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The Effects of Aging and Wear on the Mouth

Tooth loss is not part of the normal aging process. In fact, tooth loss is declining among older adults. Aging does not cause oral diseases, yet oral diseases such as tooth loss are more prevalent with age due to changes in the oral soft tissues, a depression of the immune system, an increase in the number of systemic diseases, a decreased ability to perform adequate oral hygiene and self care secondary to stroke, arthritis, Parkinson's disease, dementia, or Alzheimer's disease, and dry mouth due to greater use of prescription and over-the-counter medications.

With age, teeth become less white and more brittle; however, oral hygiene habits and use of tobacco, coffee, and tea also will affect tooth color. Teeth also can darken or yellow due to the thickening of the underlying tooth structure (dentin). Brittle teeth tend to be susceptible to cracks, fractures, and shearing. Over the years, the enamel layer (outer tooth layer) is subjected to wear due to chewing, grinding, and ingestion of acidic foods. In severe cases, the enamel is completely worn away and the underlying dentin is worn down as well. Inside the tooth (pulp), the number of blood vessels and cells decrease and fibroses increase with age; thus, capacity to respond to trauma may also decrease.

The fiber content and number of blood vessels of the periodontal (gum) tissues decrease with age. However, periodontal disease represents a pathologic or disease change and is not due to just age. The loss of bone and gum attachment (receded gums) associated with periodontal disease is collective and therefore greater in older adults. An outcome of periodontal disease is exposed root surfaces. Exposure of the root in older people probably gave rise to the term "long in tooth". Oral hygiene practices and certain medications affect the health of gum tissue. Receded gums and exposed root surfaces put older adults at high risk for dental decay (root caries) on the relatively soft root surfaces. Dental caries on root surfaces is a disease that is common among older adults. Dry mouth and a diet high in sugars and fermentable carbohydrates greatly increase the risk for root caries. Dental caries are a major cause of tooth loss in older adults.

Studies show some reduced chewing effectiveness, decreased tongue strength, and increased swallowing time with age; however, the studies do not indicate that there is any real change in the ability to swallow with age.

The number of cells that produce saliva decrease with age. However, healthy, unmedicated older adults do not have reduced saliva flow. This is because the salivary glands have a high reserve capacity. Usually when a decrease in saliva flow is noted, it is associated with medication use, illness, medical conditions, or their treatment. The number of taste buds do not appear to change with older age; thus, the ability to taste does not change significantly with age. However, smell decreases with age. Since the ability to taste is closely related to smell, taste perception may be altered in older adults.

Soft tissues of the mouth become thinner and lose elasticity with age. Soft tissue lesions are more common in older adults and tooth loss may occur. Chronic inflammation such as candidiasis (fungus growth) and denture irritation also occurs more often. Wound healing is decreased due to reduced vascularity (blood flow to the area) and immune response with age.

Oral and oropharyngeal cancer is the most serious disease associated with age. Oral and oropharyngeal cancer lesions usually are not painful. Oral and pharyngeal cancer may appear as a red or white patch, a sore or ulceration, or a lump or bump that does not heal within two weeks. Swollen lymph nodes of the neck, difficulty swallowing and speaking, and voice changes also may be signs and symptoms of oral and oropharyngeal cancer. The risk for oral and oral pharyngeal cancer increases with age, use of all forms of tobacco, frequent alcohol use, and exposure to sunlight (for lip cancer). See a dentist if any signs or symptoms of oral and pharyngeal cancer are present.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

What To Do With The Broken Denture - Denture Repair

Even though dentures are fabricated from extremely durable materials, they will break, wear out, a tooth will come out, or their fit will change. Then its time for denture repair.

Accidents happen, dogs still like to chew on plates of the dental kind, and trash compacters have never taken kindly to dentures. In fact, it is frequently not a matter of "if," but rather a matter of "when" a denture will become broken, lost, or damaged beyond repair.

One can be assured that a problem will happen when least expected, and immediate, usually important, plans definitely will be altered unless a person is prepared.

Damaged Denture - How to Expect the Unexpected and Be Prepared

A short-term use duplicate denture will bridge the gap while a regular denture is being repaired, renovated, or replaced. Sometimes this type of denture is referred to as an "embarrassment denture" because it helps a person avoid the embarrassment of being without teeth in an emergency or during planned denture maintenance.

While this type of denture may be made at any time from an existing functional denture, it generally is fabricated immediately after a new denture is made. The embarrassment denture is neither as accurate nor as esthetic and durable as the original, but it is adequate and only meant for short-term use. The cost is generally considerably less than the original denture.

Such an interim prosthesis may be relined annually and adjusted in advance to fit the current changing shape of an individual's jaws, and therefore be ready to use at a moment's notice.

However, some individuals choose to have their embarrassment denture relined and adjusted only when they need the short-term denture. Following this latter course means that they will have to wait to wear their interim denture until an appointment can be scheduled with a dentist to complete the reline and any adjustments. But a reline for an embarrassment denture can be done in the dentist's office during a single appointment so a patient may leave with it refitted in the mouth.

In either case, a person would not be without a prosthesis while their regular denture is being worked on.

The Embarrassment Denture Facilitates Planned Periodic Maintenance

All dentures need to be periodically relined to accommodate the constant change in shape of a person's jaws. There are also times when the plastic body of a denture needs to be changed due to deterioration, or the entire denture replaced because of wear or poor fit from changing mouth conditions that can no longer be remedied by relining.

While relines can be completed in one appointment office visit, more durable relines may require that a dentist keep a denture for several days. Replacing the plastic body of a denture (called a rebase) takes several days and making a replacement denture takes several weeks.

It becomes easy to see how an embarrassment denture would solve being without one's regular denture for a period of time, even for planned maintenance, while getting on with one's life.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.