A focus on dental care in senior citizens is just as important as it is for children. Indeed, oral health in your later years can be a major factor in your quality of life.
For one, aging effects on other parts of the body can make dental care more challenging. Some hygiene tasks once performed easily become harder — arthritis, for example, or loss of muscle strength may make it difficult to hold a toothbrush or floss. In such cases, you may need to find new ways to make the task easier: a power toothbrush with a larger handle; pre-loaded floss holders or a water flosser; or adaptations to a manual brush to make it easier to hold, like attaching a tennis ball or bike handle.
Other age-related conditions — and their treatments — can negatively impact oral health. Less saliva production, which is a consequence of aging or certain drugs, increases the risk of tooth decay or periodontal (gum) disease. Older adults often develop gastric reflux problems that can introduce tooth enamel-eroding stomach acid into the mouth. And medications called bisphosphonates, often prescribed to treat osteoporosis, may interfere in rare cases with bone healing after tooth extraction or similar procedures.
Prior dental work can also prove challenging to treating dental disease. It becomes more difficult to preserve teeth threatened with decay if there are significant restorations or appliances to work around. Pain perception can also diminish with age, so that dental disease may not be noticed until later stages when significant damage has already occurred.
Oral care requires more attention as we grow older, or as we care for older family members. Your best defense against disease is to continue regular six-month visits with us. In addition to normal cleanings and checkups, we’ll also screen for oral cancer (a more prevalent occurrence in older adults), review your prescriptions or other supplements and medications for any possible side effects to oral health, check the fit of any dentures or other restorations and evaluate the effectiveness of your hygiene.
While other age-related conditions may capture the majority of your attention, you shouldn’t allow that to neglect your dental care. With your continued efforts, along with our support and your family’s, you can continue to enjoy good oral health throughout your lifetime.
Today’s dentist can not only treat most dental diseases and conditions, but can almost prevent disease completely. Our true needs as a society, however, go beyond the dentist’s chair — to the lack of availability and affordability of care for every American.
That’s of grave concern to dentists — so much so that dentistry itself is already changing to meet these challenges.
In one of the most visible changes, we’re seeing accelerated technological advancement that could lower costs and extend our range of care. Advances in 3-D digital imaging are giving dentists amazingly detailed views of patients’ mouths that surpass the accuracy of traditional imaging. Telecommunications and the internet are enabling dentists in distant locations to examine patients and even review dental x-rays to guide treatment, providing a new level of care access for patients.
The means for delivering that care are also changing as the traditional paradigm of the solo practice becomes more difficult for new dentists to achieve. With educational debt and practice setup costs reaching as high as $1 million — before earning their first dollar — many dentists are joining larger groups or dental corporations. In these arrangements, practitioners don’t have the burden of overhead expenses and can concentrate mainly on their clinical work. On the downside, patients seeing multiple providers may not easily build that all important dentist-patient relationship that’s the hallmark of a solo practice. This alternative model could, however, increase the number of practicing dentists over time, making dental care more widely available.
Finally, we’re beginning to see greater collaboration between physicians and dentists. There’s an emerging understanding of the true interconnection of the body’s various systems: diseases of the mouth can affect other diseases of the body, and vice-versa. We’re also experiencing a growing development in salivary diagnosis, using this vital oral fluid to detect conditions and disease in other parts of the body. Dentists and physicians will be working more closely than ever to treat the whole person, not just individual systems — a collaboration that will improve patient care all around.
As these changes continue to emerge in dentistry, you may soon see their effects during your visits. One thing, however, won’t change — the commitment of dentists to provide the highest level of care, for both your oral and general health.
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
A toothache means you have tooth decay, right? Not necessarily — your pain could be signaling a number of potential causes. Determining where, how much and how often it hurts will help us find out the cause and apply the appropriate treatment.
A single symptom, for example, can mean many things. A twinge of tooth pain as you consume hot or cold foods might indicate localized tooth decay easily repaired by a filling. But it could also mean the tooth's root surface has been exposed as a result of periodontal (gum) disease — aggressive plaque removal and maybe even gum surgery might be necessary. Or it could be a sign of inner pulp decay: in this case you'll likely need a root canal treatment to save the tooth.
Pulp decay can also announce itself with a very sharp and constant pain radiating from one or more teeth. You shouldn't hesitate to see us for an examination — even if the pain goes away. Pain cessation most likely means the nerves in the pulp have died. The infection, however, still exists, so you'll still probably need a root canal treatment.
If you notice severe, continuous pain and pressure around a tooth, particularly about the gums, you may have a localized, inflamed area of infection called an abscess. An abscess can be the result of gum disease, but it might also stem from a foreign body like a popcorn husk, getting stuck below the gums. We'll need to conduct a complete dental examination to determine the cause and how to treat it.
Finally, a sharp pain when you bite down could mean many things such as a loose filling or a fractured (cracked) tooth. The latter especially requires immediate attention to save the tooth.
These are just a few of the possible causes behind mouth or facial pain. Although all of them are serious, a few are true dental emergencies and can't wait if we're going to save a tooth. The sooner you see us, the sooner we can help relieve the pain, minimize any damage and avert disaster.
If you would like more information on treating tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Pain? Don't Wait!”
Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.
One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.
Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.
Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.
It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.
You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.
Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.
If you would like more information on diagnosing and treating root cavities, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”
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