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Tooth decay and gum disease can lead to serious health problems, including brain or heart infections.

A growing number of older adults have something to smile about: research shows they're keeping their teeth longer. While that makes chewing and talking easier and staves off malnutrition and the discomfort of dentures or missing teeth, it also means you need to be more vigilant than ever about preventing dental problems — including some that can have life-threatening complications.

Tooth decay

One in five adults ages 65 or older has untreated tooth decay (a cavity). This develops when food and bacteria form plaque that sticks to teeth and produces toxins that break down a tooth's outer layer (enamel).

Ask the doctor

Q. Just before the holidays, I heard that a study said it was okay to eat red meat. Previously, you've said just the opposite. Help!

A. We got lots of letters like yours. The bottom line is that we stick by our longstanding advice: avoid frequent meals of red meat, and especially processed meat.

They often lead to follow-up appointments and more testing.

Modern medical imaging saves lives: it can find a blocked artery, a bulging blood vessel, or a suspicious mass. But many times, an x-ray, CT scan, MRI scan, or ultrasound exam looking for one kind of problem can reveal an anomaly that's unrelated and unexpected. Such incidental findings can lead to more testing, more medical bills, and a great deal of anxiety.

"Frequently radiologists will point out something and say it's probably benign, but recommend an MRI. Once you've been told something might be abnormal, you might feel nervous until you know what it is," says Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center.

You've tried nearly everything for your worn-out knee. But the remaining possibilities may include some risky options.

Knee osteoarthritis affects about half of us in older age. The cartilage that acts as a cushion between the bones wears away, and it hurts when the bones grind against each other. In many people, arthritis can become severe enough that they consider a knee replacement. Since surgery is an expensive and complicated option, you may wonder what else you can do to reduce knee pain. Beware: some treatments are bogus and even dangerous.

Stay away from these

The first sign that a knee pain treatment isn't the best choice: an ad promising that it's the surefire solution.

Report new symptoms immediately if you take one of these.

Taking blood thinners and prescription painkillers such as opioids can have potentially life-threatening complications. But many medications — even over-the-counter drugs — have the potential for dangerous side effects. "In most cases, the risk of serious side effects is very rare — much less than 1% of the time," says Dr. Joshua Gagne, a pharmacist and epidemiologist with Harvard-affiliated Brigham and Women's Hospital.

If you're taking any of the following drugs, learn the rare risks.

News briefs

We've reported before that heavy drinking is tied to an increased risk for developing dementia. A Harvard-led study published online Sept. 27, 2019, by JAMA Network Open suggests that the risk is even worse if you have mild cognitive impairment (MCI). Researchers analyzed the data of more than 3,000 dementia-free adults (average age 78, some with MCI) who reported their alcohol use and underwent psychological testing for six years. People with MCI who drank heavily (more than 14 drinks per week) had a 72% higher risk for dementia than people who drank less than one drink per week. However, people without MCI who drank moderately (seven to 14 drinks per week) didn't appear to have an increased risk for dementia, and even seemed to have a 37% lower risk for dementia compared with people who consumed less than one drink per week. The bottom line: "Our results suggest that moderation is the healthiest approach if you drink. And if you have mild cognitive impairment, you may want to reconsider drinking alcohol at all," says Dr. Kenneth Mukamal, a study author and researcher with the Harvard T.H. Chan School of Public Health.

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