As we age, we’re bombarded with pharmaceutical ads and medical advances promising lower blood pressure, better joint movement, stronger hearts, improved circulation and enhanced sexual vitality. But when it comes to aging teeth and gums—crickets.
The U.S. surgeon general reports that older Americans often face a “silent epidemic” of serious dental health problems, including dry mouth, periodontitis, oral cancers, and root and coronal caries (cavities), from age-related systemic diseases and functional changes.
According to Andrew Swiatowicz, D.D.S., of Swiatowicz Dental Associates in Wilmington, oral cancers are considerably more common in the senior population. A 2004 study by the National Institute of Dental and Craniofacial Research found that of 240,000 cases of oral cancer, 158,000 occurred in patients 60 years of age and older.
“More serious cases of oral cancer can result in the removal of the tongue and/or jawbones,” Swiatowicz cautions. With a 10-year survival rate of only 50 percent, early detection is key to improving outcomes for patients. “We also know that the aging population has had more dental work done to their teeth,” he says. “It is important to monitor that work to make sure it is holding up so larger problems do not occur. Teeth with fillings and crowns can still get cavities; root canals can get reinfected; implants can have bone loss; and ill-fitting dentures can damage other teeth and tissues of the mouth.”
There’s little argument among medical professionals that oral health is often indicative of overall well-being among elderly patients. The Federal Interagency Forum on Aging-Related Statistics projects that by the year 2030, the number of U.S. adults 65 years or older will reach 72 million, representing nearly 20 percent of total U.S. residents.
For this vulnerable population in particular, proper oral care and hygiene is an integral part of total health. “Your mouth is part of your body, so things that happen in there can have a systemic effect,” Swiatowicz explains. “For example, joint replacements (knees, shoulders, hips) are more common in an aging population. If you have bleeding gums, the bacteria in your mouth can make their way to the joint and cause it to fail.
“Diabetes is another disease that can be affected by your oral health,” he continues. “Since diabetes and periodontal disease (bone and gum disease) are both inflammatory diseases, they can make each other worse. Said another way, uncontrolled periodontal disease can make it harder to get your diabetes under control. There are many other diseases and conditions that are linked to or worsened by dental problems.”
Elderly patients also tend to be on more medications, making them more susceptible to drug interactions and reactions, as well as the potential for some seniors to mismanage prescription-drug dosing. Aside from these more serious complications, medications can have side effects that compromise oral health.
“Drug-induced dry mouth can cause cavities to form quickly and progress rapidly, so it is important that dentists know all the medications taken so they can help create a plan to manage this issue,” Swiatowicz suggests.
Moving forward, it’s clear that dental professionals who treat elderly patients are tasked with adopting an informed understanding of geriatric services necessary to ensure optimal overall health within this population. Equally important is encouraging the elderly to visit their dentist regularly. Swiatowicz recommends that seniors, like everyone else, visit the dentist at least twice a year. It may even be recommended that some seniors visit more than twice a year if they have medication-induced dry mouth, periodontal disease or other conditions that would need more frequent monitoring.
“Even seniors without any teeth who are wearing dentures should visit the dentist, at least annually. It allows the dentist to make sure their dentures are fitting well and, more importantly, to check for oral cancers,” he adds.
“By having regular dental checkups, you can make sure your dental work is holding up, or can be more easily corrected if it is wearing out,” Swiatowicz advises. “It really is just like a car. The older it gets, the more it should be checked or tuned up.”