Oral health: As population ages, problems with teeth and gums seem to multiply

Let’s face it, as a nation we are going gray. The baby boomer generation is now heading into their 60s and 70s, and the percentage of Americans in this age group is expanding like never before. Along with what some may consider a more distinguished appearance, that gray hair also can come with health issues that are increasingly more expensive.

Let’s face it, as a nation we are going gray. The baby boomer generation is now heading into their 60s and 70s, and the percentage of Americans in this age group is expanding like never before. Along with what some may consider a more distinguished appearance, that gray hair also can come with health issues that are increasingly more expensive.

According to a 2013 report by the Centers for Disease Control and Prevention (CDC) titled “The State of Aging and Health in America,” “The growth in the number and proportion of older adults is unprecedented in the history of the United States. Two factors — longer life spans and aging baby boomers — will combine to double the population of Americans aged 65 or older during the next 25 years, to about 72 million. By 2030, older adults will account for roughly 20 percent of the U.S. population.”

The Kaiser Family Foundation, in the 2015 Medicare spending and financing fact sheet, projects that Medicare spending will nearly double over this decade, from $555 billion in 2011 to $903 billion in 2020, which is good for your general health, but doesn’t do much for your dental health because Medicare does not cover dental procedures except in very extreme circumstances. To get the basics like cleanings, fillings, extractions and dentures, you need to purchase a separate dental coverage plan.

As you age, there are a lot of changes in your mouth, and many of these things can result in tooth loss, which means that you will need to get dentures or other restorative dental work to replace those teeth. Some of these changes are naturally occurring while others come about by lifestyle choices or are side effects of the medication you take.

For example, most people see a decrease in their skin’s elasticity, which causes your face to droop or sag. This doesn’t necessarily affect your physical health, but it can cause you to feel less secure about your outward appearance, leading to neglect of oral health processes like brushing and flossing twice a day, or getting professional cleanings at your dentist’s office. Poor oral hygiene is a common cause of tooth loss from dental cavities and gum disease.

Decreased salivary flow is also common in older patients. Often it is a side effect of necessary prescription medications, but a patient on multiple medications may have less than half the normal salivary flow. Without enough saliva, you are at much higher risk of developing cavities that can lead to tooth loss.

Periodontal disease — commonly known as gum disease — is more likely in older patients, especially those with other chronic health conditions such as Type 2 diabetes. The inflammation from periodontal disease can cause infection and decay, and in advanced stages can destroy the primary support mechanism for your teeth – the gums – causing tooth loss.

Sometimes as a result of a stroke, arthritis or dementia, manual dexterity declines to the point that a person is unable to do things such as brush and floss without the help of a caregiver. If needed, it’s important to get that help because the absence of thorough, regular care of dental cavities and gums can lead to tooth loss.

Regardless of how it happens, tooth loss has a serious impact on the health and well-being of everyone.

Stop and think for a minute about all the benefits that your teeth provide — specifically the ability to eat the meals that you love. When a person is missing one or more teeth, eating becomes more difficult (or even impossible if you have few or no teeth), and not being able to eat a variety of foods means you probably are not getting the nutrients you need for optimal health.

While the U.S. population as a whole has a lower rate of edentulism (the term for someone who is missing one or more teeth) when compared with other western countries, this condition still affects 15 percent of people age 65 to 74, and close to one in four people age 75 and older.

An article published in the International Journal of Dentistry in 2013 highlights the problem: “There is overwhelming evidence showing the negative effect of edentulism on oral-health-related quality of life. Edentulism negatively influences not only oral function, but also social life and day-to-day activities. Compromised oral function has been linked to decreases in self-esteem and a decline in psychosocial well-being.”

Many people with missing teeth are embarrassed to eat, smile or speak when others are around, and will instead avoid social situations altogether, leading to isolation. Even with dentures people often have limitations, and worry that the dentures will not stay in place when speaking and eating, which leads to a decrease in self-confidence and changes in behavior to avoid being around others in social situations.

Besides being a quality of life issue, a person with missing teeth often suffers from nutritional deficits as well. According to several studies, tooth loss can affect general health in several ways:

• Eating fewer fruits and vegetables, less fiber and carotene, and more cholesterol and saturated fats.

• Higher prevalence of obesity and an increased risk of cardiovascular diseases and gastrointestinal disorders.

• Increased rates of chronic inflammation in the stomach, leading to higher risk of upper gastrointestinal and pancreatic cancer, and higher rates of ulcers.

• Increased risk of developing diabetes.

• Increased risk of heart abnormalities, hypertension, heart failure, stroke and other coronary diseases.

• Difficulty with daily physical activity and other things that contribute to quality of life.

• Increased risk of chronic kidney disease.

• Potential risk of sleep-disordered breathing, including obstructive sleep apnea.

If there are people in your life over the age of 65, encourage them to be mindful of their oral hygiene and seek regular professional care to maintain their teeth for their entire lives.

A person with missing teeth should be guided to replace them with either removable dentures, fixed bridges or implants, and it’s important to know that many advances in recent years make replacing missing teeth much more comfortable, affordable and predictable. A full set of teeth, whether natural structure or artificial replacements, do a lot to enhance your physical, psychological and social well-being.

Indeed, few pleasures in life can compare to the enjoyment that comes from being able to eat a delicious meal or being able to flash your pearly whites when you smile and laugh.

Dr. Douglas Ashman is prosthodontist and professor at the College of Dental Medicine at Roseman University of Health Sciences in Salt Lake City. This article originally appeared in the Roseman University Summer 2016 issue of remEDy magazine.