Why Is Dental Care So Important as You Age?

How Does Aging Affect Your Oral Health?

The World Dental Federation defines oral health as to your ability to speak, smile, smell, taste, touch, chew, swallow, and convey emotions through facial expressions with confidence and without pain, discomfort, and disease. Age-related changes can directly affect your oral health, such as:

With these changes, comes an increased risk of several oral health problems.

Common Oral Health Problems in Older Adults

As with many other health conditions, the risk of dental and oral health problems increases with age. We’ll review some of the most common, below.

Dry Mouth

Dry mouth (also known as xerostomia) is the sticky, uncomfortable feeling you get when there’s not enough saliva in your mouth. Having dry mouth increases the risk of poor oral health and complications, like:

Older adults have a higher risk of dry mouth due to age-related changes and an increased risk of health conditions that can cause dry mouth, such as diabetes, Alzheimer’s disease, and stroke.

Older adults are also more likely to take a medication with dry mouth as a side effect, such as:

Gum Disease

Gum disease (also known as periodontal disease) happens when you have an infection of the gums that causes inflammation. In the early stages of gum disease, it causes red, inflamed gums. As it progresses, gum disease can cause receding gums, bone loss in the jaw, and tooth loss. Gum disease is common in older adults. It’s estimated that about 2 out of 3 adults over the age of 65 have gum disease.

Gum disease is caused by dental plaque buildup, which is full of bacteria (germs) that can infect the gums. People who smoke and those with poor oral hygiene have a higher risk of developing gum disease. Poor oral hygiene refers to not cleaning the plaque off your teeth daily with brushing and flossing.

Other risk factors for gum disease are more common in older adults, including:

Tooth Decay

Tooth decay refers to damage on the surface of your teeth that causes a cavity. Cavities happen when the acid produced by bacteria in the mouth break down the tooth enamel (the hard outer surface of the teeth). Older adults may be more likely to develop cavities due to years of wear and tear on this protective outer layer.

Cavities are common and most people have at least one cavity by the time they reach their mid 30s. People with dry mouth and receding gums are at risk of tooth decay and cavities. It’s estimated that almost 20% of adults over the age of 65 have untreated cavities.

Oral Cancer

Oral cancer is any cancer that develops in the mouth. As with most types of cancer, oral cancer is more common in older adults. Factors that increase the risk of developing oral cancer include:

What’s the Link Between Oral Health and Chronic Disease?

Researchers have linked poor oral health to an increased risk of several chronic (long-term) diseases. Often, the relationship is a vicious cycle — chronic illness can make oral health worse, and in turn, poor oral health can worsen existing medical conditions.

Malnutrition and Frailty

Malnutrition refers to decreased fat mass that leads to decreased physical and mental function. In older adults, malnutrition is mainly caused by not eating enough protein and calories.

Age-related oral health problems can make it more difficult to get proper nutrition. For example, dry mouth, infection, mouth pain, and tooth loss can make it harder to chew food. As a result, the diet is restricted to easier to chew foods, which may not be as nutritious or desirable to eat. Many older adults also have a decreased appetite related to changes in taste or digestive problems.

Poor dental health can make it difficult to get the nutrients the body needs. In turn, poor nutrition can increase the risk of other health problems in the mouth and throughout the body.

Heart Disease

Several studies have found a link between gum disease and cardiovascular (heart) disease. It’s thought that the bacteria that cause gum disease can also cause inflammation all over the body. This long-term inflammation increases the risk of developing heart disease. Treating gum disease may help improve heart-related outcomes.

Diabetes

Poor oral health and gum disease can increase inflammation, which can increase the risk of developing diabetes. A 2015 study found that even a few missing teeth can increase the risk of diabetes, heart disease, and death.

Having diabetes also increases your risk of developing gum disease, dry mouth, and oral thrush. Diabetes causes higher levels of sugar in the blood and saliva, which can fuel bacterial growth in the mouth.

Alzheimer’s Disease and Dementia

Researchers have linked gum disease to an increased risk of developing Alzheimer’s disease. A 2020 study in the United States (U.S.) found that the bacteria that cause gum disease are also linked to Alzheimer’s disease. It’s thought that the same bacteria found in people with gum disease may inflammation that can affect the brain and encourage the development of Alzheimer’s disease.

Another study found that tooth loss was associated with a higher risk of dementia and cognitive impairment (problems with memory and functioning). Researchers found that the more teeth a person loses, the higher the risk of dementia. People in the study without teeth had more than a 54% higher risk of cognitive impairment and 40% higher risk of dementia compared to people with teeth.

As Alzheimer’s disease or dementia progress, people may need help taking care of themselves, including caring for their teeth. In earlier stages, a person with dementia may need to be reminded to brush and floss their teeth. In later stages, a person with dementia may not be able to brush their teeth and will need a caretaker to do it for them. Without proper support, a person with dementia may develop worse oral health.

Respiratory Infections

Poor oral health and gum disease are linked to an increased risk of respiratory (lung) infections. It’s thought that some bacteria that cause gum disease can travel to the lungs, causing infection. However, the bacteria in the mouth can affect the lungs in other ways. For example, changes in the saliva related to gum disease may also the lungs, making them more susceptible to infection. Additionally, body-wide inflammation from gum disease can increase the risk of respiratory infections.

Barriers to Dental Care

Many dental problems are more common and more serious in older adults compared to younger people. This makes good oral hygiene and regular dental care even more important. However, many older adults encounter barriers that make it difficult to take care of their oral health.

Some health conditions can make dental care harder. People with arthritis in their hands may have difficulty holding a toothbrush and using floss. People with dementia may not be able to take care of their teeth on their own. Medical conditions that affect a person’s mobility may also make it more difficult to get to the bathroom and brush their teeth.

Older adults may also have limited access to professional dental care from a dentist due to transportation limitations, dental anxiety, or cost concerns. Dental care can be expensive and often isn’t included in insurance plans.

If you or a loved one encounters barriers to good dental care, it’s important to talk to your physician and dentist about ways to overcome these barriers.

Strategies for Maintaining Dental Care as You Age

Good oral health usually doesn’t take center stage in relation to health problems in older adults. However, good oral hygiene can improve overall well-being and increase quality of life.

Use Assistive Devices

Assistive devices are specifically designed to make life easier for people with disabilities. People with arthritis may find it easier to brush and floss their teeth with the aid of an assistive device.

There are several different kinds of assistive devices that can make teeth brushing easier. Some devices wrap around the toothbrush to make the handle bigger and easier to hold. Other devices can strap the toothbrush to the hand, allowing you to brush your teeth without gripping the handle of the toothbrush. Electric toothbrushes and toothbrushes with bristles on multiple sides can also make toothbrushing easier. A floss holder or water flosser can also be useful to help with flossing.

Replace Missing or Damaged Teeth

Your dentist can help you replace missing or damaged teeth. There are several options to repair your teeth. A crown is a cap that goes over a tooth to help strengthen a weak tooth or restore an already broken tooth. Dental bridges are a type of fixed (non-removable) partial denture to replace one or more missing teeth. Dental implants can replace missing teeth with a long-lasting medical device that functions like a natural tooth. Dentures (removable false teeth) may be helpful for people who need to replace many teeth due to gum disease and tooth loss. Your dentist can help you understand the best options for you.

Some studies have found that dentures and dental implants may also reduce the progression of dementia related to tooth loss. A 2024 study from Taiwan found that using dentures may offset the increased risk of dementia associated with tooth loss.

Eat a Balanced Diet

Maintaining good dental health may help you eat a balanced diet. Good nutrition can help prevent dental problems and improve your overall health. Eating a diet high in fruits and vegetables provides nutrients and antioxidants that can prevent gum disease and cavity formation. On the other hand, consuming foods and drinks high in sugar and drinking 100% fruit juice and soft drinks are linked to an increased risk of cavities and gum disease.

When a balanced diet is combined with proper dental care, there may be even more benefits. A 2023 study from Japan found that people who received dietary advice along with new dentures had less cognitive impairment compared to those who didn’t get any dietary advice.

Find Affordable Dental Care

Dental care usually isn’t included in traditional health insurance plans. Medicare — U.S. health insurance for people 65 years and older — doesn’t cover routine dental care. Access to dental care through Medicaid — U.S. health insurance for people with a low income — may also be restricted.

Dental schools and dental hygiene schools may offer lower cost treatment and preventive services. Some dental clinics may offer pricing based on your income. Talk to your dentist or physician for more information about low-cost dental care.

Prioritize Your Oral Health

Dental care is part of your overall health care. Good dental care involves care at home and from a dentist. At home, it’s important to brush your teeth at least twice a day. Health experts recommend using a small amount of fluoride toothpaste to help prevent cavities. You should also clean between your teeth with floss at least once a day.

Most dentists recommend a regular cleaning every six months. Dental cleanings can help remove plaque build-up you can’t get from brushing and flossing alone. Regular visits with a dentist can also help find dental problems before they get more serious. Your dentist may recommend dental visits more often if you have gum disease or if you have other chronic health problems.

Talk to your physician and your dentist for personalized recommendations for your dental care.