Why dental care is even more important as we get older
Most of us know to brush after eating, floss daily and see a dentist twice a year, but as we age, we may have to step up our game. With proper care, we can retain our teeth into old age. But there’s the rub—the typical 17 seconds of brushing and occasional flossing isn’t going to cut it, dentists say.
After retirement, many of us lose dental coverage. Nationally, the percentage of dental expenses paid by private dental insurance decreases with age, from 50% for those 55 to 64 years, to 22% for those 65 to 74 years and 14% for those 75 and older, according to a study published in the American Journal of Public Health. Medicare only covers “medically necessary” procedures, and many state Medicaid programs do not cover dental services for adults.
Preventing problems down the road is largely in our hands. Periodontist Reed Ference, DDS, of Capital Region Periodontics & Dental Implants, keeps a New Yorker cartoon in his office showing someone meeting with a priest and confessing they lied to their dentist about flossing. Guess what? Your dentist knows. Dr. Anthony Cavanagh, director of St. Peter’s Hospital Dental Center, can’t remember how often he’s heard his patients lament: If they knew it was going to cost this much or be this painful, they would have taken better care of their teeth. Here, Ference and Cavanagh share their tips for caring for your teeth as you age.
Tools of the trade
As arthritis makes it more difficult to reach every tooth, Ference recommends using an electric toothbrush with a two-minute timer. He likes the timer feature because “most people only brush for 17 seconds.” Brushing too hard can cause gum recession, so look for an electric toothbrush with a strain gauge that lets you know if you’re pressing too hard, he says.
You could also try a DIY method of adapting your toothbrush’s grip such as inserting it into a foam hair curler, a tennis ball or a section of a pool noodle.
For those with limited dexterity who find flossing difficult, Ference recommends a water pick. “The gum tissue is like a turtleneck around the tooth,” he says. When the fibers that hold the gum tissue next to the tooth are destroyed and some bone is lost, he says, that creates a space where bacteria can accumulate and cause a pocket.
The water pick “flushes the pocket out and reduces the ability of the plaque to cause damage,” he says.
We floss to remove food between the teeth and the bacteria between the teeth and gums. This requires getting the floss around the tooth and under the gums where the toothbrush can’t reach, Cavanagh says. “With floss, you want to make a ‘C’ shape so it hugs around the side of the tooth,” he says.
People mistakenly stop flossing when their gums bleed, but that’s like someone going for a run once, feeling short of breath and giving up, Cavanagh says. The more they run, the easier it gets. It’s the same with flossing—each day their gums bleed less and after a week, their gums don’t bleed at all, he says. Gums bleed because they’re inflamed; they’re inflamed because bacteria are living between the gums and the teeth.
Cavities aren’t just for kids
Cavities thrive in an acidic environment. Saliva neutralizes acidity and without it, our mouth loses its defense. As we age, we produce less saliva. Cancer treatments and common medications for heart disease, depression and anxiety can cause dry mouth, Cavanagh says.
“People with less saliva are more susceptible to dental decay,” he says. That change makes it even more important to brush after every meal as we get older. If we can’t, at least drink water after eating or after drinking anything other than water. If you drink sugary drinks, energy drinks or specialty coffees all day, Cavanagh says,“You’re basically bathing your teeth in a solution of acid and sugar.” Cavities start from bacteria feeding off the sugar in our mouths, he says.
Periodontal disease can be prevented but not cured. Also known as gum disease, periodontal disease is one of the most common reasons adults over 55 lose teeth, Ference says. Those with periodontal disease should see a dentist every three months for cleaning, he says.
While researchers used to suspect those with gum disease were at higher risk for heart disease and stroke, they now believe there’s more of a correlation than a causation, Cavanagh says. In other words, he explains, the people who have heart disease and periodontal disease may have lifestyle factors that contribute to both conditions.
Smokers and those with all types of diabetes, however, do have a higher risk of developing periodontal disease, Ference says.
Those with full dentures just need to soak their dentures in a cleaning solution while they sleep and don’t need to see a dentist. For people with removable, partial dentures, Cavanagh says, “it’s even more critical that they get in for their regular care and maintain the teeth they have left.”