More Than Just a Nice Smile

Related topics: Health & Wellness

New research underscores the importance of oral health for older adults.

Did you add "floss my teeth daily" to your list of New Year’s resolutions? Taking care of our mouths is one of those things that we sometimes don't get around to. And some older adults think that with age, it is no longer important to go to the dentist. But in truth, the older we get, the more important mouth care can be.

Oral health and overall health are closely related. Poor oral health has a negative impact on social interaction, communication and the general well-being of seniors. The effect on nutrition is the most obvious: people with painful or missing teeth, gum disease or ill-fitting dentures are much less likely to eat a nutritious diet. This makes it hard to maintain a healthy weight and take in the nutrients we need.

Researchers are also pinpointing the ways that poor oral health leads to poor health in general. The effect goes far beyond the gums and teeth:

Heart health. In November 2013, Columbia University researchers reported that brushing, flossing and regular dental visits slow the progression of atherosclerosis (narrowing of the arteries) to a significant degree. An earlier study from the American Heart Association found that people who have their teeth cleaned regularly have a 24 percent lower risk of heart attack and 13 percent lower risk of stroke. Keeping the teeth and gums clean reduces the growth of bacteria that can lead to systemic inflammation. According to nursing professor Rita Jablonski of Pennsylvania State University, "Poor oral health can lead to pneumonia and cardiovascular disease as well as periodontal disease."

Brain health. Tooth loss and gum disease have also been linked to an increased risk of dementia. New York University researchers found that gum disease may contribute to brain inflammation and Alzheimer's disease. Study author Dr. Angela Kamer reported, "The research suggests that cognitively normal subjects with periodontal inflammation are at an increased risk of lower cognitive function compared to cognitively normal subjects with little or no periodontal inflammation." University of Florida researchers also reported that oral bacteria from poor mouth hygiene is linked to brain tissue degeneration that may lead to diseases such as Alzheimer's.

Seniors face challenges to good oral health

Our teeth and gums change as we grow older. Years of wear and tear take a toll, often causing thinning enamel and broken or lost teeth. Teeth with repairs such as crowns, fillings and root canals are less hardy. As gums recede, sensitive areas of the teeth not covered by enamel are exposed. Other factors put teeth and gums at risk: 

  • Many age-related health problems, such as diabetes and acid reflux, change our oral environment in ways that promote increased tooth decay and gum disease.
  • The internal surfaces of the mouth become thinner and more fragile, so they are more susceptible to injury from hard foods and toothbrushes with hard bristles.
  • Dementia, arthritis, Parkinson's disease, stroke and other conditions that cause a loss of muscle control can make it hard to brush and floss effectively. When a frail elderly person is unable to properly clean the mouth and teeth, it's important that they receive assistance.
  • Many of the medications older adults commonly take, such as diuretics, antidepressants, pain medications, and drugs to treat high blood pressure and dementia, have the side effect of decreasing salivary flow. Dry mouth (xerostomia) can lead to extensive tooth decay.
  • While smoking doubles the risk of gum disease, cavities and oral cancer at any age, for seniors who smoke, these problems are even greater.

If teeth are lost and not replaced, the bony structures of the mouth may deteriorate. This will cause an increase in other mouth problems. Modern dentures can be quite comfortable. Proper denture care is important in order to increase their life span and to reduce bacteria.

Paying for Dental Care

Many dentists report that they see a drop-off in visits as patients grow older. The cost of care is one reason for this. Medicare does not cover dental care, and though some Medicare private health plans include dental coverage, most do not. If paying for dental care is a problem for you or for a senior you know, see the resources at the end of this article to find out about state senior support programs, clinics and dental schools that may provide low-cost care for older adults.


For More Information

Visit the website of the American Dental Association to find oral health information for people over 60. And take the "Fact or Fiction: Adults Over 60 Quiz" to test your knowledge about senior dental care.

The National Institute of Dental and Craniofacial Research offers information on oral health and includes a list of resources for locating low-cost dental care.

The information in this article is not intended to replace the advice of your doctor. If you have questions about oral health and dental care, consult your dentist or other healthcare provider.

Previous article