DENTISTRY FOR SENIORS

• DRY MOUTH (XEROSTOMIA)
• TOOTH WEAR AND EXCESSIVE STAINING
• RECESSION AND DENTAL DECAY (ROOT SURFACE)
• LOSS OR ALTERATION OF TASTE
• GUM DISEASE (PERIODONTAL DISEASE)
• DENTURE CARE
• HEAR DR. KAVEN TALK ABOUT DENTURES (mp3)

Just like every other part of the human body, teeth tend to decay and weaken more often over time. Since some seniors are limited in activity or are not able to get around on their own, these patients may skip regular dental checkups and even routine home maintenance of their teeth and gums.

It is important for seniors to know that it is never too late to preserve and protect teeth and gum health. Modern dentistry offers a variety of solutions that allow you to enjoy a healthy and beautiful smile for life.

The following information discusses conditions that tend to affect seniors. We encourage you to call us at Madison Smile Solutions and set up a consult if you would like to discuss your own questions or concerns with Dr. Kaveh.

Oral Longevity (PDF)

DRY MOUTH (XEROSTOMIA)

Dry mouth is listed as a possible side effect on many medications, but how does it affect you? Saliva is the natural cleanser of the mouth. It buffers acid produced by the body as well as acid produced by bacteria that cause decay and periodontal disease. Patients with dry mouth are at higher risk for tooth decay and periodontal disease due to decreased saliva. Dry mouth can be exacerbated by ill-fitting dental appliances such as full or partial dentures.

To combat tooth decay and gum disease when you have a dry mouth, you need to be especially careful to follow good oral hygiene habits.

• Brush your teeth at least twice a day - more preferably, after every meal and before bedtime.
• Floss your teeth every day.
• Use toothpaste that contains fluoride. Dr. Kaveh or your hygienist may recommend that you use prescription toothpaste that can help combat decay even more.
• Visit us here at Madison Smile Solutions at least twice a year for your regular cleaning and exam. At your visit, Dr. Kaveh may recommend daily use of a fluoride rinse or fluoride gel to keep your teeth healthy.

Certain products are available that can help alleviate this condition such as artificial saliva replacement drops, oral rinses such as Biotene mouth rinse and Oral Balance moisturizing oral rinse. Sugarless lemon drops have also been found to be an excellent saliva stimulant that can help increase saliva flow. Beware that most cough drops and mints contain sugar and will cause severe decay if used daily.

Do you have dry mouth? (PDF)

Oral Moisturizers (PDF)

TOOTH WEAR AND EXCESSIVE STAINING

Excessive tooth wear can cause loss of height of teeth which can lead to TMJ pain. With increased wear of teeth over time, many seniors may notice an unaesthetic appearance. Teeth can also stain. Areas where enamel is worn are excellent places for debris and plaque to accumulate and stain over the years. Also, as the protective enamel wears away, the yellowish dentin is more apparent, causing teeth to appear darker. Hypersensitivity of teeth is also common, and causes unnecessary discomfort in patient.

RECESSION AND DENTAL DECAY (ROOT SURFACE)

As one ages, the incidence for decay can increase, especially at the root surface. The exposure of the tooth's root surface can occur in seniors primarily from gum tissue receding as one ages. Root surfaces do not have a protective enamel layer and are primarily composed of softer cementum, which easily decays. Plaque and bacteria can accumulate on these surfaces, increasing the risk for this type of decay, especially in the case of dry mouth as discussed above. Since the root surface lacks enamel, decay can more easily penetrate to the tooth's pulp (nerve), which can cause endodontic (root canal) problems and, in worst scenarios, tooth loss.

LOSS OR ALTERATION OF TASTE

Many seniors experience a loss of their taste sensation as they age. Sometimes this is a normal result of aging. However, certain diseases and medications can also lead to taste loss. Ill-fitting dentures or other removable dental appliances can increase the alteration of taste. Patients should always notify their dentist and/or physician if they have any type of alteration or loss in their taste sensation.

GUM DISEASE (PERIODONTAL DISEASE)

The most common cause of tooth loss in adults is gum disease. Bacteria create toxins which inflame and irritate gum tissue. Over the years, a slow progressive detachment occurs that also breaks down the supporting bone. Teeth are no longer held in place by bone, which leads to tooth loss, especially if left untreated. Smoking, poor diet, poor oral hygiene habits, and certain medical conditions and medications can increase your chance of having gum disease. Diabetes, age, and hereditary factors can increase your risk for gum disease as well. It is imperative that one have regular dental check-ups to determine if you have this condition and to determine what treatment needs to be done.

DENTURE CARE

Approximately 40% of older Americans wear full or partial dentures. Many have adapted quite nicely. However, many denture wearers have encountered problems, both emotionally and physically. Some people have trouble eating and some may have repeated sores, which can be quite painful. Ill-fitting dentures can lead to yeast infections of the mouth (oral candidiasis), increased or uneven bone loss and even cancer believed to be from chronic irritation.

Some frequently asked questions are:

When is it time for a new denture?

Over time, tissue and bone shrinks slightly. As this occurs, dentures will not fit as well and will become loose. Denture fit may also change as one loses or gins weight. Dentures, if your dentist advises, can be relined to help them fit better. However, if their bases are too far gone, a new one may need to be fabricated.

As always, even a full denture wearer should visit the dentist on a regular basis to get an evaluation of the palate, tongue, and surrounding tissue for any problems. Sore spots should not be ignored. See the dentist if adjustments are needed. Some people have trouble eating and some may have repeated sores, which can be quite painful. We can help with problems like that.

What is the best way to get used to my new dentures?

As with any new appliance, dentures may feel odd at first. They may cause increased saliva flow or they may alter speech. One should start by cutting food into small pieces, avoid hot foods, and avoid hard foods until the tissue (where the denture rests) becomes used to the new teeth. As time goes by, one will become accustomed to them.

Do I brush them like real teeth?
No - dentures should be cleaned, if possible, after each meal. The best way is to remove them and rinse them. If one is able to, brushing the dentures is advised, as well as rinsing the mouth to clean it of any debris. If some natural teeth do remain, we suggest that you brush them as well. Always soak dentures at night after brushing them. Over the counter cleaning agents are available. Keeping the dentures soaked protects them from warping. It is also much healthier to keep the teeth out overnight to avoid excessive pressure on the soft tissue and bone. Always remember to brush your tongue and lightly brush the gums with a soft toothbrush. Special denture brushes should be used on the dentures.

Ask Dr. Kaveh about options to have an implant inserted to secure your dentures in place and keep them from slipping out at inopportune times.

SOLUTIONS FOR MISSING TEETH

The problem of broken down or missing teeth can be easily remedied in most cases. However, ignoring these dental problems may cause additional tooth and bone loss which can lead to more expensive treatments. That is why it is better to take care of minor problems right away, before they get bigger and more expensive to repair.

Replacing missing teeth will help you to keep and maintain the health of your smile for a long time. Unlike baby teeth, we want to keep our permanent teeth as long as we can. Gum disease is the leading cause of missing teeth in adults. It can be prevented or stopped by keeping your mouth as clean as possible through daily brushing, flossing, and regular check-ups.

Gaps between teeth can occur naturally or when teeth have been lost. A gap between the front two teeth is natural for some; many choose to have it closed for cosmetic reasons although it poses no harm to oral health. People often live with spaces between their back teeth for years because they do not cause a cosmetic problem. However, these spaces can lead to dental problems.

 Dental Implant PDF here

Nature's Balancing Act
When spaces are present due to missing teeth, movement will occur. If left untreated, other teeth will drift and tip into unoccupied areas. Teeth also migrate into spaces when opposing teeth are missing. To keep all your permanent teeth functioning and in their correct position, you need to replace missing teeth to maintain long term oral health.

The Effects of Missing Teeth

Your teeth are mutually dependent on each other to maintain their natural position in your mouth. This positioning helps you chew while distributing your biting forces.	When you lose a tooth the remaining teeth will move into the open space. If left untreated, more complex dental treatment may be needed to restore your normal dental health	A bridge can be used to replace missing teeth and restore dental health. Teeth on both sides of the space are prepared and a bridge is permanently cemented or bonded into place.	Dental implants are becoming more popular as a method used to replace missing teeth. An implant replaces the root of a missing tooth so that a crown can be attached to it.

Fixed Permanent Solutions
Missing teeth may set off a chain reaction of dental problems over time that can change your bite and develop food traps. This can cause bad breath, tooth decay, periodontal disease and bone loss. Depending on the circumstances involved, fixed dental devices, like bridges or dental implants, may be a solution to restore the function of your teeth and improve oral health. Even orthodontics may be recommended to return the teeth to a more ideal position to improve function and/or cosmetics. For more information, please see our sections on bridges and implants!

"Take Out" Solutions
Upper or lower dentures usually are the best solution for patients with no teeth. In situations where many teeth are missing, but the remaining teeth are stable and healthy, a removable partial denture may be recommended. "Partials" allow patients to keep their remaining healthy teeth and replace missing teeth to restore form and function. Precision partials use fixed crowns and special attachments to secure the partial and eliminate the need for conventional clasping methods. The removable design of a full or partial denture allows for daily cleaning and periodic adjustment or replacement.

The Final Choice Is Yours
Usually, there is more than one restorative solution for repairing broken-down and missing teeth. A consultation with Dr. Kaveh will help you choose the best restorative solution for your situation. You can help keep your permanent teeth longer by replacing missing teeth, brushing and flossing daily, and having regular dental check-ups and professional tooth cleanings. Stopping smoking or chewing tobacco and maintaining good nutrition will also help you achieve the optimum in oral health.

Warning Denture Cream Users

There has been much discussion in the press about the linkage between the use of denture creams containing zinc and the development of nerve damage. The article below from the NY Times (March 30, 2010) should be read by any person using denture creams and we urge you to immediately review other treatment options. There are a number of class action lawsuits already ongoing across the country. Also, please find below links for additional articles / information related to studies conducted linking nerve damage to use of denture creams.

http://abcnews.go.com/GMA/story?id=7504641&page=1
http://www.denturecreamlawyer.com/problems.html
http://www.dailymail.co.uk/health/article-1252051/Poligrip-remove-zinc-denture-adhesive-concerns-triggers-health-problems.html
http://www.neurology.org/cgi/eletters/71/9/639#37849
http://www.zestanchors.com/patients-warnings.php?warnid=16

Study Finds a Possible Link Between Denture Cream and Imbalance

http://abcnews.go.com/GMA/story?id=7504641&page=1