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The Effects Of Aging And Tooth Loss On The Mouth

Tooth loss is not part of the normal aging process. In fact, tooth loss is declining among older adults. Aging is not a general of cause oral diseases, according to dentists and other dentistry professionals, yet oral diseases such as tooth loss are more prevalent with age due to changes in the oral soft tissues, a depression of the immune system, an increase in the number of systemic diseases, a decreased ability to perform adequate oral hygiene and self dental care secondary to stroke, arthritis, Parkinson's disease, dementia, or Alzheimer's disease, and dry mouth due to greater use of prescription and over-the-counter medications.

With age, teeth become less white and more brittle; however, oral hygiene habits and use of tobacco, coffee, and tea also will affect tooth color. Teeth also can darken or yellow due to the thickening of the underlying tooth structure (dentin). Brittle teeth tend to be susceptible to cracks, fractures, and shearing. Over the years, the enamel layer (outer tooth layer) is subjected to wear due to chewing, grinding, and ingestion of acidic foods. In severe cases, the enamel is completely worn away and the underlying dentin is worn down as well. Inside the tooth (pulp), the number of blood vessels and cells decrease and fibroses increase with age; thus, capacity to respond to trauma may also decrease.

The fiber content and number of blood vessels of the periodontal (gum) tissues decrease with age. However, periodontal disease represents a pathologic or disease change and is not due to just age. The loss of bone and gum attachment (receded gums) associated with periodontal disease is collective and therefore greater in older adults. An outcome of periodontal disease is exposed root surfaces. Exposure of the root in older people probably gave rise to the term "long in tooth". Oral hygiene practices and certain medications affect the health of gum tissue. Receded gums and exposed root surfaces put older adults at high risk for dental decay (caries) on the relatively soft root surfaces. Dental caries on root surfaces is a disease that is common among older adults. Dry mouth and a diet high in sugars and fermentable carbohydrates greatly increase the risk for root caries. Dental caries are a major cause of tooth loss in older adults.

Studies show some reduced chewing effectiveness, decreased tongue strength, and increased swallowing time with age; however, the studies do not indicate that there is any real change in the ability to swallow with age.

The number of cells that produce saliva decrease with age. However, healthy, unmedicated older adults do not have reduced saliva flow. This is because the salivary glands have a high reserve capacity. Usually when a decrease in saliva flow is noted, it is associated with medication use, illness, medical conditions, or their treatment.

The number of taste buds do not appear to change with older age; thus, the ability to taste does not change significantly with age. However, smell decreases with age. Since the ability to taste is closely related to smell, taste perception may be altered in older adults.

Soft tissues of the mouth become thinner and lose elasticity with age and promote tooth loss. Soft tissue lesions are more common in older adults. Chronic inflammation such as candidiasis (fungus growth) and denture irritation also occurs more often. Wound healing is decreased due to reduced vascularity (blood flow to the area) and immune response with age.

Oral and oropharyngeal cancer is the most serious disease associated with age. Oral and oropharyngeal cancer lesions usually are not painful. Oral and pharyngeal cancer may appear as a red or white patch, a sore or ulceration, or a lump or bump that does not heal within two weeks. Swollen lymph nodes of the neck, difficulty swallowing and speaking, and voice changes also may be signs and symptoms of oral and oropharyngeal cancer. The risk for oral and oral pharyngeal cancer increases with age, use of all forms of tobacco, frequent alcohol use, and exposure to sunlight (for lip cancer). See a dentist if any signs or symptoms of oral and pharyngeal cancer are present.

By Denise J. Fedele, DMD, MS

FAQs on Dentures, Seniors Dentistry and Woman's Oral Health Needs

Q. How do you clean your dentures?

A. In cleaning your dentures you should first rinse away loose food particles thoroughly. Then moisten your toothbrush and apply denture cleanser. Brush every surface, scrubbing gently to avoid damage.

Q. Why do your teeth seem darker as you age?

A. Your teeth may seem darker because plaque can build up faster and in larger amounts as you age. Changes in dentin can cause your teeth to appear a little darker as well.

Q. Why does your mouth seem dry?

A. Dry mouth is a common problem among seniors. It is caused by certain medical disorders and is often a side effect of some medications.

Q. Are seniors more susceptible to gum disease?

A. Yes. The severity of gum disease may be increased due to ill-fitting dentures or bridges, poor diets, poor oral hygiene, other medical diseases, and even some medications.

Q. Why do seniors lose their sense of taste?

A. Seniors tend to lose their sense of taste because age decreases the sense of taste and smell. Certain diseases, medications and dentures can also contribute to the decrease of your sense of taste.

Q. Should seniors be worried about cavities?

A. Yes. The majorities of seniors have tooth-root decay and are more susceptible to cavities.

Q. Why should women be more careful with their oral health?

A. For many women, dental care depends on their different stages of life that are directly related to surges in sex hormone levels. Your dentist may request to see you more frequently during hormonal surges.

Q. How do oral contraceptives affect women’s oral health?

Gingivitis may occur with long-term use of oral contraceptives because they contain estrogen or progesterone. Women who use oral contraceptives are two times as likely to develop dry sockets and require dental care more often.

Q. How does pregnancy affect oral health?

A. There is an increase in the amount of plaque on your teeth due to pregnancy because there is an increase in estrogen and progesterone.

Q. How does morning sickness affect oral health?

A. The acid in vomit causes tooth erosion. Women can neutralize the acid by using a baking soda and water paste and rubbing it on their teeth. Rinse the paste off after 30 seconds and then brush and floss.

Q. What is the likeliness of having tumors during pregnancy?

A. Women are at risk for developing pregnancy tumors that are benign growths that develop when swollen gums become irritated. The tumors usually shrink soon after the pregnancy is over.

Q. How does plaque build-up affect pregnant women?

A. If plaque is not removed it can cause gingivitis and women with periodontal disease may be at risk for pre-term, low-birth weight babies.

Q. What problems occur for girls experiencing puberty?

A. The surge in hormones that occurs during puberty may cause swollen gums, especially during menstruation. Herpes-type lesions and ulcers can also develop. They may also experience sensitive gums that react more to irritants.

Q. What are intraoral cameras?

A. An intraoral camera is a miniature video camera that the dentist places in the patient’s mouth so that together they can view any dental problems that the patient is having. The image from the camera is enlarged and sent to a monitor for viewing.

Q. What is the purpose of intraoral cameras?

A. The purpose behind intraoral cameras is to allow the patient to see the specific area that needs treatment so that they are more likely to understand the dentist’s recommendation and accept it.

Q. How can CD-ROM be beneficial in dentistry?

A. CD-ROM is beneficial in dentistry because patient education will be much simpler with information stored on CD-ROM. Procedures can be explained to patients in advance and post-operative instructions can be provided for them to take home.

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