Healthy teeth and gums make it easier to enjoy a variety of nutritious and tasty foods as we age. While people of all ages experience dental health problems each year, thanks to advances in oral health research, today’s older adults are keeping their natural teeth longer compared with previous generations. This article offers tips to help keep your teeth and gums healthy as you age.
Tooth decay
Teeth are covered in a hard outer coating called enamel. Each day, a thin film of bacteria called dental plaque builds up on your teeth. The bacteria in plaque produce acids that can harm enamel and cause cavities. Brushing and flossing your teeth can prevent decay, but once a cavity forms, a dentist must fix it with a filling to avoid further damage.
Use fluoride toothpaste to protect your teeth from decay, especially if you are at a higher risk for tooth decay — for example, if you have dry mouth because of a health condition or certain medicines. Your dentist or dental hygienist may recommend a fluoride treatment during an office visit or advise that you use a fluoride gel or mouth rinse at home.
Growing evidence for connections between oral health and dementia risk
Studies are showing evidence for connections between poor oral health and dementia risk. For example, in 2020, NIA scientists tracked long-term data from more than 6,000 older adults and found that those with signs of gum disease and mouth infections were more likely to develop Alzheimer’s disease or a related dementia than those without. A 2021 study found that older adults with tooth loss have a higher risk of cognitive impairment and dementia, and that this risk increases with each missing tooth. However, participants who had missing teeth but used dentures did not have a significantly higher risk of dementia compared to participants without missing natural teeth. Researchers are still working to determine how oral health problems may be related to cognitive health later in life.
Gum disease
Gum disease begins when plaque builds up along and under your gum line. Plaque can cause an infection that damages the gums and bone that hold your teeth in place. A mild form of gum disease, called gingivitis, may make your gums red, tender, and more likely to bleed. Gingivitis can often be fixed and prevented by brushing and flossing every day.
A more severe form of gum disease, called periodontitis, must be treated by a dentist. If left untreated, this infection can lead to sore and bleeding gums, bad breath, painful chewing problems, and even tooth loss.
To help prevent gum disease:
- Brush your teeth twice a day with fluoride toothpaste.
- Floss or clean between your teeth once daily.
- Visit your dentist routinely for a checkup and cleaning. Tell the dentist about any medical conditions you have and medications you take.
- Eat a well-balanced diet.
- Quit smoking. Smoking increases your risk for gum disease.
How to clean your teeth and gums
Here is the way dentists recommend that you brush and floss your teeth:
- Gently brush your teeth on all sides with a soft-bristle brush and fluoride toothpaste. Replace your toothbrush every three to four months.
- Use small circular motions and short back-and-forth strokes.
- Brush carefully and gently along your gum line.
- Lightly brush your tongue or use a tongue scraper to help keep your mouth clean.
- Clean between your teeth with dental floss, pre-threaded flossers, a water flosser, or a similar product. Flossing removes plaque and leftover food that a toothbrush can’t reach.
- Rinse your mouth with water after you floss.
People with arthritis or other conditions that limit hand motion may find it hard to hold and use a toothbrush or dental floss. These tips can help make brushing and flossing more manageable:
- Use an electric or battery-operated toothbrush.
- Buy a toothbrush with a larger handle.
- Attach the toothbrush handle to your hand with a wide elastic band.
- Use a floss holder if you have trouble flossing.
See your dentist if brushing or flossing causes your gums to bleed or hurts your mouth. Your dentist can tell you the best ways to take care of your oral health.
Oral health is also very important for older adults living with Alzheimer’s or a related dementia. These individuals often need help taking care of their teeth and mouth. NIH’s National Institute of Dental and Craniofacial Research (NIDCR) provides oral health tips for caregivers in English or Spanish.
Crowns, bridges, and dental implants
There are several options available to help repair or replace missing or damaged teeth as you age. Talk to your dentist about which might be right for you:
- Crowns are tooth coverings or caps that can help strengthen damaged teeth and improve their appearance. Crowns can also be used to attach bridges, protect weaker teeth from breaking, or restore a tooth that’s already broken.
- Bridges, also known as fixed partial dentures, replace missing teeth with artificial ones to close gaps in your smile.
- Dental implants may be an option for people who have lost one or more teeth due to disease or injury, but who prefer to not wear dentures.
Dentures
Sometimes removable false teeth (dentures) are needed to replace badly damaged teeth or teeth lost because of gum disease. Partial dentures may be used to fill in one or more missing teeth. Dentures may feel strange at first. In the beginning, your dentist may want to see you often to make sure the dentures fit well. As your gums change shape over time, your dentures may need to be adjusted or replaced. Be sure to let your dentist handle these adjustments.
Be careful when wearing dentures because it may be harder for you to feel hot foods and drinks or notice bones or other hard bits in your food. When learning to eat with dentures, it may be easier if you:
- Start with soft, nonsticky food.
- Cut your food into small pieces.
- Chew slowly using both sides of your mouth.
- Avoid small crunchy foods, such as popcorn kernels, that can get trapped under the dentures and hurt your gums.
Follow your dentist’s instructions for taking care of your dentures. Keep your dentures clean and free from food that can cause stains or bad breath. Brush dentures every day with a denture-care product, and soak them in water or a denture-cleansing liquid at night. Be sure to leave them out of your mouth while you sleep to prevent swollen gums.
Dry mouth
Dry mouth happens when you don’t have enough saliva, or spit, to keep your mouth wet. It can make it hard to eat, swallow, taste, and even speak. Dry mouth can increase your risk of tooth decay, fungal infections of the mouth, and cavities. Many common medicines can cause this problem, e.g., medicines for high blood pressure, depression, and bladder-control issues.
There are things you can do that may help. Try sipping water or sugarless drinks. Don’t smoke, and avoid alcohol, caffeine, soft drinks, and acidic fruit juices. Avoid spicy or salty foods. Sugarless hard candy or sugarless gum that is a little tart may help. Talk to your dentist or doctor if your mouth feels too dry. They might suggest using artificial saliva to keep your mouth wet.
Oral cancer
Oral cancer can start in any part of the mouth or throat, including the tongue. Oral cancer is more likely to happen in people over age 40, and men are more likely than women to develop it. A dental checkup is a good time for your dentist to look for signs of oral cancer. Even if you have lost all your natural teeth, you should still see your dentist for regular oral cancer exams. This exam is quick and painless.
You can lower your risk of oral cancer in a few ways:
- Do not use tobacco products, such as cigarettes, chewing tobacco, snuff, pipes, or cigars.
- If you drink alcohol, do so only in moderation.
- Use lip balm with sunscreen.
Electronic cigarettes (e-cigarettes) are relatively new, and scientists are still learning about how they change the balance of microbes in the mouth and the long-term health effects of vaping. However, we do know that e-cigarette vapor contains cancer-causing chemicals.
Finding affordable dental care
Dental care can be costly. Medicare does not cover routine dental care, and some states limit dental coverage under Medicaid. You may want to consider private dental insurance, making sure you understand the cost of the premiums, which services would be covered, and out-of-pocket responsibilities. The following resources may help you find affordable dental care:
- Some dental schools have clinics in which students get experience treating patients at a reduced cost. Qualified dentists supervise the students. Visit the NIDCR website for a list of U.S. dental schools and other places that offer more affordable care.
- Dental hygiene schools may offer supervised, low-cost care as part of the training experience for dental hygienists. Contact your local university or college to ask if they have a program available.
- Call your county or state health department to find dental clinics near you that charge based on your income. See a list of state oral health programs.
- To locate a community health center near you that offers dental services, visit this searchable database of health centers to find one in your area.
- United Way chapters may be able to direct you to free or reduced-cost dental services in your community. Dial 211 to reach a local United Way chapter or visit the United Way website.
For more information about healthy teeth and gums
National Institute of Dental and Craniofacial Research
866-232-4528
www.nidcr.nih.gov
Health Resources and Services Administration Information Center
www.findahealthcenter.hrsa.gov
American Dental Association
800-621-8099
www.mouthhealthy.org/en
American Dental Hygienists' Association
312-440-8900
www.adha.org