Preserving the Aging Dentition
by Larry Snyder, DMD, FAGD

I was very fortunate to have known all four of my grandparents throughout my teenage years. Unfortunately, they all had dentures. I remember how terrible I felt watching Grandma Bessie in a nursing home fumbling with her dentures. Today, even if her grandson had not gone on to become a dentist, chances are she would have had some or all of her teeth.

As we get older, we notice the effects of aging--wrinkling, graying hair and a variety of aches and pains that we didn't have before. Our mouth also is affected by advancing age. Sometimes the changes are pronounced and other times they are subtle. Understanding these changes, and what can be done about them, is important to maintaining good oral health.

Your teeth may appear darker as you age. This colorless layer of bacteria, called plaque, can build up faster and in greater amounts as we age. Changes in dentin, the bone-like tissue that is under your enamel, may also cause your teeth to appear slightly darker.

Another common problem among seniors is dry mouth. This can be caused by certain medical disorders and is often the side effect of medications. Some of the common problems associated with dry mouth include a constant sore throat, burning sensation, problems speaking, difficulty swallowing, or dry nasal passages. Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive cavities can form.

Some people experience a change in appetite due to a change in their sense of taste. This may be due to age-related decreases in the sense of taste and smell, certain diseases, medications or dentures.

A major cause of tooth loss among older adults is periodontal, or gum disease. Gum disease is caused by bacteria which create toxins that irritate the gums. Gradually, and often without pain, the gums may detach from the teeth. If the condition is not treated, the supporting bone may dissolve, causing the teeth to become loose and eventually fall out or need to be removed.

What can we do to help us keep our teeth healthy for lifetime?

I recommend that my patients brush at least twice a day, once in the morning after breakfast and again at night before bed. A soft-bristled brush, as opposed to a medium or hard-bristled one, is preferable, so as not to wear away the gums. It should be replaced about every two or three months. When brushing, be sure to place the brush at a 45-degree angle to the teeth and use a gentle scrubbing motion. Be sure to brush all of the tooth surfaces, and while you are in there, brush your tongue at the same time. The particles of food on the tongue are a major reason for bad breath.

When I question my patients as to whether or not they floss, the most common answer I get is "Not as often as I should." Okay. That is a start. Flossing removes plaque from between the teeth and under the gum line, areas where the toothbrush cannot reach. If you see that your gums bleed when you floss, do not floss less! Think of the blood as disease which you are getting rid of by flossing more. If the bleeding does not eventually stop, discuss this with your dentist.

I recommend that my patients rinse with Listerine at least once, before going to bed. Ideally, we would alternate that with a fluoride rinse, which can be purchased over the counter. Listerine targets the bacteria that cause gum disease, while fluoride, whether in our toothpaste or in a rinse, makes our teeth more resistant to decay.

Of course I would be remiss if I did not add that regular checkups with your dentist should be a part of your health maintenance program. Although daily brushing and flossing help remove plaque and early tartar formation, once tartar has hardened it can only be removed by a dental professional. Some people form tartar faster than others. You and your dentist should decide together how frequently you should have dental maintenance visits. At those visits your dentist will be looking for other health problems such as oral cancer. Many oral cancers are treatable if they are discovered early. The majority of oral cancers occur in people over the age of 45. There are other medical conditions that often have symptoms that first appear in the mouth.

Getting older doesn't mean that your smile has to suffer. Looking good is every bit as important as we grow older. There are many, often simple, cosmetic dental procedures that can help to improve your smile. These techniques are by no means just for younger people. Bleaching whitens stained teeth. Bonding is a technique that "paints" tooth-colored materials on to the tooth to cover stains, to rebuild chipped or cracked teeth and to close gaps. Veneers are tooth-colored materials that fit over the teeth that can improve their appearance. Crowns accomplish the same thing while making the tooth stronger. These descriptions are simplifications of only a few of the cosmetic procedures to improve your smile, and do not go into the myriad of ways to replace missing teeth. If you are interested in improving your smile, you should discuss these and other cosmetic procedures with your dentist.

My wife is gradually learning some of Grandma Bessie's and my mother's recipes. By following the advice I have outlined for you above I hope to not only be able to enjoy these culinary treasures but to have a beautiful smile to show my appreciation for them! May you go forth and smile!

Dr. Larry Snyder completed a General Practice Residency at Strong Memorial Hospital in 1982, which emphasized optimal dental care for senior and medically compromised patients. He is available for consultations at his practice. The Smile Studio, in Rhinebeck (845-876-2628).