General's Report states: 23% of older adults aged 65-74 have severe periodontal
disease with men being more likely to have more severe disease!
Oral Health and Older Adults
People are living longer and healthier lives. And, older adults also are
more likely to keep their teeth for a lifetime than they were a decade ago.
However, studies indicate that older people have the highest rates of
periodontal disease and need to do more to maintain good oral health.
Whatever your age, it's important to keep your mouth clean, healthy and
feeling good. And it's important to know the state of your periodontal
||At least half of
non-institutionalized people over age 55 have periodontitis.
||Older people have three times
more tooth decay than children.
||Almost one out of four people
age 65 and older have lost all of their teeth.
||Receding gum tissue affects
the majority of older people.
||Periodontal disease and tooth
decay are the leading causes of tooth loss in older adults.
is a more common problem than ever for the older population causing
unprotected and vulnerable surfaces of your teeth to be exposed
- What you may not realize is that oral health is not just important for
maintaining a nice-looking smile and being able to eat corn on the cob. Good
oral health is essential to quality of life. Consider a few of the reasons:
1. Every tooth in your mouth plays an important role in speaking, chewing
and in maintaining proper alignment of other teeth.
2. A major cause of failure in joint replacements is infection, which can
travel to the site of the replacement from the mouth in people with
3. People with dentures or loose and missing teeth often have restricted
diets since biting into fresh fruits and vegetables is often not only
difficult, but also painful. This likely means they don't get proper
4. Most men and women age 65 and older report that a smile is very
important to a person's appearance.
5. And, maybe most importantly, recent research has advanced the idea
that periodontal disease is linked to a number of major health concerns
such as heart disease, stroke, respiratory disease and diabetes.
While your likelihood of developing periodontal disease increases with
age, the good news is that research suggests that these higher rates may be
related to risk factors other than age. So, periodontal disease is not an
inevitable aspect of aging. Risk factors that may make older people more
susceptible include general health status, diminished immune status,
medications, depression, worsening memory, diminished salivary flow,
functional impairments and change in financial status.
Medications and Oral Side Effects
Older adults are likely to take medications that can impact oral health
and affect dental treatment. Hundreds of common medications - including
antihistamines, diuretics, pain killers, high blood pressure medications
and antidepressants - can cause side effects such as dry mouth, soft
tissue changes, taste changes, and gingival overgrowth.
Dry mouth leaves the mouth without enough saliva to wash away food and
neutralize plaque, leaving you more susceptible to tooth decay and
periodontal disease. In addition, dry mouth can cause sore throat, problems
with speaking, difficulty swallowing and hoarseness. Your dentist or
periodontist can recommend various methods to restore moisture, including
sugarless gum, oral rinses or artificial saliva products.
Be sure to tell your periodontist
and other dental professionals about any medications that you are taking,
including herbal remedies and over-the-counter medications.
- Special Concerns for Older Women
- Women who are menopausal or post-menopausal may experience changes in
Recent studies suggest that estrogen deficiency could place
post-menopausal women at higher risk for severe periodontal disease and
In addition, hormonal changes in older women may result in discomfort
in the mouth, including dry mouth, pain and burning sensations in the gum
tissue and altered taste, especially salty, peppery or sour.
In addition, menopausal gingivostomatitis affects a small percentage of
women. Gums that look dry or shiny, bleed easily and range from abnormally
pale to deep red mark this condition.
Most women find that estrogen supplements help to relieve these
Bone loss is associated with both periodontal disease and osteoporosis.
Osteoporosis could lead to tooth loss because the density of the bone that
supports the teeth may be decreased. More research is being done to
determine if and how a relationship between osteoporosis and periodontal
disease exists. Women considering Hormone Replacement Therapy (HRT) to
help fight osteoporosis should note that this may help protect their teeth
as well as other parts of the body.
- Dental Implants
- More and more older people are selecting dental implants over dentures
as a replacement option for lost teeth. Whether you have lost one or all
of your teeth, dental implants allow you to have teeth that look and feel
just like your own.
Older adults have similar success rate with implants compared with
younger people. As long as you're in good health and your periodontist can
restore healthy gums and adequate bone to support the implant, you're
never too old to receive a dental implant.
A dental implant is an artificial tooth root placed into your jaw to
hold a replacement tooth or bridge in place. While high-tech in nature,
dental implants are actually more tooth-saving than traditional
bridgework, since implants do not rely on neighboring teeth for support.
In addition, dental implants are intimately connected with the gum
tissues and underlying bone in the mouth. Therefore, they prevent the bone
loss and gum recession that often accompanies bridgework and dentures and
preserve the integrity of facial features. When teeth are missing, the
bone which previously supported these teeth begins to deteriorate. This
can result in dramatic changes in your appearance, such as increased
wrinkles around the mouth and lips that cave in and lose their natural
Since periodontists are the dental experts who specialize in precisely
these areas, they are ideal members of your dental implant team. Not only
do periodontists have experience working with other dental professionals,
they also have the special knowledge, training and facilities that you
need to have teeth that look and feel just like your own.
Talk with your periodontist to find out if dental implants are an
option for you.
Denture wearers need to avoid
plaque buildup that can irritate the tissues under the dentures. Thoroughly
clean dentures daily and remove dentures at night to avoid bacteria growth.
If you wear dentures, you need to continue to see a dental professional
regularly. Because mouths continually change, dentures need to be checked
for proper fit to avoid irritation, increased bone loss and infections. A
change in the fit of partial dentures could indicate periodontal disease.
Cosmetic periodontal procedures are
not just for people in their 20s and 30s. You can have the smile you desire
at any age.
A study by the American Dental
Association and Oral-B in 1998 found that nearly half of survey respondents
age 65 and older selected a smile as the first thing they notice about
people. Almost 80 percent in this age group also reported that a smile is
very important to a person's appearance.
Preventing Periodontal Disease
Even if you've managed to avoid periodontal disease until now, it is
especially important to practice a meticulous oral care routine as you
age. Receding gum tissue affects a large percentage of older people. This
condition exposes the roots of teeth and makes them more vulnerable to
decay and periodontal infection.
To keep your teeth for a lifetime, you must remove the plaque from your
teeth and gums every day with proper brushing and flossing. Regular dental
visits are also important. Daily cleaning will help keep calculus
formation to a minimum, but it won't completely prevent it. A professional
cleaning at least twice a year is necessary to remove calculus from places
your toothbrush and floss may have missed.
If you have dexterity problems or a physical disability, you may find
it difficult to use your toothbrush or dental floss. Your dentist or
periodontist can suggest options such as an electric toothbrush or floss
holder or a toothbrush with a larger handle.
Treating Periodontal Disease
In the earlier stages of periodontal disease, most of the treatment
involves scaling and root planing, which means removing plaque and
calculus in the pockets around the tooth and smoothing the root surfaces.
In most cases of early periodontal disease, scaling and root planing and
proper daily home care are all that are required for a satisfactory
result. More advanced cases may require surgical treatment.
Once you've been treated for periodontal disease, periodontal maintenance
procedures or supportive periodontal therapy enables you to gain control of
the disease and increase your chances of keeping your natural teeth. In
additional to a dental examination, a thorough periodontal evaluation is
performed. Harmful bacterial plaque and calculus are then removed from above
and below the gum line. If necessary, root planing may be used to smooth
root surfaces that are infected. In addition, your periodontist or other
dental professional will review your at-home oral hygiene routine and may
suggest modifications tailored for your condition.
Gum Disease and Older Adult News Updates
Weight For Gums
Periodontal disease in older adults has
been linked with unhealthy weight loss, according to a
recent study conducted by researchers at University of
Pittsburgh. Their full findings appear in the
April edition of the Journal of the American Geriatrics
Society (JAGS). Weight loss of at least 5 percent body
weight in older adults is generally associated with increased
risk of morbidity and mortality. 6/04
disease and mortality in an aged population. We
investigated the relationship between periodontitis and
mortality in home-dwelling individuals aged (75+ years),
considering potential confounders including C-reactive protein
levels. This study involved 364 individuals. After controlling
for the common risk factors, periodontitis more than
doubled the risk of cardiovascular disease-related mortality
. Subjects who were edentulous had higher mortality than
those who were dentate without periodontitis. These
results suggest that periodontitis influences the pathogenesis
and outcome of cardiovascular disease, especially in
individuals who also have evidence of a systemic inflammatory
Spec Care Dentist. 2003
Jul-Aug;23(4):125-30. Periodontal disease and mortality in an
aged population. Ajwani S, Mattila KJ, Tilvis RS, Ainamo
Courtesy of: American Academy of