While some aspects of regular dental visits are much the same for everyone, they can be more involved for an older adult. That’s because people later in life face an increased risk of dental disease and other age-related issues.
If you’re a caregiver for an older adult, you’ll want to be aware of these heightened risks. Here are 4 areas of concern we may check during their next regular dental visit.
Oral cancer. While it can occur at any age, cancer is more prevalent among older adults. Although rarer than other cancers, oral cancer’s survival rate is a dismal 50% after five years. This is because the disease is difficult to detect early or is misidentified as other conditions. To increase the odds of early detection (and better survival chances) we may perform a cancer screening during the visit.
Dental disease. The risks for tooth decay and periodontal (gum) disease also increase with age. A primary risk factor for older people is a lack of adequate saliva (the mouth’s natural disease fighter) often caused by medications or systemic conditions. We’ll watch carefully for any signs of disease, as well as assess their individual risk factors (including medications) for decreased oral health.
Dentures. If they wear dentures, we’ll check the appliance’s fit. While dentures can wear with use, the fit may also grow loose due to continuing bone loss in the jaw, a downside of denture wearing. We’ll make sure they still fit comfortably and aren’t stressing the gums or supporting teeth. It may be necessary to reline them or consider replacing them with a new set.
Oral hygiene. Brushing and flossing are just as important for older adults as for younger people for preventing dental disease, but often more difficult due to mental or physical impairment. We can note areas of bacterial plaque buildup and recommend ways to improve their hygiene efforts.
Depending on how well your older adult can care for themselves, it may be advisable for you to come with them when they visit us. Our dental team can provide valuable information and advice to help you help them have a healthier mouth.
If you would like more information on dental care for older adults, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Aging & Dental Health.”
Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.
Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.
Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.
Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.
However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.
Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow. After several months, we may have enough regenerated bone to support an implant.
If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.
The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.
Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.
But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.
The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.
One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.
NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.
Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.
Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Although energy and sports drinks have different purposes, they have one thing in common: they often contain added citric and other acids to improve taste and prolong shelf life. Their high acid content can harm tooth enamel.
Although enamel is the strongest substance in the body, acid can dissolve its mineral content. And although saliva neutralizes acid after eating or drinking and helps restore lost minerals to the enamel, it may not be able to keep up if the mouth remains acidic for a prolonged period of time.
That could happen with both beverage types. While energy drinks have higher acid levels than sports drinks, both are high compared with other beverages.
A recent laboratory experiment studied the two beverages’ effect on tooth enamel. The researchers submerged samples of enamel in six different beverage brands (three from each category) for fifteen minutes, and then in artificial saliva for two hours to simulate mouth conditions. They repeated this cycle four times a day for five days.
At the end of the experiment the enamel in the energy drinks lost on average 3.1 % of their structure, while the sports drink samples lost 1.5%. Although energy drinks appeared more destructive, the acid in both beverages caused enamel damage. Although there are other factors to consider in real life, the experiment results do raise concerns about both beverages’ effect on dental health.
You can, however, minimize the potential harm to your enamel from energy or sports drinks. First, try other beverage choices lower in acid; water, for example, is a natural hydrator and neutral in pH. Try to only drink energy or sports beverages at mealtimes when your saliva is most active. And after drinking, rinse your mouth out with water to dilute any remaining acid.
And although it sounds counterintuitive, wait about an hour to brush your teeth after drinking one of these beverages. Your enamel can be in a softened state before saliva can re-mineralize it, so brushing earlier could remove tiny amounts of enamel minerals.
Taking these steps with energy or sports beverages could help you reduce the chances for enamel erosion. Doing so may help you avoid unnecessary damage to your teeth and overall dental health.
If you would like more information on the effect of sports and energy drinks on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Think Before You Drink.”
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