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The aging mouth — and how to keep it younger

Aging isn’t always pretty, and your mouth is no exception. Today, three-quarters of people over 65 retain at least some of their natural teeth, but older people still suffer higher rates of gum disease, dental decay, oral cancer, mouth infections, and tooth loss. While these problems are nothing to smile about, you can still do a lot to keep your mouth looking and feeling younger than its years.

Wear and tear

Teeth are amazingly strong. But they’re not indestructible. A lifetime of crunching, gnawing, and grinding wears away the outer layer of enamel and flattens the biting edges. Tooth surfaces are also affected by exposure to acidic foods such as citrus fruits and carbonated beverages, which dissolve the protective enamel. Weakened enamel can set the stage for more serious dental problems.

Just because you’ve got a few gray hairs doesn’t mean you’re out of the woods when it comes to cavities, either. A prime target of cavities in older adults is around the neck of the tooth, adjacent to the gum line. Gum tissue naturally recedes with age, so the soft root tissue becomes exposed. In addition, adults who grew up before the advent of fluoride products and dental sealants often have fillings from childhood and adolescence that eventually break down.

While there’s not much you can do to stem the natural erosion of the tooth surface, the pillars of cavity prevention — brushing, flossing, and regular cleanings at the dentist’s office — remain the same at any age. Fluoride rinses and gels, and varnishes applied by a dentist, may be able to halt the progression of root decay and in some cases reverse the damage.

You may have also noticed that your once-sparkling smile has dimmed over the years. There’s no shortage of whitening products these days. Dental bleaches containing peroxide (available over the counter or through your dentist) will lighten your teeth a few shades, although the results are less dramatic in older teeth. Whitening toothpastes and rinses can temporarily lift superficial stains, but don’t expect the effect to last. Before deciding on a bleaching method, it’s a good idea to talk to a dentist.

A strong supporting cast

While sturdy teeth are the stars of a healthy mouth, they can’t perform without a strong supporting cast — the gums and soft, wet tissue that line the oral cavity. Periodontal disease, characterized by receding gums, wobbly teeth, and deterioration of the jawbone, is the primary culprit in tooth loss among older adults. Fortunately, periodontal disease is treatable at any age with a combination of scaling to remove the hardened plaque and infected gum tissue, antibiotics, and — in advanced cases — surgery.

Make the moist of it

Hundreds of medications list dry mouth (xerostomia) as a side effect. Lack of saliva is more than just uncomfortable. It makes eating and swallowing difficult, causes bad breath, and leads to irritation and infection of oral tissues. Good oral hygiene can combat this problem.

You can moisten a dry mouth by chewing sugarless gums or sucking on sugarless candies. Simply drinking more water can help; try holding it in your mouth for a few seconds before you swallow.

The mouth-body connection

The well-being of your aging mouth is tied to the health of the rest of your body. There’s evidence of an association between gum inflammation and conditions such as diabetes, heart disease, stroke, and respiratory problems, all of which are more prevalent in later life. Scientists postulate that bacteria from gum infections travel through the bloodstream to trigger inflammation in organs and tissues at distant sites.

Keeping your mouth young in old age requires diligent do-it-yourself care: brushing with fluoride toothpaste and flossing at least twice a day. Regular dental appointments are also important.

February 2010 update

Dental Care for Adults, a special report from Harvard Health
Click to enlarge

Dental Health for Adults

Perhaps the most feared doctor appointment of all is a visit to the dentist. But the Dental Health for Adults report can provide the information you need to maintain a dazzling smile and a healthy mouth. From the latest dental care products to the newest, painless treatments and restoration options, you’ll learn how to keep those pearly whites shining for years to come. Read more

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