More Than Just a Nice Smile
It’s late, you’re busy, you’re tempted to tumble right into bed without brushing your teeth … but that is one task you shouldn’t neglect! Taking care of our mouths is one of those self-care tasks that we sometimes don’t get around to. And some older adults think that with age, it is no longer important to go to the dentist. But in truth, the older we get, the more important mouth care can be.
Oral health and overall health are closely related. The effect on nutrition is the most obvious: People with painful or missing teeth, gum disease or ill-fitting dentures are much less likely to eat a nutritious diet. This makes it hard to maintain a healthy weight and take in the nutrients they need.
Poor oral health also has a negative impact on social interaction. It stands to reason that tooth loss and gum problems could affect a senior’s self-esteem and make it harder to communicate—and a January 2022 study from New York University showed that the effect goes both ways. The study authors found that people who are lonely are less likely to practice good oral hygiene.
Researchers are also pinpointing the ways that poor oral health leads to poor health in general. The effect goes far beyond the gums and teeth:
Heart health. Research from Columbia University showed that brushing, flossing and regular dental visits slow the progression of atherosclerosis (narrowing of the arteries) to a significant degree. A study from the American Heart Association found that people who have their teeth cleaned regularly have a 24% lower risk of heart attack and 13% lower risk of stroke. Keeping the teeth and gums clean reduces the growth of bacteria that can lead to systemic inflammation.
Lung health. Studies show poor oral health can lead to pneumonia. In fact, according to Sacramento State University Nursing School professor Dian Baker, lack of attention to oral care during a hospitalization is a leading cause of hospital-acquired pneumonia.
Hypertension. Several studies have linked poor oral health to high blood pressure. The Alden blog earlier reported on studies from University College London (see “Blood Pressure High? Maybe It’s Time for a Dental Appointment!”). More recently, a study from University of Buffalo pinpointed 10 types of bacteria that raise the risk of hypertension—and several types that actually lower the risk.
Brain health. Tooth loss and gum disease have also been linked to an increased risk of dementia. Poor oral health may contribute to brain inflammation, as well as tissue degeneration that leads to Alzheimer’s disease and related disorders. In March 2019, the American Geriatrics Society noted, “People with chronic periodontitis had a 6% higher risk for dementia than did people without periodontitis. This connection was true despite behaviors such as smoking, consuming alcohol, and remaining physically active.”
Older adults face challenges to good oral health
Our teeth and gums change as we grow older. Years of wear and tear take a toll, often causing thinning enamel and broken or lost teeth. Teeth with repairs such as crowns, fillings and root canals are less hardy. As gums recede, sensitive areas of the teeth not covered by enamel are exposed. Other factors put teeth and gums at risk:
- Many age-related health problems, such as diabetes and acid reflux, change our oral environment in ways that promote increased tooth decay and gum disease.
- The internal surfaces of the mouth become thinner and more fragile, so they are more susceptible to injury from hard foods and toothbrushes with hard bristles.
- Dementia, arthritis, Parkinson’s disease, stroke and other conditions that cause a loss of muscle control can make it hard to brush and floss effectively.
- Many of the medications older adults commonly take, such as diuretics, antidepressants, pain medications, and drugs to treat high blood pressure and dementia, can cause decreased salivary flow, which can lead to extensive tooth decay.
- While at any age smoking doubles the risk of gum disease, cavities and oral cancer, these problems are even greater for older adult smokers.
If teeth are lost and not replaced, the bony structures of the mouth may deteriorate. This will cause an increase in other mouth problems. But modern dentures can be quite comfortable. Proper care of dentures is important in order to increase their life span and to reduce bacteria.
Paying for dental care
Many dentists report that they see a drop-off in visits as patients grow older. The cost of care is one reason for this. Medicare does not cover dental care, and though some Medicare Advantage health plans include dental coverage, it may be minimal. If paying for dental care is a problem for you or for a senior you know, visit the National Institute of Dental and Craniofacial Research to find possible options for low-cost dental care.
The information in this article is not intended to replace the advice of your doctor. If you have questions about oral health and dental care, consult your dentist or other health care provider.