Challenges to expect as you age
Many older adults who haven’t had a cavity in years are surprised to hear the news from their dental professional – tooth decay has become a problem again.
People in their fifties and sixties “often believe they have everything figured out when it comes to their oral health,” says Edmonton-based dental hygienist Marion Kaiser, who has worked in the profession for 30 years.
“They see decay as a childhood disease that’s well behind them and think they only have to worry about the occasional maintenance procedure, such as a crown or root canal,” she says.
“But the reality is that many older adults end up with cavities again, especially along exposed root surfaces. And once decay appears on those surfaces, it can spread like wildfire.”
Baby boomers – adults currently in their early fifties to early seventies – are at greater risk for a number of oral health conditions and diseases. In addition to tooth decay, risks increase for gingivitis (inflammation of the gums) and periodontal (gum) disease, as well as for more serious conditions, such as infections and oral cancers.
“People predisposed to gum disease because of family history or lifestyle are often perfectly healthy for many years,” Kaiser explains. Later in life, that long-time vulnerability develops into disease. Sometimes, she says, gum disease flares up for women going through the hormonal changes of menopause or men receiving hormone treatments for prostate cancer. Boomers and older seniors also find themselves increasingly dealing with a medical condition called xerostomia – commonly known as dry mouth. A person with this condition feels an excessive and often constant dryness in their mouth, due to a decrease in the amount of saliva. dry mouth has significant consequences for oral health and frequently contributes to a cycle of worsening problems.
“Saliva is designed to not only moisturize your mouth and allow you to speak clearly, but to help you swallow and digest your food. It also protects against tooth sensitivity, gingivitis and cavities,” says Dr. James DiMarino, an experienced dentist who serves as country medical affairs director for oral care with GSK Consumer Healthcare.
“So dry mouth is a serious problem that can cause rapid tooth decay and many other oral health issues,” he says. “A lot of people don’t realize that many of their concerns can be traced back to dry mouth. It’s all related. If we can mitigate their dry mouth, people are less prone to cavities, tooth sensitivity and gingivitis, for example, and will feel better overall.”
Although dry mouth is most commonly found in older adults, dental professionals say it is not necessarily a normal part of aging. The number-one cause of xerostomia is medication use, and as people get older, they are more likely to be taking at least one and often several medications to manage chronic conditions such as high blood pressure and diabetes.
“It’s a great tribute to medical progress that research has produced so many new medications that prolong and improve our quality of life,” says DiMarino. “Of course, that’s positive, but now we have a huge number of people taking medications that may limit saliva production as a side effect – and the risk increases as the number of medications increases.”
It is difficult to avoid this common condition. More than 400 medications can cause dry mouth and one in four adults in Canada experiences the condition.
Approximately 3.5 million Canadians over age 45 are taking at least two medications per day. People in that category have a 40 per cent risk of developing dry mouth, and the risk increases to 60 per cent for those taking six or more medications daily – which is common for many elderly people.
Dental professionals ask their patients to report changes in their medication use and one of the reasons is to flag any concerns related to dry mouth. They urge people who are experiencing oral dryness to speak up – to tell their dentist or hygienist about their symptoms and to learn about ways to relieve and manage the condition.
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