Dental Care Basics for Seniors (65+)

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Dental Care for Seniors (65+)

After the age of 65, new oral challenges are introduced as the body continues to age. Common conditions that affect seniors include dry mouth, oral cancer, root decay, and gum diseases. Although, active aging alone is not a risk for the development of oral diseases. Oral health also affects digestion, speech, nutrition, self-esteem, quality of life, and social mobility.

85 percent of older adults suffer from oral disease and 55 percent suffer from conditions that develop into periodontal disease. If left untreated, however, many of these conditions often result in tooth loss. Maintaining a healthy mouth by sticking to lifelong dental care habits, such as visiting the dentist at least twice a year for routine check-ups and brushing regularly with fluoride, can help reduce the risk of serious oral diseases and tooth loss.


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27 percent of seniors over age 65 have no natural teeth remaining. Although, on average, those over 65 have 18 natural teeth remaining.

Common conditions and diseases that affect people over 65 include:

gingivitis gum disease

Gum Disease (Periodontitis)

Gingivitis is a minor gum infection that develops into periodontal disease (PD) if left untreated for a long period of time. PD, also referred to as periodontitis, is a serious oral inflammatory disease that damages the gums, jawbone, and may result in tooth loss. Up to 35 percent of all tooth extractions are due to PD.

Periodontitis is the result of poor oral hygiene due to:

  • Smoking
  • Long-term use of medications
  • Old age
  • Neglected dental treatment
  • Poor nutrition

Symptoms include inflamed gums, bleeding gums, loose teeth, and gums that pull away from the teeth. Seniors with PD require specialized treatment for this disease. For example, treatment may include scaling and root planing, flap surgery, bone grafts, or gum grafts.

17 percent of seniors 65 years of age and over have periodontal disease, while 10 percent have severe PD.

cavity

Root Caries/Decay

Tooth root caries and decay are caused by exposure of the roots to decay-causing acids. As the gums pull away from the teeth (typically due to periodontal disease), the roots accumulate bacteria. This is because roots are less protected than teeth since they do not have enamel. Older individuals have a higher risk of developing gum disease, which also makes them more prone to root decay. Common treatment options for this condition include fillings, tooth extractions, and replacement teeth, such as dental implants or bridges.

bad breath

Bad Breath & Dry Mouth

Bad breath can be caused by tobacco use, poor nutrition, excessive coffee or alcohol consumption, medications, not brushing teeth regularly, and dry mouth. As people age, bad breath and dry mouth are more likely to develop, even if the individual has brushed and flossed regularly their entire life.

Dry mouth occurs when the production of saliva in the mouth decreases. This condition naturally occurs during sleep, which leads to bad “morning breath.” Older people who sleep with their mouths open or snore often are also more likely to experience dry mouth. Causes of chronic dry mouth include:

  • Prescription medications
  • Certain diseases
  • Problems with the salivary glands
  • Radiation to the head and neck (cancer treatment)

Depending on the condition’s severity, there are many natural ways to reduce bad breath, including:

  • Chewing sugar-free gum
  • Limiting caffeine intake
  • Taking over-the-counter saliva substitutes
  • Avoiding decongestant or antihistamine medications
  • Stopping all tobacco use
  • Breathing through the nose, rather than the mouth
  • Avoiding sugary foods and drinks
  • Visiting the dentist regularly (twice a year)
  • Using fluoride
inlay

Discolored Teeth

Teeth stain naturally over the course of a person’s life. These surface stains are the clearest indicators of tooth discoloration. The bumps, grooves, and “holes” in teeth pick up the stains, which results in darkening, white streaks, yellowing, or discoloration.

Tooth color is dependant on an individual’s lifestyle, diet, habits, and oral care practices. Teeth also darken due to a natural aging process, which involves a thickening of the core structure inside a tooth called dentin. This causes an overall yellowing of the teeth as we age. Teeth whitening is a common treatment used to fix discolored teeth.

Factors that may affect tooth color include:

  • Aging
  • Diseases
  • Medications
  • Tobacco use
  • Excessive fluoride use
  • Genetics
  • Hormone changes

Tooth Decay & Tooth Loss

If dental cavities are left untreated for a long period of time, more serious oral conditions or diseases may result, such as decay, tooth loss, or periodontal disease. When teeth fall out or need to be extracted due to extreme decay or gum disease, common restorative treatment options include:

Dental Implants

After an extraction or tooth loss, an implant is commonly used to replace the permanent tooth. A dental implant, also known as an artificial tooth root, is placed in a patient’s jawbone. In short, the implant mirrors the shape of a screw and bonds with the natural bone.

Dental Bridges

A dental bridge is a fixed (permanent) restoration used to replace one or more missing teeth in a patient’s dental arch. In more serious cases, multiple bridges can be positioned to provide full mouth rehabilitation.

Dentures

When a person loses all or some of their natural teeth from tooth decay, gum disease, or an injury, dentures are placed to restore some chewing functions and esthetics.

95 percent of seniors over 65 years of age have had dental caries in their lifetime. 18 percent have untreated decay.

Oral Cancer

Oral cancer, also referred to as mouth cancer, begins with the development of abnormal carcinoma cells. As a result, mouth sores, that do not disappear on their own, develop. The disease is life-threatening without early diagnosis and treatment.

Unfortunately, oral cancer is usually discovered after it has spread to another part of the body, such as the lymph nodes of the neck. Surgery, radiation, and chemotherapy are common treatment options, depending on the stage of cancer.

Early detection is the key to a high survival rate. So, it is crucial to see your dentist at least once a year for an oral cancer screening.

Stomatitis

Stomatitis is defined as inflammation of the mouth and lips. In particular, dentures may cause stomatitis in older patients if the artificial teeth do not fit correctly, aren’t cleaned properly, or grow fungus (Candida albicans) over time.


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Resources

“Adults Over 60 - Concerns.” Mouth Healthy TM, www.mouthhealthy.org/en/adults-over-60/concerns

“Bad Breath.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 10 Mar. 2018, www.mayoclinic.org/diseases-conditions/bad-breath/symptoms-causes/syc-20350922.

Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.

“Dental Caries (Tooth Decay) in Seniors (Age 65 and Over).” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, www.nidcr.nih.gov/research/data-statistics/dental-caries/seniors.

“Periodontal Disease in Seniors (Age 65 and Over).” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, www.nidcr.nih.gov/research/data-statistics/periodontal-disease/seniors.

Syrbu, John DDS. The Complete Pre-Dental Guide to Modern Dentistry. 2013.

Updated on: June 29, 2020
Author
Alyssa Hill
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Medically Reviewed: September 18, 2019
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Lara Coseo
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