Healthier mouth, teeth and gums for over fifties

Why older people need extra care with their oral health 

Taking care of teeth and gums becomes even more important as you age for a number of reasons.

Teeth become brittle

Teeth become brittle as you get older and are more likely to crack or chip as a result. This ‘opens up’ your teeth to decay-causing bacteria. Teeth can be cracked in an accident, by biting on hard foods or by grinding teeth together. Often, the first sign of a cracked tooth is pain on biting.

Saliva production falls

Saliva production tends to fall as you get older causing dry mouth, which can contribute to tooth decay. Saliva washes food away, reduces the amount of decay-causing bacteria, and helps cancel out the damaging acids these bacteria produce. It also helps rebuild enamel. Many medications commonly taken by people as they get older, such as some blood pressure medications, reduce saliva production as well.

Health conditions associated with age can put oral health at risk

Some health conditions that may affect us when we get older can also increase the risk of tooth problems and gum disease.

• People with type 2 diabetes have lower resistance to infection, which makes them more susceptible to oral health problems than people without diabetes. This includes gum diseases such as gingivitis, an inflammation of the gums that makes them bleed easily. Untreated gingivitis can lead to periodontitis, a more serious chronic bacterial infection of the gums that can damage the bone and tissue that support the teeth, causing tooth loss.
• Sjögren’s syndrome – where the body destroys its own moisture-producing glands causing dry eyes and dry mouth – is a fairly common condition in middle-aged women.
• The hormonal changes brought about by menopause in women may make gums sore and sensitive and reduce saliva production. Menopause may also make the jawbone thinner as a result of bone loss, which may lead to tooth loss.

Beating dry mouth 

About 25 percent of older people don’t produce enough saliva and experience a dry mouth. If you are one of these, it’s important to keep up good oral hygiene habits in addition to the tips suggested here to help you manage dry mouth specifically.

• Check if any medications you are taking are contributing to your dry mouth – your doctor may be able to change or reduce the culprit medications if this is the case.
• Avoid substances that are likely to increase mouth dryness, such as caffeine, alcohol, cigarettes and spicy foods.
• Stimulate saliva production by chewing sugar-free gum, holding lemon rind in your mouth, or sucking on sour lemon lozenges. Don’t suck on lollies – the sugar they contain will only make things worse.
• Use dry mouth products to help lubricate the mouth or provide artificial saliva. You can buy these products at your pharmacy and they include a toothpaste, mouthwash and mouth spray. If your dry mouth condition is particularly severe, your doctor can also prescribe you medication to stimulate saliva production.
• Use an anti-bacterial mouthwash to help prevent tooth decay. 

More information on dry mouth and how to manage it 

Smoking and oral health 

Besides staining your teeth and making them look unattractive, smoking damages your gums and the lining of your mouth by causing less blood and oxygen to reach them. This increases your risk of tooth decay and gum disease. Smoking also changes the thickness of your saliva making it less effective at protecting your teeth.

If you quit smoking it will not only improve the health of your teeth and gums, but also reduce your risk of developing mouth cancer – smokers are five times more likely to develop mouth cancer than non-smokers.

Tips for caring for your teeth 

It’s important to maintain good oral health at any age. For people over 50, revisit what you do and revise it to help you keep your teeth for life.

Here are more tips to help prevent common problems and help keep your teeth and gums in good shape:

• Drink tap water – in most places across Australia, tap water contains fluoride. Fluoride helps protect teeth by slowing down the enamel break-down caused by acids as well as helping to rebuild tooth enamel. While bottled water also helps quench your thirst, keep in mind it does not contain teeth-protecting fluoride.
• Limit consumption of sugary and acidic drinks and snacks – this includes so-called 'healthy' snacks such as fruit juices, fruit bars and muesli bars. Be careful how often you eat and drink these foods throughout the day. This is just as important for tooth decay as the amount of sugar or acid the food contains. If you need to snack, eat ‘tooth-friendly’ foods such as cheese, nuts, apples, carrots and celery. Milk-based drinks are preferable and tap water is better still.
• Limit alcohol consumption – alcohol can contribute to tooth decay and dry mouth and is a risk factor for oral cancers.
• Brush your teeth twice a day using fluoride toothpaste – you need to brush your teeth for 2–3 minutes each time. Make sure you clean every surface of your teeth in a systematic way. If possible, use a soft-bristled toothbrush with a small head so it is easy to reach all areas of your mouth. Electric toothbrushes are an alternative. Brush your tongue as well for fresher breath.
• Brush up on your brushing technique – how you brush your teeth is important too. Incorrect brushing can lead to receding gums (which is irreversible) as well as gum disease. Receding gums make you look ‘long in the tooth' and exposes the roots of your teeth, which are especially vulnerable to decay. Ask your dentist about the best way to clean your teeth or find out more from the Australian Dental Association.
• Floss between your teeth every day – flossing removes food from between your teeth that a toothbrush can’t reach. There are also other oral hygiene devices that can be used instead of, or as well as, floss. If you find using floss difficult, speak to your dentist about the best floss-alternative for your teeth.
• Visit your dentist regularly – everyone’s needs are different, so have a chat to your dentist about how often you need to have your teeth checked by them based on the condition of your mouth, teeth and gums. They can clean your teeth to remove any plaque build-up you have missed that has hardened into tartar, and give your teeth a fluoride rub.
• Chew sugar-free gum after meals – chewing gum makes your mouth produce more saliva.

Further information 

Sources 

American Academy of Periodontology. Gum diseases and other diseases. [online] [Accessed 28 Jul 2014] Available from: www.perio.org

Australian Dental Association. National dental update. Tooth decay – Australia’s most prevalent health condition. [online] 2012. [Accessed 28 Jul 2014] Available from: www.ada.org.au

Australian Dental Association. FAQ. [online] [Accessed 28 Jul 2014] Available from: www.ada.org.au

British Dental Association. Diet. [online][Accessed 28 July 2014] Available from: www.dentalhealth.org

British Dental Association. Fluoride. [online] [Accessed 28 July 2014] Available from: www.dentalhealth.org

Buencamino MCA Palmo L Thacker HL. How menopause affects oral health, and what we can do about it. Cleveland Clin J Med. 2009; 76: 467–475.

Kruszka P O’Brian RJ. Diagnosis and management of Sjögren’s syndrome. Am Fam Physician. 2009; 79: 465–470.

myDr. Glaucoma. Dental health tips for over 50s. [online] [Last updated 1 Nov 2009; accessed 28 Jul 2014] Available from: www.mydr.com.au

National Institutes of Health. National Institute of dental and craniofacial research. Study confirms dentin grows more brittle with age. [online] [Last updated 6 Jan 2014; accessed 28 Jul 2014] Available from: www.nidcr.nih.gov

Pharmacy Self Care. Oral health. Deakin, ACT: Pharmaceutical Society of Australia. 2010.

Queensland Health, Royal Flying Doctor Service of Australia (Queensland Section) and Apunipima Cape York Health Council. Section 7: Management of diagnosed conditions – oral health. In: Chronic disease guidelines, 3rd ed. 2010.

State Government of Victoria. Better Health Channel. Diabetes and oral health. [online] [Last updated 16 Oct 2013; accessed 28 Jul 2014] Available from: www.betterhealth.vic.gov.au

State Government of Victoria. Better Health Channel. Dry mouth syndrome. [online] [Last updated 21 Jul 2014; accessed 28 Jul 2014] Available from: www.betterhealth.vic.gov.au

Disclaimer
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