Seniors Face Particular Periodontal Challenges
As baby boomers age, the number of seniors needing dental care is expected to become larger than ever. People in this age bracket have a number of specific needs, some due to aging generally, and some due to the particular experiences of this generation. Tooth and gum decay, also known as periodontal disease, are common challenges for seniors. Late middle age and old age are when people are at extreme risk of developing cavities for the first time since childhood. There are two main causes of elderly people’s periodontal problems which will be examined here: dry mouth and faulty fillings.
Dry mouth is scientifically called xerostomia. It occurs when people do not produce enough saliva. Seniors are at risk because a dry mouth is a side-effect of medications commonly used to treat anemia, incontinence, Parkinson’s, diabetes, colds, anxiety, and depression, as well as of chemo and radiation treatment for cancer. When people don’t produce enough saliva, they lose one of the body’s main defense mechanisms against tartar-causing bacteria. Dry mouth can also damage teeth directly; people who have it are more likely to have cracked molars. According to the American Dental Association, 30% of people over 65 and 40% of people over 80 have dry mouth. As is the case with most health issues, smoking and excessive alcohol consumption may worsen its impact.
As fillings fail, they, too, contribute to tooth decay. One common misunderstanding about fillings is that they strengthen teeth. But often in the past, amalgam fillings (the kind made of mercury and silver alloys) were simply packed into a cavity without any effort to sculpt them to reinforce the tooth. Fillings naturally loosen after about fifteen years (usually fewer if they’re made of plastic resin), and open new gaps for bacteria to colonize. Amalgam fillings also block x-rays, preventing dentists from detecting periodontal decay underneath them.
Regular brushing and flossing are as essential for seniors, including those who wear dentures, as for anyone else, but there are some other steps that can be taken to counter periodontal disease. Humidifiers can help keep the mouth moist, as can saliva substitutes which are available commercially or by prescription. Fluoridated toothpaste is also particularly important for the older members of this age group, who were not exposed to fluoridated water while the adult teeth were coming in. Seniors may also want to ask their doctors if there are any other medication options available to them which don’t cause dry mouth and to try cutting back on caffeine and sugary snacks.
Dental fillings need to be replaced regularly, but newer ones are shaped with impressions from the patient’s mouth and made from sturdier materials. Porcelain lasts longer than resin, and gold is still more resilient. It’s reasonable to assume seventy-year-olds may go through another cycle of fillings, and oral
cancer screenings are of vital importance in preventing periodontal damage at this age, as well. Perhaps most important to note is that baby boomers are much more likely to have natural teeth than previous generations were at the same age. That difference upends dentistry’s traditional approach to seniors, as well as the assumption under which baby boomers received most of their dental services earlier in life.