Health issues

The definitive dental guide for over-60s

Apr 08, 2019

There are specific oral health problems impacting people over the age of 60 and many ways to practice good oral hygiene in older age. Source: Pexels

Our teeth and mouth change a lot as we age, but if the results of the recent Adult Oral Health Tracker are anything to go by, there’s plenty older people can be doing to protect their teeth and improve their overall oral health.

While the thought of visiting a dentist sends shivers down the spine of many, the reality is that tooth decay, gum disease and oral cancer all contribute to illness, disability and even death in older Australians. Worryingly, the latest stats show that just 51 per cent of adults brush their teeth twice a day, 15.5 per cent have severe tooth loss and as many as 47.8 per cent consume too much sugar.

What’s more is there are other specific oral health problems impacting people over the age of 60. One of the biggest is gum disease.

Mild versions of gum disease are known as gingivitis, while people with more advanced stages of gum disease are diagnosed with periodontitis. Around 61 per cent of people over 75 have moderate or severe periodontitis, which can result in the loss of bone and gums that surround the teeth.

Just 51 per cent of adults brush their teeth twice a day. Source: Pexels

“The bone can recede without the gum doing so, creating pockets around the teeth,” Dr Mikaela Chinotti, Australian Dental Association Oral Health Promoter and Dentist, tells Starts at 60.

“Accumulation of plaque on the tooth in the areas adjacent to the gums results in inflammation of the gums which can cause them to bleed when brushed and flossed. With good brushing and flossing over consecutive days, this can remove the plaque and help to restore the health of the gums.”

Diabetes and cigarette smoking are two of the biggest risk factors when it comes to the onset of periodontitis. Figures show 5.1 per cent of the population are living with diabetes and 12.2 per cent smoke daily, with the condition more common in older people. While quitting smoking and managing diabetes can reduce the risk, there is no cure for periodontitis. Still, professional cleaning can stop the disease from progressing.

“Treatment of this disease involves cleaning the teeth whilst they are numb from local anaesthetic. The cleaning occurs under the gums in the areas of the ‘pockets’ which form,” Chinotti explains. “Regular treatment can halt the disease where it does not progress further however the bone and gum tissue that is lost does not return with treatment.”

In cases where too much bone is lost without treatment, affected teeth can become loose and may even fall out.

Smoking can increase the risk of gum disease. Source: Pexels

Another common cause of oral health problems is polypharmacy – where people take a combination of medications.

“Certain medications, particularly when taken in combination, can result in decreased saliva production, which acts a protective factor within the mouth,” Chinotti says. “This can result in people developing more tooth decay.”

The most commonly referenced medications that can cause dry mouth and oral health issues include tricyclic antidepressants, antihistamines and anticholinergics. Still, it’s important to know there are many more that could also be impacting your oral health.

Side effects of medications can typically be found on the informational pamphlet when medication is prescribed, while doctors and pharmacists can also explain the impact medication can have on oral health.

“Your dentist should also inform you if they notice you are taking medications that could cause dry mouth – another important reason for filling out the medical history form comprehensively when visiting the dentist,” Chinotti says.

Certain medications can cause oral health problems, so it's important to talk about side effects with a health professional. — Certain medications can cause oral health problems, so it’s important to talk about side effects with a health professional. Source: Pexels

Unfortunately, many dental diseases are silent until they are in their advanced stages, which is why regular dental check-ups are important in detecting any problems that don’t always show noticeable symptoms.

“People tend to think because they have no discomfort from their mouth that nothing is wrong,” Chinotti explains. “Dental diseases are often silent and painless until in their advanced stages and still then may not cause discomfort.”

A dentist will typically check teeth for cavities, check for gum disease and signs of oral cancer, as well as providing oral health education. In some cases, particularly where people are experiencing higher rates of tooth decay, a dentist may suggest a toothpaste containing increased levels of fluoride to further protect the teeth.

In between visits, teeth should be brushed twice a day, while areas between the teeth should be cleaned at least once a day with floss or interdental brushes. Electric toothbrushes are also superior to manual brushes, but there isn’t enough evidence to support certain powered brushes over others.

Another common mistake people make is rinsing the mouth with water after a brushing.

Mikaela Chinotti says electric toothbrushes are better than traditional ones. Source: Pixabay

“Spit out the excess toothpaste only,” Chinotti says. “Rinsing removes the fluoride which would otherwise be left to sit on the teeth helping to re-strengthen the tooth structure.”

And, while there are plenty of mouthwashes on the market, using it is not recommended by dentists in general.

“Generally, if people floss and brush as required and adequately, mouthwash is not required to ‘remove bacteria’ because that is the job of the floss and toothbrushing. It is suggested sometimes as part of an oral hygiene routine to people who may be having trouble cleaning their teeth due to a reason, such as trauma to the mouth, for example.” Chinotti adds.

If opting to use mouthwash, alcohol-free versions are recommended and people should choose a brand that contains fluoride to protect the teeth.

In the event that teeth can’t be replaced, it’s always best to discuss concerns with a dentist to explain what the best options are. In some cases, people may be eligible for options such as dental implants, while dentures will be best for others.

These days, dentures aren’t always ill-fitting or uncomfortable and there have been significant improvements over the years in the materials used for dentures and the adhesives to hold them in place. It can take some time for the mouth to adjust to dentures but most people see improvements quickly.

There have been significant improvements to dentures over the years. Source: Getty

“It is never too late for a person to seek dental help,” Chinotti concludes.

“People may attend a dentist appointment thinking their teeth are in a state of disrepair and end up surprised that they are not as bad as they thought. It’s all about taking the first step.”