooth is exposed, which can make it more prone to decay,” says Sally Cram, a dentist and spokesperson for the American Dental Association. And if fillings fracture over time, bacteria can build up in the cracks and lead to more cavities under the old fillings.
Conditions such as dry mouth can also make teeth more vulnerable to decay. “As your mouth dries out, its pH decreases and the environment becomes more acidic, providing a breeding ground for bacteria,” says Cram.
Best Steps: To reduce the risk of cavities, brush and floss twice daily as recommended, and be especially diligent before bed, especially if you snack in the evening. “Saliva (which helps protect teeth) naturally decreases while you sleep,” says Edmond Hewlett, professor in the division of restorative dentistry at the UCLA School of Dentistry. “Anything you eat before bed, even a simple cracker, will leave debris in your mouth that bacteria can feast on overnight.”
If you experience pain, see your dentist as soon as possible. And if you’re particularly prone to cavities, ask about a prescription high-fluoride toothpaste for added protection, says Sheridan. Your dentist can also recommend a custom tray, which you fill with fluoride gel and place on your teeth for five minutes each evening.
For swollen and bleeding gums:
Gum (or periodontal) disease is an infection of the tissues that surround and support your teeth and is a major cause of tooth loss in adults. It is caused by plaque, the sticky film of bacteria that forms on your teeth. A less robust immune system increases the risk of gum disease, Cram says, but difficulty brushing and flossing, dry mouth, and missing dentist visits for cleanings can also have an effect.
Best Steps: To avoid swollen and bleeding gums, make sure to be vigilant when brushing. But remember to go slowly: too much pressure can cause the gums to recede even more. And floss as shown below. Older adults who floss regularly have a lower risk of gum disease, according to a 2020 study published in the Journal of Dental Research.
“It helps remove bacteria and food stuck between teeth that can cause gum inflammation,” says Tomas Ballesteros, professor of dentistry at Rutgers School of Dental Medicine. If a condition like wrist arthritis makes flossing difficult, try a water flosser, a device that directs a stream of water between your teeth.
For existing gum problems, you may need treatment to prevent tooth loss in addition to good dental hygiene. For minor diseases, a dentist will usually perform a deep cleaning called scaling and root planing. This usually takes more than one visit and often requires local anesthesia. More extensive gum disease may require surgery to remove damaged bone and stubborn bacteria.
If your mouth is still dry:
As you age, your mouth produces less saliva, Cram explains. This can lead to a condition known as dry mouth, which affects 30 percent of people over 65 and 40 percent of those over 80, according to the ADA – and can increase the risk of cavities and gum disease. Certain medications can also make the problem worse. Sometimes dry mouth is accompanied by a burning or tingling sensation (called burning mouth syndrome), which may be due to a vitamin B or iron deficiency, according to Cram.
Best Steps: The first and easiest thing to do is stay well hydrated, says Hewlett. “Always keep a bottle of water with you and drink it frequently to keep your mouth moist and hydrated,” he says. Other drinks without added sugar, such as milk or herbal teas, are also suitable, but alcohol and caffeine can dry out your mouth. If necessary, the ADA recommends sucking on chunks of ice.
Chewing sugar-free gum or sucking sugar-free candy containing xylitol has been shown to help relieve the condition, Sheridan says. Talk to your doctor if you think your dry mouth may be related to medications and see if you can switch to another medication. If you have a mouth burn, you may want to have your primary care provider check your iron and vitamin B levels, says Cram. If you are deficient, they may recommend a supplement.
You already know that it’s important to floss daily and brush your teeth gently with fluoride toothpaste at least twice a day for two minutes at a time.
But which toothbrush is best? Although a manual toothbrush can do a good job, you might consider an electric toothbrush, says Ballesteros. A 2019 study in the Journal of Clinical Periodontology found that its use resulted in 22% less gum recession (a risk factor for gum disease) and 18% less tooth decay.
Visit your dentist regularly. There is no hard and fast rule; It varies from person to person, but “it should be at least once a year,” Hewlett says. As you age and dental risk factors increase, it’s likely that your dentist will recommend professional cleanings at least twice a year.
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