There is much to contend with as we grow older, including a higher risk for dental disease. One possible contributing factor: dry mouth from a lack of saliva.
Also known as xerostomia, dry mouth occurs when the salivary glands secrete less than the normal two to four pints a day. Saliva performs a number of functions, but perhaps the most important for dental health is as an acid neutralizer. Within a half hour to hour after eating, saliva can restore the mouth's normal pH level to prevent acid from softening tooth enamel. When there isn't enough saliva, acid levels stay high leading to erosion of the enamel. This vastly increases the chances for tooth decay.
Although there are several causes for dry mouth, one of the more common is as a side effect from certain medications. It's estimated over 500 drugs — many taken by seniors — can cause dry mouth, including diuretics for high blood pressure and heart failure, antidepressants, and antihistamines. Some diseases like diabetes or Parkinson's may also reduce saliva flow, as well as radiation and chemotherapy.
If you've developed chronic dry mouth, there are some things that may help restore adequate saliva flow. If medication is the cause you can talk to your doctor about an alternative medication or add a few sips of water before swallowing the pills and a full glass afterwards. You should also drink plenty of non-caffeinated beverages (water is the best) during the day and cut back on sugary or acidic foods. And a cool-air humidifier running while you sleep may also help keep your mouth moist.
We may further recommend an over-the-counter or prescription stimulant for saliva. For example, xylitol, a natural alcohol sugar that's found in many gums and mints, has been found to stimulate saliva and reduce the risk of tooth decay as an added benefit.
Last but not least, be sure to brush and floss daily to remove disease-causing plaque and see us at least twice a year for cleanings and checkups (if your mouth is very dry, three to four times a year is a better prevention program). Managing chronic dry mouth along with proper oral hygiene will help ensure your mouth continues to stay healthy as you grow older.
If you would like more information on the causes and treatment for dry mouth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dry Mouth.”
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
Like many people, you might be caring for an elderly parent or family member. That care should include a focus on their teeth and gums — a healthy mouth is vitally important to their overall health, nutrition and well-being. Because of the aging process, this can be challenging.
Here are 4 areas where you should focus your attention to assure the senior adult in your life has the healthiest mouth possible.
Make adjustments for hygiene. As we grow older, arthritis and similar conditions make brushing and flossing difficult to perform. You can help your senior adult keep up these vital tasks by switching to a powered toothbrush or refitting their brush with a bike handle or tennis ball to make gripping easier. Pre-loaded floss holders or water irrigators are effective alternatives to manual flossing if it becomes too difficult.
Have dentures or other appliances checked regularly. Many older people wear full or partial dentures. Due to the nature of these appliances, the risk of bone loss over time is greater, which can eventually affect their fit. Their dentist should check them regularly and reline or repair them if possible. Eventually, they may need a new appliance to match any changing contours in the mouth.
Be aware of age-related dental issues. Age-related conditions of both the mouth and the body (like osteoporosis, which can affect bone density) can impact dental health. For example, an older person can develop lower saliva flow, often due to medications they’re taking. This, as well as gastric reflux common in older people, increases acidity and a higher risk of tooth decay. Past dental work like fillings, crowns or bridges may also make hygiene and additional treatment more difficult.
Keep up regular dental visits. In light of all this, it’s crucial to keep up with regular dental visits for continuing teeth and gum health. Besides cleanings, these visits are also important for monitoring signs of tooth decay, periodontal (gum) disease and oral cancer. It’s also a good opportunity to gauge the effectiveness of their hygiene efforts and suggest adjustments.
If you would like more information on dental care for older adults, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Aging & Dental Health.”
A woman as gorgeous and funny as Sofia Vergara surely planned to be a model and actress from the get-go, right? Wrong! Sofia’s first career choice actually was to be… a dentist! That’s right, the sexy star of TV’s Modern Family actually was only two semesters shy of finishing a dental degree in her native Columbia when she traded dental school for the small screen. Still, dental health remains a top priority for the actress and her son, Manolo.
“I’m obsessed,” she recently told People magazine. “My son thinks I’m crazy because I make him do a cleaning every three months. I try to bribe the dentist to make him to do it sooner!”
That’s what we call a healthy obsession (teeth-cleaning, not bribery). And while coming in for a professional cleaning every three months may not be necessary for everyone, some people — especially those who are particularly susceptible to gum disease — may benefit from professional cleanings on a three-month schedule. In fact, there is no one-size-fits-all approach to having professional teeth cleanings — but everyone needs this beneficial procedure on a regular basis.
Even if you are meticulous about your daily oral hygiene routine at home, there are plenty of reasons for regular checkups. They include:
- Dental exam. Oral health problems such as tooth decay and gum disease are much easier — and less expensive — to treat in the earliest stages. You may not have symptoms of either disease early on, but we can spot the warning signs and take appropriate preventive or restorative measures.
- Oral cancer screening. Oral cancer is not just a concern of the middle aged and elderly — young adults can be affected as well (even those who do not smoke). The survival rate for this deadly disease goes up tremendously if it is detected quickly, and an oral cancer screening is part of every routine dental visit.
- Professional teeth cleaning. Calcified (hardened) dental plaque (tartar or calculus) can build up near the gum line over time — even if you brush and floss every day. These deposits can irritate your gums and create favorable conditions for tooth decay. You can’t remove tartar by flossing or brushing, but we can clear it away — and leave you with a bright, fresh-feeling smile!
So take a tip from Sofia Vergara, and don’t skimp on professional cleanings and checkups. If you want to know how often you should come in for routine dental checkups, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “Dental Hygiene Visit” and “Dental Cleanings Using Ultrasonic Scalers.”
Tooth decay and periodontal (gum) disease pose the most common dangers to dental health. But there are some rare conditions that can also place teeth at risk to be on the lookout for during regular dental checkups.
One such condition is root resorption in an adult tooth, in which the root itself or its surface breaks down and is absorbed by the body. Resorption occurs naturally in a primary (“baby”) tooth so it can loosen and give way for an incoming permanent tooth. Â Resorption still occurs in a limited form with young permanent teeth but should eventually stop.
Sometimes, though, it doesn’t, either from the inside of the tooth out (internal resorption) or more often from the outside in, usually around the neck-like (or “cervical”) portion of the tooth. This more common occurrence, External Cervical Resorption (ECR), can first appear as pink spots on the enamel and then progress into cavity-like areas. If not found and treated promptly, damage can occur quickly and lead to tooth loss.
We don’t fully understand the exact nature and causes for ECR, but we have identified risk factors for its development. Excessive orthodontic force on the teeth or any other trauma can cause damage to the periodontal ligament (which holds teeth in place with the jaw bone). Teeth grinding habits and some dental procedures like internal tooth whitening can also be risk factors.That being said, though, the vast majority of people who experience these issues don’t develop ECR.
Although the causes aren’t fully understood, we can still treat it: the key to success is early detection. You probably won’t notice early signs of ECR, but we can often detect spots from routine x-rays. We can then remove the tissue cells within the lesions causing the damage and restore the area with a tooth-colored filling material. If ECR has extended near the tooth’s interior pulp layer, then a root canal treatment may be needed.
Needless to say, the more extensive ECR occurs in the roots, the less likely the tooth can be saved and may need to be extracted. It’s important, therefore, to maintain regular dental checkups (at least twice a year) to increase your chances of catching a developing problem early.
If you would like more information on root resorption in adult teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Resorption: An Unusual Phenomenon.”
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