Dental Problems in Older Adults

Dental problems in older adults are an often overlooked issue facing the health of seniors. As we age, keeping our bodies in tip-top shape becomes increasingly challenging, and our mouths are no exception. There are a number of problems that can arise inside of our mouths, affecting our teeth and gums. Despite the fact that oral health care has improved over the years, seniors continue to find themselves increasingly susceptible to dental problems such as tooth loss, root decay, uneven jawbones, periodontal gum disease, gum recession, and more serious problems such as oral cancer. Senior dental care is a critical part of self-care in your later years. Just as crucial as planning for retirement, implementing a game plan to protect your oral health is imperative for a long, fulfilling life long after you’ve stopped working.

We’ve put together a comprehensive guide to oral health for seniors, including common oral issues that older adults face, tips for dental care for seniors and how to prevent dental problems, what to expect when you’re visiting the dentist as a senior and how to pay for your dental care in retirement. Our goal is to help you avoid expensive, debilitating, and common dental problems in older adults that can get in the way of a great quality of life.

As we pass middle age and enter our senior years, there are a number of new factors to consider that contribute to the decline of our oral health. It’s normal to find it increasingly challenging to maintain a healthy mouth in our retirement years because things are changing with our overall health. For instance, many seniors experience a dry mouth, either due to age or medication that has been introduced into their daily routine. Dry mouth is a known contributor to tooth decay and can cause cavities. Equally as likely is receding gums, which expose the softer, weaker parts of the teeth, making them susceptible to tooth decay and cavities. A lack of dental care insurance coverage is also a major cause of oral health issues in the elderly. When you can’t afford regular cleanings and check-ups, your teeth are going to suffer, and sadly, many seniors go without dental coverage after they retire and are no longer on their employer’s health care benefits. Regular checkups are more likely to catch problems such as gum disease/periodontitis, which often go unnoticed by the untrained eye. Chronic conditions such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are all known to contribute to the likelihood of developing gum disease as well, and each of these conditions is more likely in elderly people. According to the CDC, social factors such as economic disadvantage and being a member of a minority also contribute to your likelihood of developing dental problems in old age.

There is no disputing the fact that seniors and dental problems are a rising issue, and the data backs it up. Studies found that 1 in 5 seniors suffers from tooth decay, and 95% of all seniors have had a cavity. Similar research uncovered that 2 out of every 3 seniors have gum disease. An unsettling statistic that was also revealed is the fact that 20% of people over the age of 65 have lost all of their teeth. Oral cancer is most prevalent in older adults, as well.

Our increasing age means we face a growing risk of developing many different health problems, including conditions and issues that affect our mouths and teeth. Let’s go over some of the most common dental problems in older adults today.

Dental care for elderly patients is about the treatment and prevention of conditions that are more likely in older age. Making things more difficult, many of these conditions can be exacerbated or triggered by our increasingly sedentary lifestyle and the introduction of new medications and treatments. It’s important to familiarize yourself with the common problems seniors face when it comes to the health of their teeth, so you can understand how to prevent them and what factors in our lives make them more likely.

Here are some of the most common dental problems in older adults.

Tooth Darkening and Tooth and Root Decay

Dentin is the softer tissue underneath your tooth’s enamel. As we age, dentin changes, which, combined with our thinning enamel, can cause the outer appearance of our teeth to darken. Darkened teeth are also caused by decades of consuming coffee, tea, wine, cigarettes, and other products known to cause staining. Receding gum lines can also contribute to the exposure of our softer tooth tissue, which can cause tooth decay. When our gums recede, it can also lead to root decay as well.

To prevent these problems from occurring or slow their progress, proper oral hygiene is imperative. Brushing and flossing twice per day is just the beginning. You’ll also want to avoid foods with high sugar content and quit smoking if that’s something you’re still struggling with. Regular dental cleanings and check-ups are also essential to catch these issues before they become destructive. Look for tubes of toothpaste with fluoride, and don’t decline the fluoride treatment at your dentist as this is a preventative measure against these conditions.

Twice as many people over 60 experience root decay than people over 30, and by the time you’re 80, the odds you’ll experience any kind of tooth or root decay is up to 96%. Prevention is easy, so set that second cup of coffee aside and make sure you’re flossing and seeing your dentist.

Loss of Teeth and Uneven Jawbone

Tooth loss and a deteriorating jawbone are often caused by periodontitis which is a severe gum infection. Ongoing inflammation causes the ligaments that hold the teeth in place to loosen, and when left untreated, can cause the tooth to fall out and the jawbone to deteriorate. As periodontitis is often unnoticeable in the early stages, it’s crucial to have a dentist examine your mouth on a regular basis. The trained eye can catch this common problem in seniors before it results in tooth loss. Patients who have cardiovascular disease, diabetes, and aspiration pneumonia are all at higher risk of experiencing this oral health concern, so if you fall into any of these categories, make sure to tell your dentist.

By the time Americans hit age 50, they are missing an average of 12 permanent teeth. That increases as they get older older. Prevention lies in regular dentist visits to catch gum issues before you might see them yourself. Regular brushing, flossing and mouthwash can help stave off the effects of deteriorating jawbones and periodontitis and, like just about everything else in life, your mouth health improves with good diet, hydration and avoiding sugary foods and drinks.

Dry Mouth and Medication Side Effects

A dry mouth, also known as xerostomia, can lead to tooth decay and cavities. Age can be a significant contributing factor to dry mouth, both due to the slower production of saliva, but also as a result of the introduction of new medications into our daily routines. It’s common to require more medication as we age for various reasons, but some of those medications can cause your mouth to dry up. This is a pervasive problem in the elderly community, with some estimates suggesting up to 57% of all seniors experience problematic dry mouth.

The good news is that prevention is not difficult and can actually be enjoyable. Sucking on some sugar-free hard candies can help your mouth produce more saliva. The same can be said for chewing sugar-free gum. Increasing the amount of water you’re drinking on a regular basis is also a great idea.

Periodontal Gum Disease in Elderly

According to the CDC, 2 out of every 3 seniors suffer from periodontal gum disease in the United States. There are numerous causes of periodontitis including dry mouth, receding gums, gingivitis, smoking, poor oral health habits, vitamin C deficiency, obesity, poor nutrition, diabetes, rheumatoid arthritis, conditions that affect the immune system and side effects of certain drugs.

Periodontal disease in elderly patients is prevented with regular dentist visits and good oral hygiene. Additionally, seniors should ensure they’re getting the nutrition they need and avoid junk foods and sugary drinks. Regular exercise to remain in your ideal weight range is also a good idea. Hydration is key and if you’ve still got a smoking habit, quitting will lower your risk significantly.

Gum Recession

Gum recession is when the gums pull back, exposing a larger portion of the tooth. This newly exposed part of the tooth is softer and more susceptible to decay. When your gums recede, it can lead to numerous other oral health problems including tooth decay, root decay, and the development of cavities. The causes of gum recession include harsh brushing, improper oral hygiene, smoking and grinding your teeth. Receding gums are common in older adults but the condition can be prevented. Using a soft bristled toothbrush can ensure harsh brushing causes less damage. Regular brushing and dentist visits are key to preventing your gum from receding further. Dental check-ups on a regular basis will also help catch complications of receding gums including cavities and decay.

Oral Cancer

Oral cancer becomes more prevalent in older adults, especially those who use tobacco products. In fact, tobacco and alcohol are estimated to have caused upwards of 75% of all oral cancer cases. Oral cancer is often asymptomatic in its early stages, which means the only way to catch it early is to see your dentist. When you see your dentist, they will often perform an oral cancer screening during which your dental practitioner may ask you to swish a dye in your mouth that will react with cancerous cells in your mouth, causing them to brighten under an oral cancer screening light. It’s painless and early detection always offers a better prognosis.

Prevention of oral cancer means quitting any smoking habit you might have and setting down the alcohol. A good diet and hydration will also help, and the most crucial part of oral cancer prevention is, of course, seeing your dentist regularly.

Thrush

Candidiasis or thrush can be identified by a white rash on your tongue and inside your cheeks. Thrush is a fungal infection caused by a yeast that is often found in healthy mouths in smaller concentrations. The condition arises from dry mouth, pregnancy, smoking, wearing dentures incorrectly, HIV, cancer, and diabetes. Left untreated, thrush can cause redness, inflammation and pain inside your mouth, making eating and drinking uncomfortable. Of particular concern to elderly people, thrush can cause denture stomatitis which are lesions where dentures meet the gums.

Practice good oral hygiene to prevent thrush, and limit food and drink that contains yeast and sugar. See your dentist regularly, but most importantly, quit smoking.

Bad Breath

Bad breath becomes more common in older adults, but it’s often a sign of other more serious conditions. When you experience bad breath, this could be a sign that you have undiagnosed periodontal disease, tooth or root decay, cavities, thrush or oral cancer. Bad breath can also be caused by a dry mouth, poor diet, certain medications, smoking and drinking alcohol.

If you find your breath is excessively unpleasant, it’s time to see your dentist to find out why. To prevent this from happening, the first step is always to quit smoking. Enjoy a healthy diet full of lean proteins, lots of leafy greens, vegetables and fruits and proper hydration. Brushing regularly in combination with flossing on a daily basis can help bad breath significantly. See your dentist on a regular basis as well, to catch any bad breath causing conditions before they become too serious.

Denture-Induced Stomatitis

Denture-induced stomatitis is a condition that affects seniors at a much greater rate than younger people, mostly because they are more commonly denture wearers. Denture stomatitis is, like thrush, caused by a fungal yeast, often concentrated in areas where the gums meet your dentures. This condition causes painful lesions and can make wearing your dentures extremely uncomfortable.

There are many different factors that can cause denture stomatitis. Improper cleaning of dentures is a common cause, as is the improper placement of your dentures in your mouth. Poor dental hygiene can also cause this condition and the consumption of food and drink with high sugar content can, as well. Your dentures may also contribute to the problem due to their age or what they’re made with. Smoking is also a major cause of this condition.

Prevention is relatively easy. You’ll want to make sure you’re properly cleaning your dentures on a regular basis while also practicing good oral hygiene. Regular dental visits will help you identify when and if you need a new appliance, and can help you catch any condition affecting your mouth in its early stages. Lower your sugar intake and eat a healthy diet, and drop the smoking habit to ensure you’re not affected by denture stomatitis.

The key to avoiding all of these oral health conditions is in prevention and for the most part, these preventative measures are relatively easy. Here are some key tips for maintaining good oral health in geriatric patients:

• You’ll start with a good diet, which is going to benefit all aspects of your health, not just your dental health. Avoid foods with high sugar content and stay away from excessive fried and junk foods.
• Stay hydrated with at least eight glasses of water per day.
• Ensure you’re brushing with a soft-bristled brush at least twice per day.
• Flossing is crucial in preventing gum disease and decay, and most dentists will recommend you do it at least once per day.
• If you can, reduce your coffee consumption.
• Eliminate your tobacco use in all its forms.
• Enjoy alcohol in moderation.
• See your dentist regularly and when you have oral health concerns. Ensure your dentist performs a cancer screening at least once per year.
• Clean your dentures regularly.
• Ensure you’re wearing your dentures properly.
• Fight dry mouth with sugar-free gum, candies, and increased water intake.
• Be aware of the side effects of any new medication you’re on.

With the exception of smoking cessation, each of these preventative measures is easy, and some are even enjoyable. They are a small effort to put in to ensure the long-lasting health of your teeth.

As a senior visiting the dentist, you may be asked some questions upfront. They might include your age, the date of your last dental examination, and anything different you may have noticed in your mouth lately.

Your dentist may then perform a cancer screening which will include putting pressure and rubbing around your neck, chin, cheeks, and lips, checking for lumps, bumps, and moles. Your dentist may also perform a light screening by introducing dye into your mouth that will highlight cancerous tissue under a light shone in your mouth. This is painless and the dye is harmless.

Next, your dentist will check your bite and jaw, listening to any clicking sounds that might happen as you open and close your mouth. He or she might also look at how your teeth come together when you bite closed.

Every once in a while, you’ll be asked to stay still for some x-rays of your teeth and mouth so the dentist may identify problems sooner.

After all of these preliminary screenings, your oral health practitioner may recommend taking preventative antibiotics before your cleaning. This is often recommended in patients with compromised immune systems. The reason why is because our mouths are full of bacteria and even a routine cleaning can bring up a lot of it. Sometimes, during your routine cleaning, that bacteria can be swallowed and affect other areas of your body, including your heart. This is less common in people who have a perfectly functioning immune system. As seniors tend to have weaker immune functions, often you’ll be provided with antibiotic prophylaxis to prevent any complications from your dental procedures.

Once you’ve taken your antibiotics, you’ll get your cleaning which can include either the use of a water pick or a metal instrument to clear plaque build-up from your teeth. You may have your teeth polished and flossed, and you’ll be offered a fluoride treatment which is always a good preventative measure, especially for seniors.

Finally, if you have dentures, your dentist will examine your appliance and the areas of your mouth where the dentures meet your gums.

Paying for health care can be challenging for seniors, and dental problems are no different. Unfortunately for seniors, Original Medicare won’t cover your routine dental care, which can make oral care for elderly patients complicated. You may find that Original Medicare will cover certain medically necessary procedures, such as when dental issues find you in the emergency room. But you will not be covered for routine preventative care. That’s why it’s beneficial to plan to maintain your dental health before you’re retired. You may still have access to your employer’s benefits for some time after your retirement, so the first place to check for assistance in paying for your dental care is your employment benefits.

You can also opt into a Medicare Advantage plan that offers dental care as well as coverage for vision, hearing and prescription medication. Medigap insurance can fill in where Original Medicare coverage stops as well.

Private dental coverage from insurance providers is also a possibility for covering your regular dental care. The American Association of Retired People offers dental insurance plans for members. Other private insurance providers will allow you to select a dentist in their network and pay reduced fees. Find your dental insurance plan on the website of the National Association of Dental Plans.

You might also ask your dentist for a payment plan. Many dentists offer financing at low rates.

Our content is created for educational purposes only. This material is not intended to provide, and should not be relied on for tax, legal, or investment advice. Everdays encourages individuals to seek advice from their own investment or tax advisor or legal counsel.