Demographic changes to the population mean that by 2050 the number of people in the 60+ age group will double, meaning there are more teeth to care for and that increase in age brings some interesting problems.
Dry mouth is a common complaint in people over 65. The saliva does not simply dry up with age it is usually as a result of a medical condition or medication. Common categories of drugs that induce dry mouth include : Tricyclic antidepressants; sedatives; antihistamines; antihypertensives; cytoxics and Anti- parkinsonism drugs. In addition Diabetes and Alzheimer’s are common causes.
The saliva is vitally important for the protection of the teeth as well as swallowing and mastication. The saliva acts as a bu ering solution to neutralize the acid produced by bacteria during the decay process. If patients have a dry mouth they should sip water which must not be sweetened with anything or there are salivary substitutes which contain mucins .
The lack of saliva also means that our first defense against decay is severely weakened. One of the first consequences of a dry mouth is a significant increase in dental decay.
Regular checkups with your dentist every 6 months are crucial to spotting and treating decay early. Patients with very high decay rates should be seen every 3 months. Prevention of decay can be improved with an improvement in oral hygiene. Cleaning teeth can become more complicated with age as people struggle with manual dexterity. There can also be a lack of motivation as people often feel that their teeth have lasted 70 plus years so will keep them going. Unfortunately the teeth can fail alarmingly quickly and adaptation to dentures with advancing age is more di cult.
The use of toothpaste with an increased amount of fluoride is a good step in preventing tooth decay. Most toothpastes have 1000ppm of fluoride but Duraphat make toothpastes with 3 to 5 times this amount. They are only available from your dentist. Fluoride mouthwash can also help but the teeth must be clean first. If the teeth are covered in plaque then the fluoride will have no e ect.
Cleaning of your teeth should be monitored by your dentist or even better by a hygienist. When you look at your teeth in the mirror your eyes and teeth are fixed so you can only see the teeth from one perspective. If I asked you to clean a car but you had to stand on one spot directly in front of the bonnet you are unlikely to be very successful. However this is what we ask of our patients every day when they clean their teeth. Constant reminders are necessary to build up an e ective cleaning regime.
Improving oral hygiene and cleaning not only with an electric toothbrush but using interproximal brushes to go between the teeth are very important. If you have started to have more decay treated ask your dentist about a toothpaste with increased fluoride or a fluoride mouthwash.
Do not ignore problems with either your teeth or the soft tissues as fixing these problems becomes more complicated with time.