Aging & Dental Health: What You Need to Know (AU)

High blood pressure. Osteoporosis. Diabetes. These are just a few potential health problems older Australians face as they enter their golden years. 

With so many things to think about, it’s easy to see why oral and dental health might fall under the radar—especially as a trip to the dentist isn’t usually at the top of anyone’s “good times to be had” list. In the grand scheme of things, dental and oral health might seem much less serious than other issues. After all, we’re talking about teeth here, right? 

Wrong.

Oral and gum problems have long been linked to conditions like diabetes, certain respiratory issues, and obesity. As with so many aspects of health, it’s complicated. Some health problems negatively affect oral health problems or make them harder to manage. This can go both ways, with one problem making the other worse and feeding into a damaging cycle. 

Research continues to show a deep connection between our oral health and overall health:

  • In 2020, the Journal of Alzheimer’s Disease published a study indicating the bacteria that causes gum disease is also associated with the development of Alzheimer’s disease and related dementia.
  • According to Harvard Medical School, individuals with gum disease have twice or even three times the risk of experiencing a heart attack, stroke, or other major cardiovascular event. 
  • Research from the Journal of the American Geriatric Society (2022) showed older adults with oral health problems experienced higher rates of disability and limited mobility. 

There’s also a growing awareness about the impact our oral health can have on the quality of day-to-day life as we age. According to research conducted by Aged Care Research & Industry Innovation Australia (ARIIA), one in five older Australians is socially isolated, with that figure rising to one in three for older adults living in residential care. Missing teeth and oral health problems can make eating and speaking much more difficult and cause further isolation. 

Fortunately, there’s never been a better time to take charge of your oral health. Treatment and at-home care options are more advanced and accessible than ever, and awareness about the need for community-based care is also on the rise. Early detection and treatment of oral health problems, along with proper oral hygiene, can help ensure your mouth, gums, and teeth are ready to thrive with you each year. 

Knowledge is also key. Understanding the risks and different factors affecting your oral health can also help you navigate your way to optimal oral health at any age. Here’s some info on aging, oral care, and more:

How Aging Affects Oral Health

Aging, and everything that comes along with it, can cause changes to our dental and oral health. Common effects of aging on oral health include:

  • Natural effects of aging: You change as you get older, and so does your mouth. Teeth can shift throughout the years, and gums can recede and shrink.
  • Wear and tear: Throughout aging, the enamel of teeth (the protective layer) can get worn down. This is also called attrition. It can increase the risk of dental problems and cavities.
  • Other health problems: If you’re an older adult experiencing other health conditions, this can have a substantial effect on your oral health. Related conditions may include diabetes, osteoporosis, obesity, and chronic inflammation.
  • Complications from medications: Because seniors are more at risk for developing chronic health conditions, they are also more likely to be prescribed medications to treat these conditions. Some medications can affect oral health (more on this below).

Inflammation: The Connection Between Overall Health and Oral Health

The bacteria in your gums, which is caused by plaque and particle build-up, can travel to other parts of your body through the bloodstream and respiratory tract. This creates inflammation – a major source of sickness, infection, and weakened immune response in the body. The result is a damaging pattern: the mouth releases bacteria, causing inflammation which then makes it harder to fight off the bacteria in the mouth. More bacteria are then released – causing more inflammation. 

At the heart of many connections between oral health and other health problems is the traveling of bacteria in the gums and mouth to other tissues and organs of the body, and the resulting inflammation and problematic immune response. 

Common Oral Health Problems in Older Adults

Gum Problems

More than half of Australians over the age of 65 suffer from some degree of gum (periodontal) disease. Gum disease is caused by the bacteria in plaque, which can cause inflammation and irritation in the gums. This can result in the gums separating from the teeth and forming pockets that may house food particles and more bacteria – creating a dangerous cycle that can worsen inflammation. Eventually, gum disease can weaken gums and the ligaments that support the teeth, and even the bones around the teeth. When the supporting structure of the tooth is destroyed, the tooth becomes loose and will eventually fall out.  

Gum disease is relatively painless until it is severe, so it’s easy for many seniors to have the condition without knowing, especially as their teeth and gums may be less sensitive. 

Tooth Decay

Wear and tear throughout the years weakens the tooth’s protective layer, called the enamel. This leaves teeth vulnerable and prone to decay, which leads to cavities and dental problems. The receding of gums – another effect of aging on one’s mouth – can also leave root surfaces exposed and more susceptible to decay. Root surface decay was shown in recent Australian studies to be common in residential home-age adults. It’s harder to detect than crown tooth decay.

Oral Cancer

Cancers of the mouth (called oral and pharyngeal cancers) are diseases mainly affecting older adults. They are most frequently diagnosed in patients aged 55-64, with a median diagnosis age of 64.

TMJ Disorders

Many older adults experience TMJ (Temporomandibular Joint) disorders, which affect the bone structure connecting the jaw to the skull. The associated grinding of teeth can damage tooth structure and enamel, leading to bone loss. This is especially true for older adults whose enamel may already be vulnerable due to wear and tear and chronic health conditions. 

Tooth Loss

Tooth loss is a significant concern for older adults, with approximately 25% of Australian adults over 65 suffering from complete tooth loss. Tooth loss occurs when severe dental issues are not prevented or treated, and it severely impacts an individual’s quality of life as it affects everyday activities like eating and talking. 

Health Issues That Can Cause Oral Health Problems

Some health problems that are common in seniors can cause or exacerbate oral health issues, including:

Diabetes

The high blood sugar caused by diabetes weakens white blood cells that aid the body in fighting off pathogens and bacteria – including the bacteria caused by plaque, the cause of tooth decay and gum problems. Diabetes also causes blood vessels to thicken, slowing the natural movement of nutrients traveling in and waste products moving out of muscle tissue (including in the mouth). This, too, makes gum infection more common in people with diabetes.

Diabetes can cause other oral health problems, including:

  • Dry mouth: Diabetes can decrease saliva flow, increasing the risk of ulcers, infections, and decay.
  • Thrush: The antibiotics taken by those with many infections caused by diabetes may increase the risk of a fungal infection. The high-glucose saliva of those with uncontrolled diabetes can also create fungal issues or make them worse.
  • Delayed healing: Diabetes may slow the blood flow to an affected site after a procedure or dental surgery, which can prolong healing time and lead to more infections.

Osteoporosis

Osteoporosis weakens bones and can severely impact oral health. As the jawbone becomes weakened by osteoporosis, teeth can become loose. This can result in severe decay, gum damage, and, ultimately, tooth loss. 

Osteoporosis is a degenerative condition characterized by systemic bone loss; gum disease causes localized bone loss in the mouth as a result of bones being attacked by infection. The relationship between osteoporosis and gum disease is still being researched; however, studies have shown that both diseases share risk factors common among older adults (hormonal changes, age, and vitamin deficiencies, to name a few). Radiographic measurements and clinical studies have shown an association between the two conditions.

Respiratory Diseases and Aspiration Pneumonia

Gum (periodontal) bacteria travels rather easily to its neighbor, the lungs. As part of the immune response, the lungs may then “overreact” with a response of damaging inflammation. In this response, the connective tissues of the lungs can be damaged. 

The movement of bacteria from the gum and into the respiratory tract can also produce aspiration pneumonia, making problems like chronic obstructive pulmonary disease harder to treat.

Medication and Oral Health

Aging often includes dealing with chronic and systemic conditions like hypertension, urological problems, issues with bones and joints, and more. Many older adults are prescribed medications to treat these problems – sometimes multiple medications. Medications typically have side effects, and many of these side effects can impact oral health.

Dry mouth, or xerostomia, is one of the most common side effects of medications prescribed to older adults, and it can affect their oral health. Although dry mouth isn’t necessarily a natural part of the mouth’s aging process, many older adults experience it as a side effect of a medication or chronic health issue. Not only is dry mouth uncomfortable, but it can lead to more plaque, causing tooth decay and gum problems. Dry mouth can also cause bad breath, impacting social interactions and quality of life.

In rare cases, medications (including bisphosphonates and antiresorptive agents) used to treat osteoporosis have caused a serious condition called osteonecrosis, which can cause substantial damage to the jaw bone.

Older adults may also be extremely sensitive to some medications. This is especially concerning as they may also be prescribed multiple medications. Reactions to medications can impair memory and cognitive function, adding a layer of difficulty to proper oral care and hygiene. 

Prevention: How to Protect Your Teeth and Gums as You Age

Learning about the many oral health challenges older adults face can be worrying. However, realizing the huge impact that proper dental care and preventative measures can have on oral health outcomes is empowering to many. Most of the oral health problems above can be controlled and limited, if not outright prevented, by taking care of your mouth and oral health.  

Caring for Your Oral Health

Daily Oral Hygiene

Caring for your teeth and gums is one of the most important factors in preventing oral health problems. A good daily protocol includes:

  • Brushing teeth at least twice daily with a soft-bristled toothbrush and fluoride toothpaste. Receding gums or tooth sensitivity may require special toothpaste. 
  • Flossing or using interdental cleaners daily. (See this article for more accessible flossing options)
  • Using a microbial mouthwash after meals and brushing to help remove any particles or plaque. Alcohol-free mouthwashes are often recommended, as alcohol can dry out the mouth. 
  • If bristles appear worn, replace your toothbrush every three to four months or earlier. 

Professional Dentist Care

Seeing a dentist every six months for a professional cleaning and check-up can make all the difference in ensuring oral health. This is especially true for older adults, who may become less sensitive to the pain or discomfort caused by an oral issue due to medication or loss of sensitivity. Unnoticed, the problem gets worse without treatment.

A dentist can identify oral health issues—like decay or gum inflammation—early on, when they are easy to treat. This will limit the damage the disorder can cause and help prevent further issues, like tooth loss. 

Diet and Nutrition

Sugary foods can cause tooth decay and increase plaque production, so limiting high-sugar sweets and drinks can be essential to avoiding oral health. Eating a well-balanced diet can help promote overall health and oral health (for more information about nutrition and oral health, check out our guide on nutrition and oral health here). A good diet will also increase immunity and make you less susceptible to inflammation and infections – including gum and mouth infections.

FAQs 

Do teeth weaken with age?

Generally, older adults experience weakened teeth as they age. This is due to both the natural aging process (wear and tear on the tooth enamel over the years) and oral health conditions (decay and gum inflammation) that may be related to chronic or systemic health conditions or the medications used to treat them.

How do you keep your teeth healthy as you age?

Preventative measures to keep your mouth and teeth healthy can make a huge difference. Rather than seeing oral health problems as inevitable, take pride in your smile and do everything you can to maintain it – especially knowing this can boost your oral health and your general health and quality of life. 

Practicing good oral hygiene daily (brushing twice a day, flossing at least daily, and using a suitable mouthwash after brushing and meals) can help avoid decay and gum inflammation, which are the cause of so many dental problems. Seeing a dentist at least twice a year can help catch any problems early on and help avoid severe issues like gum disease and tooth loss.

What issues do the elderly face in terms of oral health care?

Older adults are dealing with a mouth that has encountered more use and may experience natural aging problems affecting the mouth, like teeth shifting and shrinking teeth and gums. 

Chronic and systemic health problems that are often encountered by the aging population can have a serious negative impact on oral health. Inflammatory and degenerative diseases can weaken gums and bones, making the mouth much more vulnerable to tooth decay and gum disease. If left untreated, these issues can lead to tooth loss.

Medications taken for these conditions can also cause oral health concerns. Some may cause dry mouth, which can increase tooth decay and affect the quality of life. Others may cause memory or cognitive problems, which can affect a person’s ability to perform daily oral care.

The fact that dental care is not covered by government health plans for seniors complicates issues further for older adults. This limits access to professional preventative care and treatment, and it’s one reason self-care is so important. Caring for your teeth now and planning for routine maintenance check-ups can help avoid problems and costly emergencies later.