Aging and Dental Health

When it comes to maintaining dental health there are many challenges people face as they age such as a lack of dexterity for flossing and brushing and a lack of transportation to dental visits. Learn why senior citizens should continue to seek dental care at least twice a year to keep their teeth and gums as healthy as possible.

Is tooth loss inevitable, or is it possible to have healthy teeth your whole life?

Dr. Darren McKeever: Well, there seems to be this misconception that as we age, we’re going to have to lose teeth, as if it’s a foregone conclusion, and that is absolutely a myth. There is no reason why people can’t take well-enough care of their teeth so that they can last literally their entire life. Personally, I do believe that depending on how well you treat your teeth and how well the initial dentist who gets his or her hands on you treats your teeth, sets the tone for the rest of your life. But really, with good care, good maintenance, and good treatment when treatment is necessary, there’s no reason why people can’t keep their teeth healthy and have them for their entire life.

How common is periodontitis in seniors?

Dr. Darren McKeever: Well, we think of periodontitis or gum disease as an old person’s disease, and whereas it’s definitely more common to have loss of attachment, which is the negative result of periodontitis, it’s more common to see that in our seniors. The reality is periodontitis is much more aggressive at a younger age, so when you get it at younger age, it’s much more aggressive in the amount of bone loss that it causes, and that tends to set the tone for us as we age and we become seniors.

There tends to definitely be a little more exposure to periodontitis in our seniors, but I wouldn’t say nowadays it’s anywhere near as common as it used to be. Seniors are now seeing the benefits of the years of dentists paying a lot more attention to the gums in terms of managing and maintaining them, so I think we’re seeing periodontitis definitely a little more common in seniors, but nowhere near the way it was years ago.

Many older people suffer from arthritis. Do you see this affecting the quality of their brushing and flossing?

Dr. Darren McKeever: Unfortunately, that’s true. As we age the dexterity, the feedback when we brush our teeth tends to be a little bit muted. If you can’t manipulate the brush as well, over time you’re not as effective. Flossing is hard to begin with, but if you’re having trouble working it digitally with your hands because of arthritis or other issues, it tends to be a little less effective.

Nowadays we’re seeing this being countered by a lot of these newer, not that new, but a newer technology of the electronic toothbrushes where they actually are more effective with less effort. You really just have to put it on the tooth and the gums, and they do all the work. But definitely as we age, the dexterity issues come into play, and it does diminish people’s ability to keep themselves clean.

For people with dentures and removable devices, what challenges do they face as they age?

Dr. Darren McKeever: Well first and foremost, one of the biggest challenges is not having the dog eat them, or not just getting them thrown out in a napkin, but aside from that if that doesn’t happen, over time what happens is that the bone that the dentures or the removable appliance rests on changes. It’s not a situation that’s going to be the same the day that the appliance was made as compared to maybe two, three, five, ten years down the road, so those are one of the challenges because things are going to change. They have to be maintained. Sometimes dentures have to relined.

Also, with a partial removable appliance, we tend to see that the clasps that hold them on create a lot of attrition on the sides of the teeth as the clasps move up and down over the teeth. They also tend to torque the teeth a little bit, but more often than not, with removable appliances we tend to see recurrent decay, because people don’t take them out enough and clean them enough. They treat them like they’re regular teeth, and with their intimacy of contact on the natural teeth, they tend to hold plaque and debris closer to the teeth, and you can wind up with more decay a lot faster.

But overall, it’s really just a changing process that we see of age and the bone changes. Those are really the biggest challenges that we see.

We know regular dental visits are important, but for seniors getting to the dentist twice a year may be a challenge. Do older adults still need to see the dentist twice a year for checkups, and what is the norm?

Dr. Darren McKeever: Unfortunately, I think as we all age we tend to need a little bit more maintenance. I think two times a year is the minimum that seniors should go. Really, more ideally would be three times a year. With seniors, we tend to see, because periodontal diseases and the loss of attachment is a little more common than when we’re younger, we get root exposure, and the roots decay much, much faster than natural teeth with the enamel on them when they don’t have the loss of support. If you get a cavity on the root, it can turn into a root canal rather quickly, so you want to catch these things a lot quicker so that when you’re treating them, you can be minimally invasive.

In addition to that, unfortunately with the attrition that’s accumulated over time with a lot of our seniors, they get these bite changes. If somebody isn’t analyzing those, you can press a restoration into a higher level of function that it wasn’t designed for originally, and rather than just a simple adjustment of the bite, you may wind up breaking something that’s going to have to have a major repair or even a replacement. Overall, I think seniors a minimum of two times a year, but three is a lot more ideal.

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If you are interested in speaking with Dr. Darren McKeever, visit or call 973-839-8180 to schedule an appointment.

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