Oral Health: Adults

Oral Health: Adults

Oral Health: Adults

Information

Oral Health

Regular and correct hygiene habits are essential to health. With age and disease, there may be a decrease in manual dexterity making it more difficult to practice these habits. Older adults may need to use electric toothbrushes and other special brushes to clean between teeth. People with arthritis or other limitations to movement may need modified toothbrushes with thicker handles.

Many adults have the habit of visiting their dentists only when a problem arises in their mouth. Apart from eating a well-balanced diet and practising effective home care, regular dental visits are crucial for maintaining a good and effective dentition for all age groups. The belief that fluoride only benefits children is not true as fluoride helps prevent decay in all age groups. Our mouths affect our physical health and our psychological well-being at any age. Good oral habits like brushing and flossing need to be maintained all through life.

Follow these simple steps to keep your teeth and gums healthy.

  1. Brush twice daily, especially once before bedtime. Make sure that all the surfaces of teeth and gum are cleaned for effective plaque removal
  2. Use fluoride toothpaste and after brushing spit the toothpaste out. Avoid rinsing the paste from your mouth after brushing as this will wash the fluoride away from your teeth
  3. Floss or use interdental brushes once daily to clean between your teeth
  4. Avoid eating sugary, sticky and acidic foods and drinks in between meals
  5. Eat a wide variety of nutritious foods
  6. Visit the dentist for regular check-ups. The dentist can spot and stop any problems with your teeth and gums at the early stages
Dental Check-up

There are many things a dentist can spot during a dental check-up such as weakening older fillings, early signs of gum (periodontal) disease, gum recessions, tooth and root surface decay, and many other oral problems that can affect your general health. Early detection will help treat the problem at the early stages and stop it from becoming more severe. Dentists can also look for early signs of oral cancer and other diseases that affect your general health.

During a check-up, dentists may also take x-rays that will help them see cavities between the teeth and under old fillings, bone loss under the gums, and infections at the end of the root, the dentist will also use x-rays to help assess the shape of the roots before root canal procedures. You can also get a professional clean done by our dentist to remove calculus (hardened, calcified plaque) that is hard to remove from the teeth by brushing and flossing alone.

Common Problems

Gum Disease

Gum (Periodontal) disease is an inflammatory disease caused by bacteria accumulation (dental plaque) above and below the gum line. Dental plaque is a soft, sticky and initially invisible film of bacteria that forms on teeth. If not removed by brushing and flossing, the bacteria in dental plaque can cause tooth decay and gum disease. Gum disease is a major cause of tooth loss in adults. Signs of gum disease may include red, swollen or bleeding gums, bad breadth, gum recession, pain or discomfort in teeth, gums or soft tissues of the mouth, or loosening of teeth over time.

Gingivitis (gum inflammation) is a mild form of gum disease and is most common in adults. At this stage, the bacteria attack the soft tissues around your teeth, creating red or swollen gums which become prone to bleeding. Gingivitis can be treated and reversed by professional cleaning and effective home care. If left untreated, gingivitis can develop into periodontitis, affecting the supporting bone and ligaments of your teeth, resulting in loose teeth and eventually tooth loss.

Uncontrolled gum disease has been associated with increased risk of diabetes, heart disease, stroke, and respiratory disease. People with diabetes are more prone to infections and need to be especially aware of the possibility of having gum disease. Older adults with poor oral hygiene may suffer from gum disease without being aware of it until advanced symptoms like looseness of the teeth occur. You can prevent gum disease by brushing twice daily and flossing once a day. This is complemented by scaling and root planning of all affected tooth surfaces and the gum areas. Scaling and root planning is a deep-cleaning, non-surgical procedure, done under local anesthetic, whereby plaque and tartar from above and below the gum line are cleaned away and rough spots on the tooth root are made smooth. Smoothening the rough spots removes bacteria and provides a clean surface for the gums to re-attach to the teeth. Afterwards, you may feel some discomfort for up to 48 hours.

Erosion

Erosion is the loss of the surface of the tooth, especially enamel that is caused by acid attack. This is different from bacterial acid attack that we call tooth decay. Enamel is the hard outer surface of the tooth seen when we smile and it protects the sensitive dentine underneath. Erosion of the enamel can lead to exposure of the dentine, which may lead to pain and sensitivity with cold foods and drinks.

Erosion is a slow process that people generally do not become aware of until significant enamel is already lost. Erosion often shows up as hollows on the top surface of the molar teeth or the teeth seem to become smaller or thinner as the enamel erodes away. As the enamel wears away exposing the underlying dentine the teeth may appear a darker yellow colour -the colour of the dentine- and sensitivity to hot, cold or acidic foods and drinks may become noticeable.

How to prevent dental erosion?

  1. Limit the number of times each day you eat and drink acid foods and drinks – this reduces the number of acid attacks on your teeth
  2. Don’t hold your drinks in the mouth or swish the drinks around your mouth
  3. Finish your meals with cheese or a milk drink as this will help to neutralize the dietary acids
  4. If you eat or drink anything acidic, wait for about one hour before brushing your teeth. Brushing straight after acidic foods and drinks may cause even more enamel damage.
Tooth Sensitivity

Tooth sensitivity is a common complaint which is a relatively easy problem to solve. Studies show that 1 in 4 people suffer from sensitive teeth, particularly for the 25-45 age groups and in women. People most likely to suffer from marginal tooth sensitivity are those who over-enthusiastically brush their teeth, consume more than usual amounts of wine or citrus drinks, have had treatment for gum disease or have special medical problems like bulimia.

People whose teeth are sensitive feel pain when they eat or drink things which are very cold, hot or sweet and when brushing. Pain from sensitivity is sudden, sharp, and stabbing but subsides very quickly. If left untreated, the pain of sensitivity can lead to poor oral hygiene – it can become quite painful for the sufferer to brush their teeth so they stop doing a thorough job, which only makes the sensitivity problem worse. The problem area is usually near the gum margin where the tooth “nerve” may be exposed because of a receding gum line. Their problem is the tooth margin – just below the enamel and where the ‘nerve’ is most exposed. Normally it is covered up.

Dentists can recommend desensitising toothpastes as a good way to deal with the problem. Dentists also advise people to use the right type of toothbrush, especially as many tooth sensitivity comes from over-brushing with a hard brush. Soft brushes are recommended but even with a soft brush a careful non-scrubbing technique is recommended. If you are experiencing continued problems with tooth sensitivity, it is probably a good idea to visit the dentist. No one needs to suffer from this problem and there is often a simple solution.

Tooth Decay

Older adults may see an increase in tooth decay due to reduced saliva. Saliva helps to wash away the acids produced by bacteria in plaque – acids that attack the tooth structure and cause decay. Adults may also be prone to decay because of exposed root surfaces or worn-out chewing surfaces where the protective layer of hard enamel has been lost. Decay on these surfaces can spread rapidly. We can carry out saliva tests to check on the quality of saliva and recommend ways to increase protection against tooth decay. Examples of such protection include regular fluoride applications, use of calcium creams at home and the use of fluoride containing filling materials rather than amalgams.

Teeth Whitening

If you wish to have a brighter smile, then teeth whitening may be an option for you. Ask your dentist for help as they can provide more effective teeth whitening treatments than the ‘do-it-yourself’ kits available at pharmacies. Before having your teeth whitened, your dentist will check to make sure your teeth are suitable to be treated. In some cases treatment may be difficult or ineffective, for example with staining caused during tooth formation by certain antibiotics. Teeth whitening may make your old fillings or crowns look darker after treatment, so it is very important to be checked and advised of this.

Dry Mouth

Dry mouth or Xerostomia is a condition where the mouth becomes very dry due to reduced saliva flow. With age, our salivary glands may naturally produce less saliva leading to dryness of the mouth. It is also caused by certain medical conditions and is also a side effect of medications such as antihistamines, painkillers, high blood pressure medications, diuretics, antidepressants and others. Problems associated with dry mouth are difficulty in swallowing, sore throat, problems with speaking and a burning sensation in the mouth. People suffering from dry mouth are more susceptible to tooth decay, gum disease, bad breath and soft tissue irritation for denture wearers.

Your dentist can help prevent problems associated with dry mouth by recommending appropriate methods or treatments to restore moisture in your mouth, or by discussing your medications with your doctor to allow a change if that is possible.

Worn-Out Denture

Dentures need to be changed every 3 to 5 years. This is because the gums and teeth that support dentures will change shape and position over time. Continuing to use worn-out dentures that do not fit well can cause a range of problems like ulcers or sores on the gums and looseness of remaining teeth. Furthermore, chewing will not be so efficient. We schedule regular check-ups for older patients to make sure that their dentures are in good condition and that they are cleaning their dentures and natural teeth.

FAQs

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