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Dentistry for Senior Patients: What Should You Know?

It's important for senior patients to take good care of their oral health.

There are currently more than 54 million senior Americans aged 65 or older—that’s 16.5 % of our current population. By 2030, the US Census Bureau projects, one of every five Americans will belong to this category. Aging is a fact of life, but there’s plenty you can do to maintain your health, especially your oral health, as you age! Here are the facts.

What are the most important oral health concerns for senior patients?

Mobility and dexterity needed for cleaning teeth properly. “From a practical standpoint, mobility is an important concern for senior patients,” says Dr. Kelly RIchardson. “A limitation in mobility could affect your dexterity in cleaning your teeth (one of the most basic parts of good oral care), which is why we ask at every appointment whether you’ve experienced any recent health changes. If you’re finding it challenging to clean your teeth properly due to this kind of issue, there are solutions we can recommend.”

Other issues affecting senior patients can include:

  • Chronic diseases such as arthritis, chronic obstructive pulmonary disease (COPD), diabetes, and heart disease, which may cause or result from gum disease.
  • Darkened teeth, which may result from years of stain-causing foods and drinks; a thinning of the teeth’s enamel (outer layer); changes in the dentin layer (just beneath the enamel); or a more serious problem
  • Diminished sense of taste, which can contribute to poor nutrition
  • Dry mouth (xerostomia), which can result from medications or illness that causes reduced saliva flow
  • Gum disease, which may cause bleeding but which is still reversible in its first stage. Its later stage is not reversible and can lead to bone damage and tooth loss.
  • Oral cancer
  • Root decay
  • Tooth decay
  • Tooth loss, which can affect chewing ability and thus lead to nutritional deficiencies in older patients
  • Uneven jawbone, caused by not replacing missing teeth

Can senior patients in good oral health expect to keep their teeth as they age?

If you take good care of your health and teeth, you can certainly expect them to last throughout your life,” says Dr. Richardson emphatically. However, remember that your mouth changes as you age. According to the American Dental Association, it’s more important than ever for you to keep up with regular dental visits during your senior years because the nerves inside your teeth can decrease in size, making them less sensitive to cavities and other issues that could arise. Your hygienist or dentist can catch these issues during your routine visits.

However, if you lose a tooth or teeth at any point, it’s important to replace them, says Dr. Gio Iuculano

“There are several reasons why you should replace missing teeth,” he explains. “First, it helps you maintain healthy jaws, so you don’t develop pain or dysfunction, which could limit your ability to open your jaws, and/or lock your jaw open or closed. Replacing missing teeth also helps you chew food properly. This allows you to be able to eat a good variety of foods, and not be limited to soft foods only. Finally, it keeps your teeth from shifting around in your mouth. If your teeth are constantly shifting, it makes it more difficult to keep your teeth throughout your life.”

Should seniors expect that their dentist will recommend specific proactive treatments, either in-office or at home?

“Specialty treatments aren’t necessarily exclusive to seniors,” explains Dr. RIchardson. “If you’re a senior patient, you’ll want to be sure your teeth get more fluoride, either through using a good quality toothpaste or having a fluoride varnish treatment in your dentist’s office. And gum recession can get worse with age, as more tooth roots may become exposed, so it’s important to keep an eye on that. But many specialty treatments are specific to a patient’s own oral health situation rather than their age. If you’re struggling with a dental issue, see your dentist.”

Are there certain dental treatments that are not recommended for people past a certain age? For example, could a patient in good health have their teeth whitened?

Senior patients in good health can safely have many kinds of treatments—whitening, implants, and more. Dr. RIchardson notes, “It depends on the individual’s overall health. In the case of whitening, if the patient’s roots are exposed, their teeth will be more sensitive, so we would want to consider desensitizing their teeth before a whitening treatment.”

How can senior patients best care for their oral health as they age? What should they do or not do?

Dr. Richardson has these recommendations:

  • Practice regular oral care. Be sure to get regular dental checkups, and attend scrupulously to caring for your teeth at home. Floss your teeth daily and brush them twice daily for at least two minutes each time.
  • Pay attention to how dry your mouth is. Dry mouth can contribute to a number of other conditions including bad breath, difficulty speaking and swallowing, and in some cases, tooth loss. If your mouth is becoming overly dry, talk to your dentist about a solution.
  • If you have a big change in your overall health, or if you anticipate undergoing surgery or a significant medical treatment, tell your dentist. Your dentist will want to help you prevent issues that could otherwise occur if you have to skip your regular dental visits for a while. For example, before undergoing chemotherapy or radiation treatment, have your teeth cleaned if you can. The cleaning helps to reduce the bacteria load in your system. If you’re scheduled for orthopedic surgery (such as rotator cuff surgery, for example) that might make it difficult for you to thoroughly clean your teeth, your dentist can recommend alternative ways for you to clean your teeth until you’re able to resume brushing and flossing.

Dr. Gio adds these important oral health care steps for seniors:

  • Take steps to avoid developing cavities. Eat a good diet of mainly unprocessed foods, and avoid excessive sugar. If you can, be sure to floss once daily and brush your teeth thoroughly twice each day, and schedule regular hygiene appointments. If you develop a cavity, treating it when it is small is always less involved and less expensive to treat than when it has become larger.
  • Make sure you can properly chew food. If you can, choose a diet rich in natural, unprocessed foods (such as meat, fish, nuts, vegetables, fruit, and dairy) that require chewing to help keep your teeth, gums, and jaws healthy and strong. Over time, choosing softer foods can contribute to a decreased ability to chew and an increased risk of losing teeth. If a lack of teeth forces you to eat only soft food, you may miss important vitamins, minerals, and nutrients, which can lead to worsened overall health.
  • Strive to keep your gums healthy and free of infection. Gum infection is a form of chronic inflammation that puts a strain on your immune system. An easy and effective way to achieve and maintain healthy gums is by flossing daily.

Is it time for your next dental visit? Schedule your appointment now.