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The Effects Of Aging And Tooth Loss On The Mouth

Tooth loss is not part of the normal aging process. In fact, tooth loss is declining among older adults. Aging is not a general of cause oral diseases, according to dentists and other dentistry professionals, yet oral diseases such as tooth loss are more prevalent with age due to changes in the oral soft tissues, a depression of the immune system, an increase in the number of systemic diseases, a decreased ability to perform adequate oral hygiene and self dental care secondary to stroke, arthritis, Parkinson's disease, dementia, or Alzheimer's disease, and dry mouth due to greater use of prescription and over-the-counter medications.

With age, teeth become less white and more brittle; however, oral hygiene habits and use of tobacco, coffee, and tea also will affect tooth color. Teeth also can darken or yellow due to the thickening of the underlying tooth structure (dentin). Brittle teeth tend to be susceptible to cracks, fractures, and shearing. Over the years, the enamel layer (outer tooth layer) is subjected to wear due to chewing, grinding, and ingestion of acidic foods. In severe cases, the enamel is completely worn away and the underlying dentin is worn down as well. Inside the tooth (pulp), the number of blood vessels and cells decrease and fibroses increase with age; thus, capacity to respond to trauma may also decrease.

The fiber content and number of blood vessels of the periodontal (gum) tissues decrease with age. However, periodontal disease represents a pathologic or disease change and is not due to just age. The loss of bone and gum attachment (receded gums) associated with periodontal disease is collective and therefore greater in older adults. An outcome of periodontal disease is exposed root surfaces. Exposure of the root in older people probably gave rise to the term "long in tooth". Oral hygiene practices and certain medications affect the health of gum tissue. Receded gums and exposed root surfaces put older adults at high risk for dental decay (caries) on the relatively soft root surfaces. Dental caries on root surfaces is a disease that is common among older adults. Dry mouth and a diet high in sugars and fermentable carbohydrates greatly increase the risk for root caries. Dental caries are a major cause of tooth loss in older adults.

Studies show some reduced chewing effectiveness, decreased tongue strength, and increased swallowing time with age; however, the studies do not indicate that there is any real change in the ability to swallow with age.

The number of cells that produce saliva decrease with age. However, healthy, unmedicated older adults do not have reduced saliva flow. This is because the salivary glands have a high reserve capacity. Usually when a decrease in saliva flow is noted, it is associated with medication use, illness, medical conditions, or their treatment.

The number of taste buds do not appear to change with older age; thus, the ability to taste does not change significantly with age. However, smell decreases with age. Since the ability to taste is closely related to smell, taste perception may be altered in older adults.

Soft tissues of the mouth become thinner and lose elasticity with age and promote tooth loss. Soft tissue lesions are more common in older adults. Chronic inflammation such as candidiasis (fungus growth) and denture irritation also occurs more often. Wound healing is decreased due to reduced vascularity (blood flow to the area) and immune response with age.

Oral and oropharyngeal cancer is the most serious disease associated with age. Oral and oropharyngeal cancer lesions usually are not painful. Oral and pharyngeal cancer may appear as a red or white patch, a sore or ulceration, or a lump or bump that does not heal within two weeks. Swollen lymph nodes of the neck, difficulty swallowing and speaking, and voice changes also may be signs and symptoms of oral and oropharyngeal cancer. The risk for oral and oral pharyngeal cancer increases with age, use of all forms of tobacco, frequent alcohol use, and exposure to sunlight (for lip cancer). See a dentist if any signs or symptoms of oral and pharyngeal cancer are present.

By Denise J. Fedele, DMD, MS

Toothache - Why Won't My Tooth Pain Go Away?

Technology in dentistry now offers attractive options in dental fillings for cavity restorations in dental care. Called composites, these new tooth-colored dental fillings are excellent choices for front teeth and other repairs that might be visible. Composites duplicate the natural appearance of a tooth in restoring decayed teeth or repairing a defect and giving you a more attractive mouth.

What Dental Care Material Is Used in the Composite Filling?

Dental fillings composites are made from a mixture of microscopic plastic and ceramic resin particles. Another type of tooth-colored dental fillings used in dental care are called a resin ionomer, which releases fluoride useful for preventing tooth decay.

Besides Their Cosmetic Value, What Other Benefits Do Composites Provide in dental care

The bonding process used in restoration provides strength to the tooth, making it more structurally sound. It also seals the tooth, decreasing the chance of sensitivity to hot and cold. Some composites made with materials releasing fluoride are ideal for treating root decay, a condition when gums recede, exposing tooth roots to more cavity-causing plaque. These fluoride-releasing materials also are useful dental fillings for decayed baby teeth.

What Is the Process for Dental Care Treatment?

Following removal of the decayed area, a mild acid solution is used to prepare the tooth's surface for bonding and dental fillings. A bonding agent is then brushed over the surface. Several layers of the composite are applied during the next dental care process. For a natural appearance, the dentist matches the color of the dental fillings composite to the tooth.

Then, it is chemically hardened or cured with a special light and finally polished for a natural-looking finishing touch.

How Durable Are these Dental Fillings?

In a five-year clinical study of dental care, some of the resin materials demonstrated 100% effectiveness for adhesion and retention. Like other types of dental fillings, they may require periodic replacement. While the material is very durable, they may not perform quite as long as silver fillings or amalgams for their resistance to the rigors of grinding and chewing.

Scheduling dental care on a regular basis is an important part of good oral hygiene. Your dentist will check your fillings each time to ensure their performance.

By Brian J. Gray, DDS, MAGD, FICO

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