By John Hackbarth, DDS
In my practice these days, I see a large number of older patients. The Baby Boomers are all in their 60’s and 70’s, and thanks to improving medicine there are many older individuals as well.
Dental health is always important but in older persons I think it becomes increasingly important. The mouth is where we often see signs of other systemic problems. Also if your oral health is not good, inflammation there can lead to other problems like heart attacks and strokes.
As one ages, there is increased wear on the teeth. This can be made worse in those who clench and grind. That is one reason we recommend night guards because we want to minimize the amount of wear that is happening. Worn teeth can lead to sensitivity and well as TMJ issues. In severe wear cases it can be difficult to repair broken or decayed teeth due to lack of space in the bite.
In older individuals we also often see more plaque and tartar on teeth. I think this is sometimes due to trouble with brushing and flossing. It is my opinion that everyone needs to use a power toothbrush. The brand I like is Sonicare. This brush is easy to use and does a great job of cleaning if used properly. I also think that its larger handle is easier to manipulate for some older individuals. Along with brushing, cleaning between your teeth is critically important. Some people have trouble holding floss. If that is the case for you, I recommend using the floss sticks. Put them in your car and floss at red lights. Throw some down on the table by your chair and floss when you watch TV. Another valuable tool is the interproximal brush. These small hand-held brushes are designed to clean between your teeth where there is more space which often happens if there is some gum recession.
People often ask me what toothpaste I recommend. I say there are some ingredients that are useful in toothpastes. They are baking soda, xylitol (which is antibacterial), and dicalcium phosphate (which can help in remineralization and reducing sensitivity). There are also toothpastes that are formulated to reduce tooth sensitivity. What about Fluoride? Fluoride, while not good to ingest, is beneficial to making enamel more resistant to decay. While I don’t recommend it for young children, for older individuals it is a help.
What about mouthwashes? If you like them, use them. They are not an answer for cleaning your teeth, but many people like the fresh feeling they get from their use. The key takeaway from all of this is that Technique in plaque removal is the important factor, not products. You have to brush and floss well.
Another problem we see in older individuals is dry mouth. While there are some systemic factors that can cause this, it is most often a side effect of medications. Dry mouth is a serious problem and leads to increased tooth decay. There is a new product on the market that we have seen good results with. It is called Saliva Max. It is a prescription item, and your dentist should be able to prescribe it for you if you have this problem.
One last thing. We often see increased periodontal problems due to diabetes. Type 2 diabetes is becoming increasingly a problem for older individuals. It is important to keep your glucose levels under control and see your dental hygienist on a regular basis. Diabetics have more inflammation and don’t seem to heal as fast as other individuals
