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A healthy smile is
a bonus at any age. Too often older people-especially those who wear false
teeth (or dentures)-feel they no longer need dental checkups. If you haven't
learned the basics of oral health care, it is not too late to start. And
even if you have, it's a good time to review.
Tooth Decay (Cavities)
Tooth decay is not just a children’s disease; it can happen as long as
natural teeth are in the mouth. Tooth decay is caused by bacteria that
normally live in the mouth. The bacteria cling to teeth and form a sticky,
colorless film called dental plaque. The bacteria in plaque live on sugars
and produce decay causing acids that dissolve minerals on tooth surfaces.
Tooth decay can also develop on the exposed roots of the teeth if you
have gum disease or receding gums (where gums pull away from the teeth,
exposing the roots).
Just as with children,
fluoride is important for adult teeth. Research has shown that adding
fluoride to the water supply is the best and least costly way to prevent
tooth decay. In addition, using fluoride toothpastes and mouthrinses can
add protection. Daily fluoride rinses can be bought at most drug stores
without a prescription. If you have a problem with cavities, your dentist
or dental hygienist may give you a fluoride treatment during the office
visit. The dentist may prescribe a fluoride gel or mouthrinse for you
to use at home.
Gum (Periodontal)
Disease
A common cause of tooth loss after age 35 is gum (periodontal) disease.
These are infections of the gum and bone that hold the teeth in place.
Gum diseases are also caused by dental plaque. The bacteria in plaque
causes the gums to become inflamed and bleed easily. If left untreated,
the disease gets worse as pockets of infection form between the teeth
and gums. This causes receding gums and loss of supporting bone. You may
lose enough bone to cause your teeth to become loose and fall out.
You can prevent gum
disease by removing plaque. Thoroughly brush and floss your teeth each
day. Carefully check your mouth for early signs of disease such as red,
swollen, or bleeding gums. See your dentist regularly every 6-12 months
- or at once if these signs are present.
Cleaning Your
Teeth and Gums
An important part of good oral health is knowing how to brush and floss
correctly. Thorough brushing each day removes plaque. Gently brush the
teeth on all sides with a soft bristle brush using a fluoride toothpaste.
Circular and short back-and-forth strokes work best. Take the time to
brush carefully along the gum line. Lightly brushing your tongue also
helps to remove plaque and food debris and makes your mouth feel fresh.
In addition to brushing,
using dental floss is necessary to keep the gums healthy. Proper flossing
is important because it removes plaque and leftover food that a toothbrush
cannot reach. Your dentist or dental hygienist can show you the best way
to brush and floss your teeth. If brushing or flossing results in bleeding
gums, pain, or irritation, see your dentist at once.
An antibacterial
mouthrinse, approved for the control of plaque and swollen gums, may be
prescribed by your dentist. The mouthrinse is used in addition to careful
daily brushing and flossing.
Some people (with
arthritis or other conditions that limit motion) may find it hard to hold
a toothbrush. To overcome this, the toothbrush handle can be attached
to the hand with a wide elastic band or may be enlarged by attaching it
to a sponge, styrofoam ball, or similar object. People with limited shoulder
movement may find brushing easier if the handle of the brush is lengthened
by attaching a long piece of wood or plastic. Electric toothbrushes are
helpful to many.
Other Conditions
of the Mouth
Dry mouth (xerostomia) is common in many adults and may make it
hard to eat, swallow, taste, and speak. The condition happens when salivary
glands fail to work properly as a result of various diseases or medical
treatments, such as chemotherapy or radiation therapy to the head and
neck area. Dry mouth is also a side effect of more than 400 commonly used
medicines, including drugs for high blood pressure, antidepressants, and
antihistamines. Dry mouth can affect oral health by adding to tooth decay
and infection.
Until recently, dry
mouth was regarded as a normal part of aging. We now know that healthy
older adults produce as much saliva as younger adults. So, if you think
you have dry mouth, talk with your dentist or doctor. To relieve the dryness,
drink extra water and avoid sugary snacks, beverages with caffeine, tobacco,
and alcohol - all of which increase dryness in the mouth.
Cancer therapies,
such as radiation to the head and neck or chemotherapy, can cause oral
problems, including dry mouth, tooth decay, painful mouth sores, and cracked
and peeling lips. Before starting cancer treatment, it is important to
see a dentist and take care of any necessary dental work. Your dentist
will also show you how to care for your teeth and mouth before, during,
and after your cancer treatment to prevent or reduce the oral problems
that can occur.
Oral cancer
(mouth cancer) most often occurs in people over age 40. The disease frequently
goes unnoticed in its early, curable stages. This is true in part because
many older people, particularly those wearing full dentures, do not visit
their dentists often enough and because pain is usually not an early symptom
of the disease. People who smoke cigarettes, use other tobacco products,
or drink excessive amounts of alcohol are at increased risk for oral cancer.
It is important to
spot oral cancer as early as possible, since treatment works best before
the disease has spread. If you notice any red or white patches on the
gums or tongue, sores that do not heal within 2 weeks, or if you have
difficulty chewing or swallowing, be sure to see a dentist.
A head and neck exam,
which should be a part of every dental check-up, will allow your dentist
to detect early signs of oral cancer.
Dentures
If you wear false teeth (dentures), keep them clean and free from food
that can cause stains, bad breath, and gum irritation. Once a day, brush
all surfaces of the dentures with a denture care product. Remove your
dentures from your mouth and place them in water or a denture cleansing
liquid while you sleep. It is also helpful to rinse your mouth with a
warm salt water solution in the morning, after meals, and at bedtime.
Partial dentures
should be cared for in the same way as full dentures. Because bacteria
tend to collect under the clasps of partial dentures, it is especially
important to clean this area.
Dentures will seem
awkward at first. When learning to eat with false teeth, select soft nonsticky
food, cut food into small pieces, and chew slowly using both sides of
the mouth. Dentures may make your mouth less sensitive to hot foods and
liquids, and lower your ability to detect harmful objects such as bones.
If problems in eating, talking, or simply wearing dentures continue after
the first few weeks, see your dentist about making adjustments.
In time, dentures
need to be replaced or readjusted because of changes that occur in tissues
of your mouth. Do not try to repair dentures at home since this may damage
the dentures which in turn may further hurt your mouth.
Dental Implants
Dental implants are anchors that permanently hold replacement teeth. There
are several different types of implants, but the most popular are metal
screws surgically placed into the jaw bones. If there isn’t enough bone,
a separate surgical procedure to add bone may be needed. Because bone
heals slowly, treatment with implants can often take longer (4 months
to 1 year or more) than bridges or dentures. If you are considering dental
implants, it is important to select an experienced dentist with whom you
can discuss your concerns frankly beforehand to be certain the procedure
is right for you.
Professional Care
In addition to practicing good oral hygiene, it is important to have regular
check-ups by the dentist whether you have natural teeth or dentures. It
is also important to follow through with any special treatments that are
necessary to ensure good oral health. For instance, if you have sensitive
teeth caused by receding gums, your dentist may suggest using a special
toothpaste for a few months. Teeth are meant to last a lifetime. By taking
good care of your teeth and gums, you can protect them for years to come.
Additional Dental
Health Information
More information
about general dental care is available from:
National Institute
of Dental Research (NIDR)
Building 31, Room 2C35
31 CENTER DR MSC 2290
BETHESDA MD 20892-2290
301-496-4261
NIDR publishes
information on oral research and general dental care. Some publications
available are:
- Fever Blisters
and Canker Sores
- Fluoride to Protect
the Teeth of Adults
- Rx for Sound Teeth
- What You Need to
Know About Periodontal (Gum) Disease
National Oral
Health Information Clearinghouse
1 NOHIC Way
Bethesda, MD 20892-3500
301-402-7364
NIDR also
offers publications on oral health for special care patients through
the National Oral Health Information Clearinghouse. Special care patients
are people whose medical conditions or treatments affect oral health.
Publications available include:
- Dry Mouth (Xerostomia)
- Chemotherapy and
Oral Health
- Periodontal Disease
and Diabetes - A Guide for Patients
- Radiation Therapy
and Oral Health
- TMD (Temporomandibular
Disorders)
- What You Need to
Know About Oral Cancer
American Dental
Association (ADA)
211 East Chicago Avenue
Chicago, IL 60611
800-621-8099
ADA distributes
educational materials on dental health and sponsors the National Senior
Smile Week.
National Agricultural
Library Food & Nutrition Information Center
Room 304
10301 Baltimore Blvd.
Beltsville, MD 20705 2351
310-504-5719
The Food
AND Nutrition Center offers the bibliography Nutri-Topics Series:
Nutrition and Dental Health. This bibliography lists information
available to consumers.
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