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Keeping Teeth Healthy for Longer

Simple tips for heading off the common dental problems that come with age

Female dentist examining a female patient. She's showing her dental x-ray image.

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Growing up, it may have seemed as if tooth loss was an inevitable part of aging — remember grandma’s dentures grinning at you from her night table? Times have definitely changed: 75 percent of people over the age of 65 now keep at least some of their teeth, according to the American Dental Association (ADA). But there’s still a lot of room for improvement: 20 percent of older adults have untreated tooth decay, more than two-thirds have gum disease, and nearly 1 in 5 has lost all of their teeth, according to the Centers for Disease Control and Prevention (CDC). “It’s important to take care of your teeth, not just because it makes you look better and makes it easier to eat, but because untreated gum disease has been linked to conditions such as heart disease, Type 2 diabetes and even possibly certain types of cancer,” says Judith Jones, a professor of dentistry at the University of Detroit Mercy and a spokeswoman for the ADA. Here are six ways to keep your choppers sparkling and in tip-top shape.

1. Brush twice a day

The most important thing you can do is brush your teeth for two minutes, twice a day, with a fluoridated toothpaste, advises Karyn Kahn, a dentist at the Cleveland Clinic. If possible, use an electric toothbrush. Compared with manual toothbrushes, powered ones — whether electric or sonic — reduced dental plaque 21 percent more and gingivitis (gum inflammation) 11 percent more after three months of use, according to an analysis of 56 studies published between 1964 and 2011 by the research organization Cochrane. Just don’t get carried away with brushing, as too much pressure can wear down tooth enamel and erode gums. And know that whitening toothpastes can similarly wear down enamel.

2. Don’t forget the floss

More than one-third of Americans would rather do an unpleasant activity like wash dirty dishes, clean the toilet or sit in traffic than floss. But flossing once a day does seem to reduce gingivitis, or mild gum disease, according to a 2011 review of 12 studies by Cochrane. “Flossing reaches the area between your teeth that is inaccessible to a toothbrush, breaking up dental plaque there before it becomes organized enough to do its damage,” explains Kahn. This is particularly important as you age, since gum tissue between teeth shrinks, leaving bigger gaps where food can get stuck. If you have arthritis in your hands, which makes it difficult to use floss, you can also try using an interdental brush, a small brush which is specially designed to clean between teeth and is easier to hold than floss. For best results, floss before brushing — it’s much more effective in reducing plaque between your teeth and in your mouth than doing the reverse, according to a study published this past August in the Journal of Periodontology.

3. Monitor your mouth

Dry mouth — a condition in which the salivary glands in your mouth don’t produce enough saliva to keep your mouth moist — is more common with age, especially if you take medications to treat conditions like urinary incontinence, depression, insomnia and high blood pressure, according to a 2017 review in the Journal of the American Geriatrics Society. But this condition is more than just a nuisance: Saliva helps prevent tooth decay by washing away food particles and neutralizing acids produced by enamel-destroying bacteria, explains Jones. “This is one reason why some people who never had cavities when they were younger start developing them in their 50s and 60s,” she says. If you’re noticing a persistent sticky, dry feeling in your mouth, speak to your dentist. You can alleviate symptoms by switching to other medications and using over-the-counter mouthwashes for dry mouth that contain xylitol, such as Biotene Dry Mouth Oral Rinse or Act Dry Mouth Mouthwash. If you have severe dry mouth, your dentist can prescribe a saliva-stimulating medication such as pilocarpine (Salagen) or cevimeline (Evoxac).

4. Eat the right foods

Try to get three or four servings of dairy products such as low-fat milk, yogurt and cheese daily. These foods are rich in both calcium and phosphorus, which help promote strong teeth, says Jones. Another must-eat: citrus fruits, tomatoes, peppers and leafy greens. They’re all rich in vitamin C, which promotes gum health. Avoid dried fruit; while it might seem like a healthy snack, it’s sticky, which means it can stay on your teeth and thereby damage them. (If you do eat some, just make sure to rinse your mouth with water afterward). Make your beverage of choice water — sodas, even diet ones, are acidic and therefore bad for your teeth, and alcohol can cause dry mouth, especially over time. Finally, don’t overdo it on the snacking. The more often you eat, the more acid you introduce on your teeth. Try to rinse your mouth out after any meals or snacks to get rid of food particles, and avoid snacking late at night, which has been linked to greater tooth loss.

5. See your dentist at least once a year

Even if you’ve gone through your first half-century with nary a cavity, you should still keep seeing your dentist for annual checkups. “As you age, the nerves inside your teeth become smaller and less sensitive, so by the time you feel pain from something like a cavity, the condition may have advanced so much that you’ll lose a tooth or require a more costly and extensive treatment,” explains Jones. “You can also be completely cavity-free and still have early-stage gum disease.” Your dentist can also screen you for oral cancer, which is more likely to occur with age. If you have other conditions such as existing gum disease, if you are a smoker, or have Type 2 diabetes, your dentist may want to see you even more frequently — say every three to six months. And don’t forget the x-rays. If you don’t have cavities or gum disease, you still need to bite down on those wings every two to three years, according to the ADA.

6. Opt for dental coverage

Less than 40 percent of people over the age of 65 carry dental insurance, according to a recent report from the federal Agency for Healthcare Research and Quality (AHRQ).  But if you don’t, it can be pricey: Costs for seniors averaged $913 per person in 2015. “A lot of people are shocked to learn that Medicare doesn’t cover routine dental cleanings and exams, or procedures such as root canals,” says Jones. You can try a community clinic or university dental school. They often offer low-cost dental care provided by dental students who are supervised by faculty members, says Jones. (Search for a center or school near you at toothwisdom.org.) Discount dental plans are another option, where you select a dentist within its network who provides services for up to 60 percent less than the typical fee. You can search for a dental plan at the National Association of Dental Plans (NADP) website.

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