Geriatric Dentistry: Oral Health of the Mature Person

Jan 4, 2018

Thanks to the continued advances in medical care, people are living much longer, healthier lives. Although the increased availability of health care advice and resources have contributed to people leading relatively normal lives well into their 80s and 90s, these extended years can take their toll on oral health. And, as such, these mature years of life present their own challenges when it comes to dentistry.

Here are some of the more common oral health challenges associated with the golden years, and what you do if you experience any of them.

  1. Increased Difficulty in Oral Hygiene Maintenance

Those of a certain age face an increased probability of developing arthritis. While potentially debilitating in itself, arthritis also makes it much more difficult to maintain a good level of oral care. A person who has painful hands cannot brush their teeth as vigorously as they once could, which can lead to many other dental problems. When this happens, plaque and tartar can build up which often leads to dental caries (decay) and gum diseases.

What You Can Do

Are you finding it difficult to brush your teeth as well as you could when you were younger? If so, ask your dentist or hygienist to recommend a suitable mechanical toothbrush for you, which will enable you to maintain a good level of oral health care at home. You should also consider increasing your routine dental check-up appointments from every 6 months to every 3 months. While an increase in visits will cost you more in preventative dollars, you will save yourself more money in the long run by reducing your need for repairs.

  1. Diet

It isn’t unusual to have lost one or more teeth during the more advanced years of life, or be less physically able to eat the foods you once could. Because of this, it often becomes more convenient to snack on softer foods, which usually have a high sugar content. Unfortunately, this increases the risk of developing dental caries (tooth decay).

What You Can Do

When you consume these softer foods, try to include them as a part of your regular meals. Immediately after eating, make sure you (or somebody else, if need be) clean your mouth and teeth, and remove all debris. Doing so greatly reduces the chances of experiencing dental issues. If you’re a resident of a nursing home, your dentist should instruct your care providers of your oral hygiene needs. Poor diet and inadequate oral hygiene are currently one of the most significant health care challenges in nursing homes.

  1. Receding Gums

As we age, our gums tend to shrink – which, unfortunately, is an unavoidable process of our advancing years. When the gums recede, the roots of our teeth become more exposed. The roots are much darker in color than our crowns (the part of the tooth above the gumline), which can be unsightly in appearance to some. Although the change in esthetics can be upsetting, a more serious issue is the increased risk of developing root caries.

What You Can Do

Unfortunately, there is little that can be done about gum recession in mature persons. However, as the risk of root caries increases due to root exposure, it’s critically important that you maintain as high a level of oral care as you possibly can.

  1. Tooth Root Decay

Recession of the gums is more prevalent in our mature years, which exposes the much softer dentin surfaces of the teeth. This dentin is much more prone to decay, and it decays much faster and easier than the hard enamel of the crowns. A combination of gum recession, decay-prone dentin exposure, and a reduced ability to maintain a thorough oral hygiene regime can cause the rapid and aggressive progression of root caries (decay) that can destroy teeth within a matter of months. Because of this, root caries are high on the list of oral health challenges faced by mature adults.

What You Can Do

While receding gums are inevitable, you can greatly reduce your chances of developing root caries (decay) by maintaining a regular and thorough oral care regime. You should also visit your dentist for routine check-ups more frequently than you used to.

  1. Increased Need For Root Canal Therapy

Because exposed tooth roots due to gum recession can develop caries (decay) much quicker than crowns (the visible top portion of a tooth), the need for endodontic treatment increases.

What You Can Do

To avoid the need for root canal therapy, which can be both expensive and dustructive of the tooth structure, you should maintain your oral care as best you can, and increase the frequency of your routine dental check-up appointments.

  1. Increased Wear on the Surfaces of the Teeth

Although not a condition directly associated with maturity, bruxism (involuntary grinding of the teeth) can contribute to teeth wearing down prematurely. Bruxism often happens at night during sleep, and one night of grinding can cause around 100 day’s worth of wear. If left untreated, sufferers of this condition can find their teeth all but destroyed by the time they reach middle age. Bruxers in their mature years that have not received treatment will know all too well the effects – teeth that, over time, have become short, worn, and most likely sensitive.

What You Can Do

If you’ve been a lifelong bruxer without treatment, in almost all circumstances, there is little that can be done to save your natural teeth. This is because the damage to the teeth after many years of grinding will usually have worn too much of the tooth structure away. Alternatives include tooth-replacement procedures such as dentures and dental implants. Prevention as early as possible is always the best measure to take – usually from the use of occlusal bite guards from an early age.

  1. Old Tooth Restorations

After many years of service, tooth restorations such as fillings, crowns, and partial dentures begin to degenerate. This can create gaps between the surface of the tooth and the restoration itself, which can lead to dental caries (decay) occurring, along with many other dental issues. If you’re of a mature age, you ensure you’re receiving thorough dental care – more so than during your younger years. There are many tooth-restorative materials that contain decay-preventive chemicals to ensure your tooth restorations limit your chances of developing dental caries.

What You Can Do

Visit your dentist often, as they will assess any tooth restorations you may have, and inform you as to whether they have worn to the point that they need replacing. To maximise the lifespan of your tooth restorations, you should maintain impeccable oral health care.

  1. Increased Risk of Periodontal Disease

While diseases of the gums and bone are uncommon in youth, they are much more prevalent in mature adulthood, and most mature people have some form of periodontal disease. Signs of periodontal disease include mobile, spaced teeth, and foul-smelling breath.

What You Can Do

If you suspect you have some form of periodontal disease, you should seek professional assistance form your dentist in the form of scaling, rinses, antibiotics, or surgery. To reduce the likelihood of developing periodontal diseases, try to maintain a thorough oral care regime and visit your dentist more frequently.

  1. Bone Shrinkage Beneath Dentures

Around 40 million people in the U.S. wear dentures. As each year passes, the gums and bone that support the dentures shrinks. The supporting bone can shrink as much as half an inch over the course of a lifetime, which results in loose and poorly adapted dentures, greatly reduced chewing efficiency, and poor nutrition intake. Although some people wear their dentures for decades, most dentures only have a functional lifespan of around 10 years.

What You Can Do

If you wear dentures, you should have your dentist check them for you at least once a year. They will assess them to see if they still fit your mouth correctly, and reline or remake them if necessary. A more cost-effective alternative is dental implants, which – if cared for correctly never need to be replaced.

  1. Discoloration of the Teeth

Teeth naturally discolor with age, and this process happens sooner with regular consumption of pigment-containing foods and drinks such as coffee, tea, cola, and any food that contains coloring. The only disadvantage of discolored teeth in mature adults is their appearance, which can be treated through many procedures such as bleaching or microabrasion.

What You Can Do

Try to limit your consumption of colored foods and drinks such as tea and coffee, maintain impeccable oral health care, and visit your dentist regularly.

Just as age affects every other area of our bodies, time inevitably takes its toll on our teeth and gums. While some areas cannot be prevented, such as gum shrinkage, you can limit your chances of developing other related diseases by maintaining the best oral care regime you can manage, increasing the frequency of your dental check-ups, and avoiding sugary, colored foods and drinks as often as possible.

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About the Author:

Dr Aust is married to Mrs Dr Aust and has two children and a dog Max. You can read more here.

He is sharing his expertise with you. Download 5 Things I Learned After Treating Over 10,000 Patients from here.