As one gets older, there is a gradual slowdown of tissue growth. The repair process takes longer. Aging tissues have decreased blood circulation. Irritations and infections are more likely to occur in the mouth. Older people produce less saliva which leads to an extra build up of plaque. Plaque encourages the growth of bacteria which leads to the two main dental problems affecting today’s seniors. The first of these is caries (cavities) which occur on the root surfaces of the teeth. Root caries increase in frequency from about one in nine at age 30 to approximately two in three for those over age 60.

The second damaging result of plaque buildup is gum (periodontal) disease. Although gum disease is common among all adults, there is a dramatic five-fold increase in destructive types of gum disease between 20 and 75 years of age.

Fortunately, most dental diseases are preventable. By following a few easy measures, seniors can keep their teeth strong and healthy for a lifetime. Getting there isn’t magic and it isn’t luck. Here’s how to do it.

1. Daily Brushing and Flossing Routine

Take the time to brush and then floss your teeth thoroughly at least once every 24 hours, preferably at bedtime. After 24 hours, plaque build-up starts to harden into calculus (tartar) and becomes difficult to remove.
Brushing should be done carefully to remove plaque on all exposed tooth surfaces. That includes the tops, sides and along the gum line. Tip the toothbrush at a 45-degree angle towards the gumline. Brush with a gentle circling or with a short back-and-forth, vibrating motion. Don’t scrub the teeth too hard. Brushing the teeth too vigorously causes the gums to recede and exposes root surfaces. It also wears down the tooth structure.
Don’t forget to brush your tongue. Debris and bacteria can collect on the tongue surface. That can cause bad breath and other dental problems.

A soft brush with rounded bristles is recommended. Toothbrushes should be replaced every three to six months. A worn toothbrush won’t get the teeth clean. Bacteria can also build up on toothbrushes over a period of time.
Flossing takes care of areas where the toothbrush cannot reach, namely, in between teeth. Dental floss and dental tapes are both effective. Floss daily using about 18” of floss wrapped around the middle fingers. Leave about two to three inches in the middle to work with. Work floss gently between teeth and then down below the gum line. Wrap floss into a C-shape around each tooth. Scrape away from the gum several times. Don’t forget to floss behind the last molars.

In general, brush and floss at the same time every day until it becomes routine. Work systematically from one tooth to another in the same way each time. This guarantees not missing any spots.
For seniors who are less able to care for their teeth because of physical limitations, a variety of oral hygiene aids are available. Dentists, oral hygienists and dental assistants are trained to teach and encourage patients to use these devices.

2. Full and Partial Denture Care

Dentures must be thoroughly brushed at least once a day. If you have dentures, rinse them after meals whenever possible. Remove them from your mouth and clean with a soft brush. A non-abrasive toothpaste or denture paste can be used. Soaking dentures in a glass of water containing a mixture of one teaspoonful of water softener and one teaspoonful of bleach for 30 minutes once a week will remove most stains and tartar buildup. Do not use bleach directly.

The ridges of your gums and your tongue should be brushed daily with a soft brush. This removes debris that could cause tissue irritation and bad breath. It also stimulates circulation of the gums underneath the dentures.

For seniors with partial dentures, both the prostheses and the remaining teeth need to be meticulously cleaned. The best time for cleaning is before retiring and after eating. Remove the partial dentures and clean them using a small brush with non-abrasive toothpaste or denture paste. A commercial denture cleaning solution can be used if additional cleaning is required. Soak partial dentures in the solution for 15 to 30 minutes daily, followed by a thorough brushing. Avoid bleach solutions that may tarnish some metal partial dentures.

Clean dentures over a basin partly filled with water. If you drop them they will be less likely to break if they fall into water. Do not leave either full or partial dentures in at night. Removing them allows the tissues to rest and lessens the risk of tissue irritation and fungal infection. Taking the dentures out at night also reduces the amount the gum ridges will shrink so the dentures will not need to be relined or remade as often. Prolonged partial denture use can be very destructive on the remaining teeth. However, there are certain special circumstances in which wearing dentures during sleep may be warranted. Consult with your dentist.

3. Regular Dental Check-up

Many people think that a dentist is someone to see only when they have a problem with their teeth. But the fact is, seeing a dentist for a regular check-up is an integral part of good dental health. Dentists can detect problems at an early stage. Chances are they can be treated effectively and inexpensively. Modern dentistry has progressed to a point where there is no need to suffer during treatment. New dental materials are available for durable, conservative and long-lasting restorations. Many “cosmetic” procedures can make a significant improvement towards overall health and self-image.

For seniors without any natural teeth, periodic examination of the mouth is a wise idea. The denture-supporting tissue changes over time. Good dentures eventually become ill-fitting dentures that can damage the mouth. Diseases can develop in the oral cavity even without the presence of teeth.

4. Professional Cleaning

Professional cleaning by a dentist or a dental hygienist does more than just whiten the teeth. It is impossible to remove all plaque and tartar even from daily brushing and flossing. Regular professional cleaning removes the residual debris.

In general, six month intervals between check-ups and cleaning is a good rule of thumb. For seniors with difficulty caring for their own teeth, shorter intervals between visits may be needed. The good news is that basic check-up and cleaning is not that expensive. In most cases, it costs less than a cup of coffee each day.

5. Topical Fluoride

Fluorides contained in toothpastes, rinses and various varnishes are one of the most effective ways of treating early root caries. These measures are recommended particularly for seniors who live in low-fluoride areas. Fluoride application may help reduce tooth sensitivity as well.

6. Chewing Gum

Chewing sugarless gum for 20 minutes after meals can reduce acidity in saliva and helps remove plaque. It also stimulates saliva production which helps to dilute and clear away sugars. However, excessive prolonged gum chewing is not a good idea as it puts unnecessary stress on teeth and strain on jaw muscles.

7. Stop Smoking

Smoking can cause heart and lung diseases as well as lung cancer. It may also cause cancer of the oral cavity (mouth). Nine out of 10 people suffering from oral cancer are smokers. This indicates an extremely high risk for tobacco users. Changes in the oral soft tissues and staining of the teeth are common in seniors who are long-term smokers.
It has been shown that quitting smoking can reverse early changes in oral soft tissue. Stopping the tobacco habit may help to slow the reduction in bone density as well.

8. Regular Medical Check-up

Some more widespread health problems such as diabetes and infections may affect the oral cavity because the body’s defences are weakened. Gradual physical decline of the elderly may interfere with daily oral hygiene. Seniors on long term drug therapy need to be aware of the possible effects of these medications on their teeth. Consult with your family doctor regularly about changes in your health.

9. A Well-balanced Diet

Often seniors choose high carbohydrate foods and those requiring less chewing. As a result, some of the essential nutrients from food may be lost. Vitamin deficiency is common among seniors with poor eating habits. Adequate protein and mineral intake is very important. A decrease in carbohydrates and fats is strongly recommended for healthy teeth and gums.

The belief that tooth loss is an inevitable result of old age is no longer valid. Improvement in dental health of seniors relies on proper oral hygiene, prevention and early treatment of oral diseases, and a greater use of dental services. With the right care, everyone’s teeth can be good for life.

Teeth For Life Practical advice to ward off dental disease