Keep your teeth healthy well into late adulthood and into your golden years.
Keep Your Mouth Young
Just a few decades ago tooth loss and edentulism was almost a foregone conclusion. Older adults expected to eventually lose all their teeth as the aging process slowly wore down their teeth and gums. Those in "the Greatest Generation" almost all expected to one day rely on the use of dentures to retain a degree of functionality.
Thanks to advances in dental health and hygiene, older adults are retaining their natural teeth well past retirement. Today, over 75 percent of Americans over 65 years of age retain at least some if not all of their natural teeth. That’s an amazing statistic that indicates the great strides we have made in the oral health arena.
However, there is still much work to be done for older adults. Thanks to natural oral aging, older adults are at significantly greater risk of a variety of oral health issues, from dry mouth to cavities. Loss of teeth increases dramatically as a person ages. Those 75 years of age and older, for example, are twice as likely to be completely edentulous than those between 65 and 74.
"Good, balanced nutrition plays a key role in the health of the entire body, including the teeth and mouth."
--- DR. MAMALY RESHAD, DDS
Natural oral aging changes your mouth in a number of irreversible ways that make maintaining and retaining teeth more challenging.
Attrition of dental surfaces wears away enamel.
Intrinsic stains develop over time as dental surfaces are exposed to staining agents.
Disease and infection wreak havoc on not only the teeth but the soft tissues and bone as well.
Particularly concerning for older adults is the recession of the gingival tissues.
Eventually, as gum recession progresses the dental roots become exposed and vulnerable to bacterial infection.
Additionally, the soft tissues of the mouth and gums themselves, like aging skin, become less elastic over time and more prone to damage.
All these factors add up over time and contribute to the loss of teeth as people age. However, while aging is inevitable, tooth loss is not. It is very possible to retain many if not all of your natural teeth well into late adulthood.
11 Dental Tips for Older Adults
Good, balanced nutrition plays a key role in the health of the entire body, including the teeth and mouth. Watching what you put in your mouth will go a long way towards promoting better oral health.
Consuming a diet rich in vitamins and minerals and low in simple sugars and carbohydrates is critical for good oral health. Meanwhile, a poor diet has been heavily implicated as a risk factor for several chronic diseases that are known to be associated with oral diseases.
As an example of the multitude of ways diet is tied to oral health, look at some of the known ways diet can either increase or decrease the risk of cavities. Studies show that dietary fibers reduce the absorption of bacteria-fueling sugar. Cheese has cariostatic properties which inhibit the development of dental caries. The calcium, phosphorus, and casein found in dairy products also inhibit the formation of cavities.
Whole grains and minimally-processed foods encourage stimulatory mastication and the production of saliva which has antimicrobial properties. These are but a tiny slice of the many nuanced interactions that our food has with our oral health.
The bottom line for healthy teeth: eat healthily.
Sugar is delicious. Our bodies crave it. Unfortunately, our sometimes compulsive desire for sweets often leads to overconsumption.
Instead of a handful of berries every once in while, almost everything we consume contains either natural or added sugars. That’s a real problem when sugar is also the main food source for the destructive oral bacteria that are the largest cause of cavities in older adults. Studies indicate that older adults are just as at risk for developing dental caries as young children.
Our bodies are not adapted to the world of plentiful sugar that we find ourselves in today. Not only does sugar fuel enamel-destroying bacteria, but it also leads to other health issues such as diabetes, that can also have a negative effect on oral health. This is particularly true for older adults who suffer higher rates of diabetes. Nearly a quarter of US adults over the age of 65 suffer from diabetes today.
Your oral microbiome plays a crucial role in your dental health. Not all bacteria are bad. In fact, out of the 700 plus species of bacteria that live in our mouths, only a tiny fraction is responsible for the majority of oral health problems.
In order to deny these harmful bacteria space to live in our mouths, sometimes it is helpful to assist beneficial and benign species the opportunity to outcompete the unwanted ones. This can be accomplished through a well-balanced, nutrient-rich diet. It can also be accomplished with the use of oral probiotics and the consumption of probiotic foods, such as yogurt.
Look for products with active cultures that can provide a probiotic boost to the microflora in your mouth and in your gut for maximal health results. Be careful to look for extra sugar and flavorings added to many yogurts that can make them more like junk food. For this reason, navigating the yogurt aisle of your favorite grocery store can be confusing.
Dr. Reshad's Tips on Choosing Yogurt
Read the nutrition facts on the label and avoid added sugar.
The healthiest choice is plain, unflavored yogurt. You can "sweeten" it yourself with fresh fruit. You can also make your own chia seed yogurt to make plain yogurt less tart. It's as easy as mixing 2 cups (473 ml) of yogurt with 1.5 to 2 tablespoons (22-30 ml) of chia seeds and letting it sit overnight in the fridge. Bottom line: Added sugar can turn healthy food into a junk food. Choose plain yogurt when possible. My shortcut: Avoid any product that lists sugar as the first or second ingredient.
Look for yogurt with the "Live and Active Cultures" seal.
Avoid yogurts that have been pasteurized after production. Click here for a list of the Live & Active Cultures Seal program participants.
Choose plain yogurt.
Add your own fresh fruit. Many yogurt bands have "fake fruit" which is a mixture of sugar and food coloring or vegetable juice. Plain is best.
Following are a few healthy choices you may want to try. This list is by no means exhaustive, but are a few of my recommendations.
Stonyfield Organic Yogurt
They are a good organic brand. They have several different products to choose from. However, some of their fruit-flavored yogurts do contain added sugar that you will want to avoid.
Dannon All Natural Yogurt
It has only two ingredients: low-fat or fat-free milk and protein, which is a natural thickener. It also carries the "Live and Active Cultures" seal. This is a good yogurt with no added sugar. The rest of the Dannon yogurts, though popular, have lots of added sugar and therefore you will want to avoid those yogurts.
Fage Total Plain
If you enjoy Greek yogurt, this is a good choice. The Fage Total Plain line of yogurt contains only milk and a variety of live cultures. It is also available in full-fat, 2%, and 0% varieties. But, like the other brands, stick to the plain varieties. The brand's flavored or fruit-added yogurts contain plenty of added sugar.
One of the major causes of intrinsic and extrinsic staining of teeth over time is the consumption of beverages. Imagine drinking coffee for many decades. Eventually, the acidic nature of the coffee along with the presence of tannins and other staining agents will damage and discolor teeth in a way that even brushing can’t remove.
To help protect your teeth and allow them to age gracefully without requiring repair or replacement, consider using a straw.
A simple straw will allow for the consumption of beverages of all kinds without exposing enamel to the harmful effects of acid and staining tannins. For adults with prosthetic teeth, using a straw will protect your replacement teeth from unseemly staining as well.
Discoloration as a result of everyday exposure to staining agents is one very obvious sign of dental aging.
One of the biggest contributors to both intrinsic and extrinsic staining of teeth is a yellowish or brownish substance found in many popular beverages known as tannins.
Tannins can be found in everything from coffee to tea to wine. They are the substances that give these popular beverages their color and even their taste. Over time, however, tannin pigment molecules accumulate on teeth and lead to staining that is difficult to remove and cause teeth to look duller, yellower, and older.
Regular dental checkups are a must for patients of all ages. However, I recommend that patients near or over the age of 65 should visit their dentist no less than twice per year or once every six months. Most patients older than 65 will likely want to visit their dentist even more often than that to maintain good oral health and to catch any potential dental issues before they get out of hand.
As we age, it will become more and more important to work closely with our doctors and to undergo regular monitoring for oral health issues common in older adults. Your dentist is the first and last line of defense against a myriad of aging-related oral health issues.
Your dental prosthetics, prosthodontics, and orthodontics are functional extensions of your mouth. As such, they must be maintained, cleaned, and kept in good working order to support good oral health.
Just like on natural teeth, prosthetics can often experience the same buildup of plaque and bad bacteria which can lead to further tooth loss and infections. While replacement teeth, such as implants and dentures, are not natural teeth, they still play a critical role in the health of your mouth.
Your gums help hold your teeth firmly in place and keep your soft tissues connected to underlying bone structures. When the gums are compromised, so too are the teeth. That’s why progressive oral conditions such as gum disease are so destructive for your mouth. Over time, as periodontitis, or gum disease, advances, the teeth become loose in their sockets and fall out.
Severe periodontal disease is especially pronounced in older adults who, as a result of aging, may have weaker connective tissues, weaker immune systems, and less underlying bone to adequately support their teeth in general. Periodontitis is the most common cause of tooth loss in adults and is, like many oral conditions, exacerbated by age-related pathologic processes.
Another symptom associated with aging is dry mouth. As we get older, our salivary glands naturally produce less saliva. Making matter worse, many medications also directly or indirectly cause dry mouth or xerostomia.
While dry mouth may not sound like a big deal, it has major implications on oral health. For starters, your saliva contains a potent brew of antimicrobial chemicals and dissolved minerals, such as calcium, that is crucial for building and maintaining dental enamel. When your mouth experience xerostomia, the teeth are not adequately bathed by saliva, resulting in a rapid buildup of bacteria and catastrophic demineralization.
Smoking is perhaps one of the worst things that you could do to your teeth. Quitting tobacco, on the other hand, is perhaps one of the best things you could do for your teeth.
Tobacco consumption harms your teeth, your gums, and your entire mouth in a variety of ways that contribute to premature dental aging. Tobacco smoke, tar, and many of the ingredients contain potent staining agents that leave teeth looking yellow and older. Meanwhile, nicotine and other chemicals irritate gums resulting in leukoplakia, gum recession, and often oral cancer. Smoking also suppresses saliva production and causes the mouth to dry out resulting in xerostomia and all the problems associated with dry mouth.
DR. MAMALY RESHAD
Advanced Prosthodontics - USC
Chairman - Fixed Prosthodontics and Operative Dentistry