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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.

Learn About Prosthodontics

Dentures are replacement teeth that can be removed. Many people who are missing one tooth, several teeth or all their teeth benefit greatly from false teeth.

Prosthodontics improve your chewing and speech, and support your facial muscles. They make a big difference in your appearance and your smile, and can boost your self-confidence.

Made from acrylic resin, most dentures are very natural-looking and can be matched in color and appearance to your other teeth. Several visits to a denturist are usually required over the course of a month to take the impressions and make sure your false teeth fit right. These multiple appointments with a prosthodontist are necessary for receiving all the benefits you'll gain from them -- your increased ability to chew, a great-looking smile, and confidence when speaking.

Complete Dentures

A complete denture is for people who have no teeth in their lower jaw or upper jaw, or both jaws. In addition to the other suggestions for denture care listed below, complete dentures should be removed and cleaned two or three times daily to keep your gums healthy and to allow your tissues to relax.

Partial Dentures

Partial dentures are for people who have some natural teeth remaining, or who only need to replace a few teeth. The benefits are the same as for full denture wearers: your facial muscles will be supported, your smile improved and your ability to chew and speak will be enhanced.

Immediate Dentures

If a tooth is damaged and cannot be restored, you and your dentist may decide to create temporary dentures. That way, the dentist can pull your tooth and you can wear the temporary denture until a permanent solution is designed for you.

This temporary solution allows you to continue with your professional and social commitments without showing a gap in your smile. Sometimes an immediate denture is used to replace a number of hopeless teeth at one time. Generally, the prosthodontics will require relining, rebasing, or being completely remade three to six months later.

Getting Used to Your False Teeth

Even dentures that fit beautifully require an adjustment time. At first, you may experience minor speech changes and some eating difficulties. You may also notice an increased flow of saliva during this period.

While you're getting used to your replacement teeth, you may want to keep high-profile events to a minimum and give yourself time to adjust. You may also want to start with soft food that is easy to chew, while your comfort level increases.

Some prosthodontics wearers notice a slight change in their facial appearance. Knowing what to expect helps to anticipate normal adjustments for denture wearers and to effectively manage them.

While the dentist may advise you to wear your false teeth initially at night, normally you will remove your dentures while you sleep. Taking a break for eight hours gives your tongue and saliva a chance to do its natural job of cleaning and stimulating your gums.

Caring for Your Dentures

• Handle with care.
• Remove and brush daily.
• Use a brush and cleansers designed for dentures.
• Don't use abrasive cleaners or abrasive toothpastes, which will leave scratches.
• Don't sterilize them in boiling water or in the dishwasher -- the hot water will warp them.
• If you wear a partial denture, remove it before you brush your natural teeth and clean it carefully with a brush and cleanser.
• When the false teeth are not in your mouth, soak them in a glass of water or cleanser. Dry dentures can become brittle and crack or break.
• Keep your dentures in the same place and away from children and pets -- keep them safe and reduce the chances of losing or misplacing them.
• Have your mouth and the dentures checked at least once yearly by your denturist.

by Brian J. Gray, D.D.S., M.A.G.D., F.I.C.O.

+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.