Published December 6, 2019
In America, our population is aging. It is estimated that 25% of the US population will be over the age of 65 by 2050 and according to the census bureau, there will be more seniors over 65 than children under 18 by 2034. Just a couple of generations ago, the expectation was that most people would have dentures when they got older. Thankfully, today seniors are keeping their own teeth at greater rate than any prior generation.
Keeping natural teeth as one age’s has many benefits including better nutrition (able to eat a wider variety of foods), improved overall health (due to better nutrition), and increased satisfaction with eating and smiling. The saying goes, “getting old isn’t for wimps”. True or not, many seniors experience dental problems as they age. In this article I’ll discuss the challenges of maintaining teeth as we age and strategies to deal with those challenges.
Dental problems that have a higher prevalence as we age include and increase in cavities, gum disease, cracked and worn teeth, and lost teeth. Cavities are more prevalent for a couple of reasons. As we age, we experience receding gums which exposes root surfaces. Root surfaces are weaker and more susceptible to cavities. Retired individuals tend to have more opportunities to snack which increases cavity risk as well. Polypharmacy (taking multiple medications) is also a factor. Many medications cause dry mouth which greatly increases the risk for cavities. Also, our teeth take a beating over the years when you consider how many chewing cycles occur over 50 or more years. This causes cracks that weaken teeth and wear which can expose the weaker portion of teeth that are more susceptible to cavities.
Other challenges include cracked, fractured and lost teeth that require extensive restorations or replacements. The most common cause of lost teeth in older individuals is from gum disease (also called periodontal disease). Gum disease is found in 42% of all adults and likely closer to 50% in those over 65. Besides tooth loss, gum disease is important because it is linked to several general health conditions such as diabetes, Alzheimer’s, heart disease, stroke, and more. All these reasons are why regular dental care is critical, which is the last challenge – access to care.
Access to dental care is a challenge as retired individuals on a fixed income are less likely to invest in dental care. Unfortunately, Medicare does not help cover dental expenses. With the newly available Medicare Advantage plans that are provided by private companies, patients rarely come out ahead financially. The other challenge is accessing care for individuals who are home bound or difficulty transporting. Without regular dental visits, the risk for dental problems increases as does the magnitude of dental problems that do develop.
Prevention is the first and most important strategy to deal with the challenges related to aging and dental health. As a society, we haven’t valued dental health as a public health issue. Therefore, it is up to individuals to make a priority to seek dental care and to do all they can at home.
Home prevention strategies include brushing twice a day for two minutes. The use of an electric brush becomes even more important as we age due to gradual loss of dexterity. Electric brushes have larger handles which allow a better grip and the brush heads do most the work; thus, dexterity isn’t as important. Being cognizant of dry mouth and finding strategies to deal with it is also greatly important for older individuals who are often on many medications that cause dry mouth. Using fluoride products, avoiding excessive snacking, candies, and sugary drinks between meals is also critical.
This topic has more facets than this article allows, including discussion of nursing home care and information for families and caregivers. For more information please search the American Dental Association website for aging and dental health.