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Age and Oral Health How Teeth Change with Age (50s, 60s)

Aging and Oral Health

So as you enter your fifties and sixties, you’re going to notice a lot of changes, not only with everything but your mouth as well. And so I’m here to walk you through what you can expect with your mouth in that era.
Hi, I’m Dr. Brett Langston. I’m a prosthodontist and owner of Dental Implant and Aesthetic Specialist here in Brookhaven, Georgia, and I’m here to help you watch your mouth.

The Impact of Aging on Oral Health

So, generally speaking, as we age, like with the rest of our body, the mouth starts to go through some major changes. There’s a big change from your teens to your thirties and forties, and then once you hit your fifties and sixties, a lot of times that’s when you start having lots of things come into play, whether it’s medications, whether it’s illnesses, whether it’s the rest of your body kind of changing and acting differently, the mouth is kind of a beacon of all those changes coming together.

Medications and Dry Mouth

I’ll start with the number one thing we see in a lot of our patients in the fifties and sixties is a lot of medications you’re taking have a lot of side effects. Now, a lot of times, the side effects that impact the mouth are kind of glossed over, kind of put as an afterthought, which is fine because some of these medicines are lifesaving and absolutely important for your heart, brain, liver, and overall health. But you do have to be aware that a lot of these medications can have an impact on your mouth and can have an impact on your dental health going forward.

Combating Dry Mouth and Sleep Apnea

So, the biggest side effect we see is dry mouth. Unfortunately, it seems like the majority of medications you see will have that as a side effect. A dry mouth is important because saliva plays a huge role in overall oral health. Saliva helps rinse bacteria away, keep everything lubricated, and keep bacteria from forming on the teeth’ surfaces. And so if dry mouth is going to be a side effect that you’re dealing with, we have ways to combat that, but you have to be aware of it, whether it’s saliva substitutes, mouth rinses, there are lots of cool stuff that we can, there are special tabs you can put on your mouth overnight to help with the dryness.

Then one thing that kind of compounds that is, at this age, a lot of people start entering into sleep apnea treatment, start entering into the C Pap world, which is basically forced air down your airway. So if you’ve already got a dry mouth combination with forced air in your mouth, you’re creating a really dry environment. And so it’s really important that you don’t go to bed with any kind of substrate on your teeth. So it’s really important to brush your teeth really well, rinse really well, you need to drink a lot of water throughout the day or swish with water to kind of rehydrate those tissues and eliminate food from getting trapped in the nooks and crannies because at this age in life, we start to see in our patients a lot of times what I call nitpicky cavities, which are basically right at the gum line at the edges of where you’ve got crowns, where all of a sudden that gum tissues pull back a little bit and so that root structure is there and it’s really prone to break down and decay.

The Importance of Dental Cleanings and Early Detection

That’s why it’s really important that you come to see us for cleanings, just to keep an eye on things because even though it’s a small cavity, if we don’t catch it early, it can develop into something really big. And by big I mean more than just a filling, it can sneak underneath the crown. Then we have to take the crown off to a new crown, it could sneak into the nerve, and then we’re talking about root canals. It could get to the point where, unfortunately, we can’t save the tooth, and then you’re a lot more involved both in the time and finances of an implant or a bridge or something along those lines. So home care is important and also having a good relationship and consistent visits to see us so we can catch these small things early.

Another factor to consider is that at this age, a lot of people have had root canals, or if you haven’t had a root canal, your healthy teeth just through natural wear and tear. The nerve actually shrinks back a little bit. So sometimes the teeth are less sensitive when you are in your twenties. If you have a little cavity, you might feel it really early, and we can catch it soon. Sometimes, on teeth, especially those that have had root canals, there’s no nerve. And so a little tiny cavity under a crown that’s had a root canal, if we don’t catch it and you don’t know that it’s there, can develop into something really big or can get to the point where the tooth breaks off and it’s in an unsavable situation.

Bone Loss, Tooth Shifting, and Orthodontics

So in your fifties and sixties, as the body ages, we start to see a lot more bone loss, and we also start to see some tooth shifting. And as those teeth shift, all of a sudden, the bite isn’t quite the same way it always was. A lot of times, we see that in the lower front area. As those teeth start to shift, they overlap and move into new locations, and all of a sudden, you start biting in a way you’re not used to. And so what happens is those bottom front teeth that are little tiny teeth can’t handle that force load. And we see a lot of chipping and braking of the bottom teeth in the front and even the top teeth in the front as well because those teeth have shifted, and actually, we’re doing a lot of orthodontics now, a lot of clear braces to help realign everything to get it back to where it’s more of a passive fit, so you’re not overwhelming those teeth.

Consequences of Bone Loss

Another concern with bone loss over time is as the bone decreases and those teeth start to shift, all of a sudden, you start developing little nooks and crannies in areas where before the bone and tissue filled it so food couldn’t get in there. But you’re going to start to notice little food traps. Little areas where before you never had trouble flossing. Now, food gets packed in there. There are spaces. It requires you to be more diligent with your home care because all of a sudden, there are areas that were easily cleansed before, and now you’ve got to work extra on top of that to make sure you don’t have bacteria or cavities sneaking around in those little nooks and crannies.

Also, in this stage of life, people start to lose teeth, whether that’s from trauma cavities or periodontal disease. And so it’s really important that you have a great relationship because the majority of the time when you lose one tooth, you need to make sure it’s not going to start the process towards damaging the other teeth.

Now, occasionally, if there’s a tooth way in the back, not part of your normal bite force, there are times when we don’t need to address missing a tooth. So that’s not to say every missing tooth needs to be replaced, but you need to make sure that it is looked at and it’s part of a plan because once you start losing teeth, all of a sudden, the front teeth are doing more work, they’re not designed to do that, they’re going to start breaking down. So it’s almost like a domino effect. As you get older, teeth start breaking down, and if you don’t adequately address that, you can start to have a pretty big impact on your overall oral health.

The Importance of a Good Relationship with Your Dental Team

So while dental home care is important, it’s equally as important that you have a good relationship with your dental health team. And one of the great things I love about our team is that we don’t ever guilt trip. We’re not here to make you feel bad. Listen, I know Covid was crazy. The world got turned upside down. People had plans, but everything got thrown to skew. So if you’re off track, if you haven’t been to a dentist in a long time, even before that, there’s no shame in coming in to see us. We want to make sure you’re healthy. Our primary goal is to take care of your teeth and make you the best mouth you can have. So again, reach out to us. We would love to have you come in. It’s never been too long to see a dentist, and the most important thing is getting in a timely manner so we can prevent things from happening.

The biggest issue with dentistry is little things always grow into big things. I have so many patients that we have this conversation where, man, I really wish we’d met each other five years ago. We could have addressed this when it was something really small, but now we’re in a situation where it’s a bigger undertaking. So the take home message is we would love to see you come be a part of our team, we’ll help take care of you. We look forward to meeting you. I’m Dr. Brett Langston, prosthodontist and owner of Dental Implant and Aesthetic Specialist, and I’m here to help you watch your mouth.