The Natural Wear and Tear on Your Teeth
Enamel Thinning and Discoloration
Over a lifetime, the enamel that protects your teeth gradually wears away due to chewing, grinding, and exposure to acidic foods and drinks. This thinning reveals the softer, naturally yellowish dentin layer beneath, which can give teeth a darker or more yellow appearance. Additionally, years of consuming coffee, tea, wine, and tobacco can accelerate staining. The erosion of enamel also makes your teeth more vulnerable to decay and sensitivity.
Increased Tooth Sensitivity
Increased sensitivity is a common side effect of aging. As enamel thins and gums recede, the protective barrier over the tooth's root surfaces is lost, exposing the dentin. Dentin contains microscopic tubes that lead to the tooth's nerve. When exposed, these nerves can become sensitive to hot, cold, sweet, or acidic foods and drinks, causing sharp, sudden pain.
Tooth Wear, Cracks, and Fractures
Decades of chewing and, for some, unconscious grinding or clenching (bruxism), can cause teeth to wear down. Older teeth can also become more brittle and are therefore more prone to chipping, cracking, or fracturing, particularly if they have old, large fillings. A damaged tooth may require a crown or, if fractured below the gumline, an extraction.
Teeth Shifting
Many people notice their teeth shifting as they age, even if they had orthodontic treatment earlier in life. This movement can lead to crowding, gapping, and bite misalignment. This is often caused by the natural weakening of the jawbone over time and changes in the position of the gums.
Changes in Your Gums and Soft Tissues
Gum Recession
As we get older, it is common for gums to recede, pulling away from the teeth and exposing the sensitive roots. While this can be a natural part of aging, it can be worsened by overly aggressive brushing or, more commonly, by periodontal (gum) disease. Exposed roots lack the protective enamel of the tooth crown, making them highly susceptible to decay.
Higher Risk of Periodontal Disease
Gum disease is a significant concern for older adults, with the CDC reporting that two in three adults aged 65 and older have gum disease. Factors like plaque buildup, systemic health issues (such as diabetes), and a weakened immune system increase the risk. Untreated, gum disease can cause the breakdown of gum tissue and bone that support the teeth, eventually leading to tooth mobility and loss.
Delayed Healing
As with other body tissues, oral tissues may become thinner and less elastic with age, and the rate of cell renewal slows down. This can result in slower healing from infections, injuries, or oral surgeries. A weaker immune system can also contribute to a longer recovery time.
Common Conditions in the Aging Mouth
Dry Mouth (Xerostomia)
Dry mouth, or xerostomia, is one of the most prevalent issues facing older adults, though it is not a normal part of aging itself. Instead, it is most often caused by medications used to treat common age-related conditions such as high blood pressure, depression, and allergies. Reduced saliva flow increases the risk of tooth decay, gum disease, and fungal infections like thrush, since saliva helps neutralize acids and wash away bacteria.
Root and Coronal Decay
Cavities are not just a problem for kids. Due to dry mouth and receding gums that expose the vulnerable tooth roots, older adults are highly susceptible to root decay. Decay can also occur around the edges of old fillings or crowns, which may have become worn over time.
Oral Cancer Risk
Older age is a significant risk factor for oral cancer, with the risk increasing for those over 40. Regular dental check-ups are crucial for early detection, as dentists can perform a thorough screening to look for red or white patches or sores that do not heal.
Diminished Sense of Taste and Smell
Changes in taste and smell perception can occur with age, impacting an individual's enjoyment of food. This can be influenced by medications, disease, or wearing dentures. This loss can sometimes lead older adults to use excessive salt or sugar to enhance flavors, which is a concern for those with certain health conditions.
Comparison of Oral Health Concerns: Younger Adults vs. Older Adults
| Feature | Younger Adults | Older Adults |
|---|---|---|
| Primary Decay Location | Pits and fissures on tooth crowns | Exposed root surfaces and around old restorations |
| Gum Health | Generally healthy, with gingivitis caused by plaque | Higher risk for periodontitis and gum recession |
| Common Concerns | Cavities, wisdom teeth, cosmetic issues | Dry mouth, root decay, failing restorations, tooth loss |
| Saliva Production | Typically healthy | Often reduced due to medication side effects |
| Enamel | Strong and intact | Thinner and more worn over time |
| Risk of Oral Cancer | Low | Higher, especially over age 40 |
Maintaining Oral Health as You Age
Adapting Your Oral Hygiene Routine
As manual dexterity may decrease with age due to conditions like arthritis, adapting your brushing and flossing can be helpful. Electric toothbrushes with larger handles can be easier to grip and more effective at removing plaque. For flossing, interdental brushes or water flossers can make cleaning between teeth simpler and more accessible.
The Role of Medication Management
It is vital to provide your dentist with a complete list of all prescription and over-the-counter medications you are taking. Discussing potential oral health side effects, like dry mouth, with your doctor can help you manage or potentially find alternative medications that don't have the same impact. For those with dry mouth, staying hydrated, using artificial saliva products, and chewing sugar-free gum with xylitol can offer relief.
The Importance of Regular Dental Visits
Routine dental check-ups and cleanings are arguably more important as you get older. Your dentist can perform oral cancer screenings, check for signs of gum disease, and address issues with older dental work like fillings or crowns. Even if you wear dentures, regular visits are necessary to check your oral tissues for infections or sores.
Healthy Diet and Lifestyle
Maintaining a balanced diet rich in fruits, vegetables, and calcium-rich foods supports not only your overall health but also your oral health. Limiting sugary snacks and beverages is crucial to prevent decay, especially with reduced saliva flow. Avoiding tobacco and excessive alcohol consumption also lowers the risk of oral cancer and gum disease. For more information, the Centers for Disease Control and Prevention offers a wealth of resources on adult oral health.
Conclusion
While aging brings inevitable changes, the decline of your oral health is not a foregone conclusion. By understanding what happens to your mouth when you get older, you can take proactive steps to protect your teeth and gums. Adapting your hygiene routine, managing medication side effects, and maintaining regular dental visits are all key to ensuring your smile remains healthy and strong throughout your golden years. Prioritizing oral health is a vital part of overall well-being, and it’s a commitment that pays dividends for a lifetime.
