As access to dental care and education about good oral hygiene keep improving, more Australians are keeping their teeth into old age. The most recent National Dental Telephone Interview Survey in 2013 found that more than 80% of people aged 65 and over still had some of their natural teeth remaining – but these teeth may be at greater risk, as many oral health risks increase with age.
A good oral hygiene routine of brushing your teeth twice a day, flossing daily and a healthy diet can help you to keep your teeth for life. It's also important to have regular dental check-ups so your dentist may be able to catch and treat any problems before they become serious and can offer you advice about caring for your teeth and gums to prevent problems from developing.
Lifestyle risks for oral health
As well as keeping your teeth and gums clean and cutting down on sugar, it's important to know what other activities can contribute to dental problems. Giving up some bad habits or trying to make other improvements in your life could lower the risks to your oral health and general health.
Tobacco use is steadily declining in Australia as the health risks have become more widely understood. Smoking can affect your teeth and mouth in many ways, from the aesthetic concern of nicotine and tar stains on teeth to increasing your risk of serious oral diseases.
Smoking is a risk factor for dry mouth and gum disease, the leading cause of tooth loss for older people. It's also the primary risk factor for oral cancer, which is 9 times more likely to affect smokers. If you're in a risk category, your dentist may recommend an oral cancer screening during your regular check-ups.
Drinking alcohol occasionally can be part of a healthy lifestyle, but drinking excessively can affect your oral health. Like smoking, drinking too much alcohol can also increase your risk of developing dry mouth and oral cancer.
Acidic drinks contribute to tooth erosion that can damage the enamel, making teeth more sensitive, more easily damaged and darker in appearance. Drinks with strong pigments such as red wine can also stain teeth.
If you often experience stress, this could also cause problems in or around your mouth. Trying to avoid stressful situations or talking to a professional could help to reduce the stress in your life and associated health risks.
Stress is linked to conditions such as bruxism (teeth grinding or clenching), which can damage teeth and lead to other conditions such as temporomandibular joint disorders (TMJD), affecting the jaw joints. Stress is also a risk factor for sleep disorders such as obstructive sleep apnoea (OSA).
What dental problems affect older people?
Even if you take good care of your teeth and gums and avoid bad habits, age itself is a risk factor for many oral health conditions. This can be due to prolonged exposure to acidic food and drink, bacteria and general wear and tear on teeth, as well as the greater likelihood of having a related health condition that can impact on oral health.
Tooth wear and damage
A lifetime of chewing and grinding food and exposure to acids can wear down the protective enamel layer of teeth, making them weaker and more vulnerable to damage from tooth decay or injuries.
If a weakened tooth is causing pain or sensitivity when you eat and drink, or your dentist thinks a tooth may be at risk of chipping or cracking, they may recommend placing a dental crown or other restoration to help restore its strength and shape.
Tooth decay (also called dental caries) is the most common dental disease. It's caused by bacteria that can build up on the teeth to form plaque. This bacteria feeds on sugar that enters your mouth and releases acids that can erode the tooth over time.
If tooth decay isn't treated, or if you consume a lot of sugar, it can form cavities in the tooth. Your dentist can fill a cavity by placing a white filling or other restoration, depending on how much of the tooth's structure remains.
If a tooth is too badly damaged by decay, the only option might be to remove it and replace it with a strong artificial tooth. In 2010, tooth decay was the most common reason for a tooth extraction among Australians over 65.
If your gums have receded, decay can also attack the exposed tooth roots, which are softer and not protected by enamel. If bacteria reaches the soft interior of the tooth (the dental pulp), it can cause an infection or inflammation, which can be very painful or make the tooth more sensitive to temperature.
If you have a tooth infection, your dentist may recommend root canal treatment (endodontics). This involves removing the infected tissue, replacing it with an artificial substitute and then rebuilding the tooth with a crown or filling. If a tooth is too badly damaged to save with a root canal, extraction may be the only option.
As nerves in the teeth lose some of their sensitivity, you might have a tooth infection without knowing it. That's one reason why regular dental visits are important for catching problems early, when there may be a better chance of saving the tooth.
Gum disease (periodontal disease) is the inflammation of the gums in response to bacteria. Older people are more likely to have gum disease as the risk factors can accumulate with age. The most recent National Survey of Adult Oral Health 2004–2006 found that more than half of Australians over 65 had gum disease.
In its early stage (gingivitis), gum disease can cause irritation, swelling or bleeding of the gums. Gingivitis can usually be treated through a combination of oral hygiene treatments at a dental clinic and improving your daily oral hygiene at home.
The advanced stage of gum disease (periodontitis) can damage the gums and connective tissues that support the teeth, even leading to tooth loss if it's not treated in time. Gum disease is the most common cause of tooth loss for older Australians.
Saliva is important for rinsing the mouth, helping to neutralise acids on the teeth and making chewing and swallowing easier. If you're producing less saliva than you used to, you may have a condition known as dry mouth syndrome (or xerostomia), which increases your risk of tooth decay and other problems.
Dry mouth is a common side-effect of many medications, so talking to your doctor about changing a prescription could help. Other causes of dry mouth include tobacco use, certain medical conditions and cancer treatments.
As well as treating the underlying problem, your dentist may recommend that you drink more water, chew sugar-free gum to stimulate saliva flow, or they may provide a saliva substitute.
Even if your teeth and gums are healthy, they could show signs of ageing. In 2013, 22% of older Australians said they felt uncomfortable about some aspect of their dental appearance, the number being higher for women.
As tooth enamel wears down over time, the yellow dentine layer beneath shows through more, which can make teeth look more yellow or darker with age. A lifetime of staining from red wine, coffee, tea, sauces and other food and drink pigments can also contribute to tooth discolouration.
If you want to remove stains and whiten your teeth, your dentist may offer cosmetic treatments such as teeth whitening (in-office or at home) and porcelain or composite dental veneers fitted over the front of teeth. You should be free from oral health problems and understand the possible risks before having a cosmetic dental treatment.
Missing teeth are another common problem linked with age. Even as Australians are keeping their natural teeth for longer, over 65s had an average of 10.8 missing teeth in 2013 (slightly higher for women).
Whether you've lost teeth to gum disease, extractions or injuries, your dentist will recommend having them replaced with artificial teeth. Replacement teeth can help you to eat and speak normally, support your mouth, jaw and face, and prevent a premature aged appearance.
There are several options for replacing a missing tooth or teeth, and your decision should be based on what's best for your needs and your price range. The most popular options are:
- Dentures – full or partial dentures can replace as many teeth as needed. Dentures are the most affordable option, but they can also be less convenient in the long term.
- Dental bridge – one or more replacement teeth supported by the healthy teeth on either side. Fixed in place, but no surgery is involved and they don't support the jaw like an implant.
- Dental implant – a strong foundation for a bridge or dentures, implants are surgically placed in the jaw to support new bone growth. This is the most expensive option, but an implant may last a lifetime.
Talk to a dentist
If you want to know more about how to look after your teeth at any age, or it's time for your check-up, contact our dentists at Sailors Bay Dentistry.
Australian Institute of Health and Welfare (AIHW): Chrisopoulos S, Harford JE & Ellershaw A 2016. Oral health and dental care in Australia: key facts and figures 2015. Cat. no. DEN 229. Canberra: AIHW.
AIHW: Harford JE & Islam S 2013. Adult oral health and dental visiting in Australia: results from the National Dental Telephone Interview Survey 2010. Dental Statistics and Research Series no. 65. Cat. no. DEN 227. Canberra: AIHW.
Australian Dental Association. Lifestyle Risks (65+) [Online] 2017 [Accessed September 2020] Available from: https://www.ada.org.au/Your-Dental-Health/Older-Adults-65/Lifestyle-Risks-(1)
Better Health Channel. Teeth and mouth care [Online] 2019 [Accessed September 2020] Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/teeth-care