Common Dental Problems for People over 50

dental healthAs you age, you become susceptible to new health problems that were less of a concern when you were younger. People over 50 are at higher risk of developing several common dental conditions.

If you are over 50, you can get cavities on surfaces of teeth that did not have them before, around old fillings, or at the roots of teeth. The roots become softer and more exposed as you age. You can reduce your risk of developing cavities by drinking fluorinated water or using a toothpaste and mouth rinse that contain fluoride.

Saliva protects the teeth from decay, but many older adults develop dry mouth. This is often a side effect of medications, which many older adults take. Dry mouth can cause a sticky feeling in your mouth; trouble swallowing; dryness in your throat; dry, cracked lips; a metallic taste in your mouth; persistent bad breath; or increased thirst. If you have dry mouth, you can stimulate saliva production by drinking more water or chewing sugar-free candy or gum. Your dentist may also prescribe a saliva substitute or recommend an over-the-counter product.

Gingivitis is an early form of gum disease that can cause the gums to become swollen or red or to bleed easily. If left untreated, gingivitis can lead to periodontitis, which can cause the gums to pull away from the teeth and form pockets that can become infected. Periodontitis can eventually lead to loss of bone and teeth. Visit your dentist regularly for checkups and cleanings.

The risk of developing oral cancer increases as people age. It is often caused by heavy smoking and alcohol use. The Human Papilloma Virus can also cause oral cancer. The best way to survive oral cancer is to get screened by your dentist and catch it early.

Teeth can become crowded in people over 50, which can cause food to get stuck and lead to decay. Misaligned teeth can also lead to erosion of teeth and damage to supporting tissue and bone. Crowding and periodontal disease can lead to tooth loss. If you believe your teeth have shifted, see an orthodontist. You may need a retainer, spacer, or braces, or you may simply need to get your teeth cleaned more often.

Respiratory Conditions and Oral Health

dentist patientMany medications used to treat respiratory conditions can affect oral health. If you have a respiratory illness, it is crucial that you tell your dentist about all the prescription and over-the-counter drugs you take, the dosages, how often you take them, and when they were prescribed.

Cromolyn, a medication used to treat asthma, can cause nausea, cough, a bad taste in the mouth, and irritation in the mouth or throat.

Strong anti-inflammatory medicines called corticosteroids that are used to treat asthma can cause dry mouth. They can also contribute to fungal, or yeast, infections in your mouth and slow down your healing process.

If you use an inhaler that contains steroids, use a spacer, a plastic tube that attaches to the inhaler and holds the dose while you inhale. After you use your inhaler, rinse your mouth with water to reduce your risk of getting a yeast infection.

When you visit the dentist, you should take your inhaler with you. Tell your dentist how often you have asthma attacks, what triggers them, how serious your asthma is, when you had your last asthma attack, and any visits to the hospital that were related to your asthma.

The adrenal glands normally produce hormones that help the body respond to stress. Steroids used to treat asthma may make the body less able to respond to stress, which can cause problems during dental visits in rare circumstances. Tell your dentist if you have been taking steroids for more than two weeks.

Chronic obstructive pulmonary disease (COPD) does not affect the mouth and teeth, but people with the condition sometimes have colds or upper respiratory infections and may take steroids for long periods of time. This can contribute to yeast infections and the body’s decreased ability to handle stress.

If you have COPD, the way you sit in the dentist’s chair may affect your breathing. Your dentist can help you find a comfortable position. He or she can supply oxygen if you need it during the visit. If you use oxygen at home, be sure your portable tank is full and take it to the dentist’s office for your appointment.

Tuberculosis can cause large lymph nodes in the neck and can rarely cause painful sores in the mouth. A saliva or “sputum” culture can determine whether or not your tuberculosis is active. If you have active tuberculosis, you should not go to the dentist because you could spread it to other people. If you need emergency dental care, go to the hospital. If your tuberculosis is inactive, you can go to the dentist.

A sinus infection can cause pain in the upper teeth that can be mistaken for a dental problem. If you have sinusitis, you may have pain in more than one tooth on the same side of your mouth.

Medications used to treat a sinus infection, such as antihistamines, can cause dry mouth, which can increase your risk of developing tooth decay and a yeast infection. Breathing through your mouth can also cause your mouth to become dry.

If you have a sinus infection, tell your dentist what medications you are taking. If you have chronic sinusitis and have been taking antibiotics for several weeks, bacteria can become resistant to them. If you need an antibiotic, your dentist may need to prescribe a different dose or type.

Screening Can Detect Oral Cancer Early

oral cancer screeningOral cancer can manifest itself in the form of growths or sores on the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx. If not diagnosed and treated early, oral cancer can be fatal.

Oral cancer can cause swelling, thickening, lumps, bumps, rough spots, crusts, eroded areas, or velvety white, red, or speckled patches in the mouth. It can also cause bleeding in the mouth or numbness, pain, or tenderness in the face, mouth, or neck. Oral cancer can cause sores on the face, neck, or mouth that bleed easily and do not heal within two weeks, a soreness or feeling that something is stuck in the back of the throat, or difficulty chewing, swallowing, talking, or moving the jaw or tongue. Oral cancer can also cause hoarseness, chronic sore throat, change in the voice, ear pain, a change in the way the teeth or dentures fit together, or dramatic weight loss.

According to the American Cancer Society, men are twice as likely to develop oral cancer as women. Men over 50 have the greatest risk. Other risk factors include smoking, using smokeless tobacco, excessive drinking of alcohol, excessive sun exposure, and family history of cancer. Over a quarter of oral cancers are found in people who did not smoke or drink excessively.

Many dentists believe that oral cancers can be detected through screenings. The American Dental Association and the American Cancer Society recommend oral cancer screening.

Your dentist can check for signs of oral cancer during a routine exam. If your dentist notices lesions in your mouth, he or she can perform additional tests to determine whether they are or may become cancerous.

One procedure involves coating lesions with a blue dye. If an area appears darker than the rest of the mouth, it is more likely to be or become cancerous.

Another procedure involves rinsing the mouth with a fluorescent rinse and then looking at the mouth with a special light. Abnormal tissue looks different when seen under the light.

Exfoliative cytology involves scraping cells from the mouth or lip with a piece of cotton, brush, or small wooden stick. The cells are viewed under a microscope to see if they are abnormal.

A brush biopsy involves using a brush to collect cells from all the layers of a lesion. The cells are studied under a microscope to see if they are abnormal.

Some tests can detect oral cancer early and improve survival rates. It is important to see your dentist for regular exams and oral cancer screenings.

Study Finds Correlation between Dentists and Obesity Rates

dentist patientResearchers at the Yale School of Public Health conducted a study that identified a correlation between higher prevalence of dentists and lower adult obesity rates. The researchers found that for every additional dentist per 10,000 people in a county, the adult obesity rate declined by 1 percent. The results of the study were published in the September 1 issue of the Journal of the American Dental Association.

The researchers decided to look at dentist prevalence because it had never been studied in relation to obesity rates. The information was made publicly available as part of the Robert Wood Johnson County Health Rankings and Roadmaps program.

The researchers controlled for other factors that have been correlated with obesity rates, such as education and income levels, the number of recreational facilities and fast food restaurants, and obesity rates in surrounding counties.

After controlling for all of these factors, the researchers found that greater numbers of dentists correlated with lower obesity rates. The effect was even more apparent in counties with higher concentrations of primary care physicians. The prevalence of dentists also correlated with significantly lower obesity rates in counties where over 25 percent of children live in poverty.

A correlation does not prove that having more dentists necessarily caused lower obesity rates. The correlation could have several explanations. It could mean that people who visit the dentist are more health conscious and tend to eat healthier foods than those who do not go to the dentist. It could also mean that dentists are doing a good job of educating their patients so they can make healthy food choices.

The findings could inspire further research that can look at individual patients and dentists, longitudinal studies of communities, and intervention studies in which dentists educate their patients about how to eat healthy and prevent obesity.

The researchers believe that dentists could play a role in reducing obesity rates across the country. According to the Centers for Disease Control and Prevention, obesity affects 34.9 percent of American adults and costs $147 billion for health care expenses annually.

What Your Mouth Says about Your Overall Health

oral healthYour dentist can diagnose a lot more than just cavities and gum disease from looking at your mouth. Oral health problems can contribute to a host of other medical problems, and many medical conditions can affect oral health.

Almost 50 percent of American adults have some form of periodontal, or gum, disease, which often goes untreated. Gum disease can lead to problems with the teeth and other medical conditions. Changes in the appearance of the gums can also allow a dentist to diagnose other health issues.

Gingivitis and more serious gum disease, periodontitis, are associated with tooth loss, heart disease, diabetes, and other medical problems. Researchers believe the inflammation associated with gum disease can contribute to cardiac problems.

People with diabetes are at increased risk of developing abscesses, infections that occur at the root of a tooth or on the gums between teeth. A person who is having trouble managing blood sugar is prone to abscesses, and the inflammation that abscesses cause can make it more difficult for the person to control his or her blood sugar. Healthy people can also develop abscesses. If you get one, you should see your dentist.

Stress and anxiety can raise levels of the hormone cortisol, which can cause inflammation throughout the body, including the gums. This inflammation can cause gum disease which, if untreated, can lead to tooth and bone loss.

About 5 percent of pregnant women get pregnancy tumors, small red growths that can appear on the gums or between the teeth. While pregnancy tumors are not dangerous, they can lead to increased sensitivity. Women with pregnancy tumors may need extra dental care.

Anemia, or iron deficiency, can cause the gums to lose their normal red color. People with anemia can have gums that are pale pink, or even white.

Autoimmune diseases, including lupus and Crohn’s disease, can lead to sore red spots in the mouth, and lichen planus, another autoimmune disease, can cause sores on the skin and white spots in the mouth. These tender and painful spots can cause ulcers in the mouth, but they usually respond well to treatment.

Antidepressants such as Prozac, Paxil, and Zoloft (SSRIs) and some antihistamines used to treat allergies can decrease the flow of saliva, which can lead to dry mouth and cavities. A dentist can recommend sprays, saliva substitutes, or other treatments for this problem.

Be sure to visit your dentist for regular exams. Your dentist may be able to diagnose medical problems you don’t even know you have or may be able to help you avoid developing them in the first place.

Stress Can Affect Oral Health

stressStress can affect people in many ways, both mental and physical. Many people do not realize that stress can even affect their oral health.

Canker sores are small ulcers with a white or grayish base and red border that can be found inside the mouth. Experts are not sure of their cause but believe they may be due to problems with the immune system, bacteria, or viruses. Stress, fatigue, and allergies can increase the likelihood of getting canker sores. They are not contagious. If you get a canker sore, avoid spicy and acidic foods and treat it with over-the-counter topical anesthetics. Canker sores generally disappear within 10 days.

Cold sores, or fever blisters, are caused by the herpes simplex virus. They are fluid-filled blisters that are generally found on or around the lips, but they may also appear under the nose or around the chin. Cold sores are contagious. They can be triggered by emotional upset, a fever, sunburn, or a skin abrasion. If you get a cold sore, begin treating it immediately with over-the-counter medication or a prescription antiviral medication. Fever blisters often heal on their own in about a week.

Being stressed out can make you grind your teeth. Many people who grind their teeth are not aware that they do it. If you already have a tendency to grind your teeth, or bruxism, stress can make it worse. Teeth grinding can cause problems with the temporomandibular joint (TMJ) that is located where the skull and lower jaw meet in front of the ear. If you grind your teeth, your dentist may recommend a night guard or other appliance to treat the problem.

Stress can affect your mood and lead to depression. This can make you less likely to follow good eating habits and to take care of your teeth and gums, which can contribute to cavities or gum disease. If you are becoming depressed, talk to your doctor and find strategies to help you reduce your level of stress.

Stress can have many effects on the body, including oral health problems. If you believe that stress is affecting your oral health, consult your dentist about treatments and discuss ways to reduce stress with your doctor.

Smoking and Its Effects on Oral Health

dentistSmoking can lead to lung cancer and many other medical conditions, but it can also cause a host of oral health problems. If left untreated, those issues can lead to gum disease, tooth loss, tooth decay, cancer, and other problems.

Smoking can cause many problems in the mouth, such as bad breath, tooth discoloration, inflammation of the salivary glands on the roof of the mouth, buildup of plaque and tartar, loss of bone in the jaw, increased risk of leukoplakia (white patches in the mouth), gum disease that can lead to tooth loss, delayed healing after oral treatment procedures, failure of dental implant procedures, and oral cancer.

Smoking cigarettes, cigars, and pipes and chewing tobacco can affect the attachment of bone and soft tissue to the teeth, which can lead to gum disease. This makes smokers susceptible to infections, such as periodontal disease. It can also reduce blood flow to the gums, which can slow healing.

Research has found that smoking cigars and pipes is just as dangerous as smoking cigarettes for tooth loss, bone loss, periodontal disease, bad breath, stained teeth, and oral cancer. Smokeless tobacco carries the same risks, in addition to the threat of gum recession, which can expose the roots of teeth and make them prone to sensitivity and decay. Sugars in smokeless tobacco also increase the risk of tooth decay.

If you smoke, quitting can greatly reduce your risk of developing these problems. Reducing the amount you smoke can also lower your risk.

Your doctor or dentist can help you quit smoking with medication and nicotine gum or patches. You can also attend a smoking cessation class or support group that is offered by your local hospital, employer, or insurance company. Other treatments, such as herbal remedies, hypnosis, and acupuncture, are helpful for some people.

Dental Treatments for Sleep Apnea

mandibular oral applianceSleep apnea is a potentially life-threatening condition that affects over 18 million Americans. Many do not know they have it and are not receiving treatment.

Sleep apnea occurs when tissue in the back of the throat collapses and causes the airway to become blocked. This reduces the amount of oxygen traveling to the organs, including the heart and brain. When the blood-oxygen level gets low enough, the person wakes up briefly. In some people, this happens hundreds of times per night.

Sleep apnea can cause fatigue, memory loss, depression, impaired concentration, stroke, heart attack, congestive heart failure, and hypertension. People with sleep apnea tend to be older, obese, and have thick necks, but the condition can affect anyone.

A sleep specialist can diagnose sleep apnea. One common treatment is Continuous Positive Air Pressure (CPAP), which provides a steady stream of air through a tube connected to a mask to keep the airway open. An oral and maxillofacial surgeon can eliminate tissue in the soft palate, uvula, and tongue to keep the airway from collapsing. Other, more complex surgeries can reposition the mouth and facial bones. Oral appliances, weight loss, avoiding tobacco and alcohol, and changing sleeping position are other common treatments.

tongue retaining oral applianceOral appliances are a good treatment option for people with mild to moderate obstructive sleep apnea who do not want to use CPAP, do not respond well to it, or are not good candidates for the treatment. Oral appliances can be used alone or in combination with weight loss, surgery, or CPAP.

Oral appliances maintain an open, unobstructed airway in the throat when worn while a person is sleeping. They reposition the lower jaw, tongue, soft palate, and uvula; stabilize the lower jaw and tongue; and increase the tongue’s muscle tone. Custom-made oral appliances work better than ones sold over-the-counter.

Oral appliances fall into two main categories. Tongue retaining appliances use a suction bulb to hold the tongue in a forward position, which prevents the back of the tongue from collapsing during sleep and blocking the airway. Mandibular repositioning devices reposition the lower jaw and keep it protruding during sleep. This indirectly pulls the tongue forward, which stimulates muscle activity, keeps the tongue rigid, and opens the airway. It also keeps the lower jaw and other structures stable to prevent the mouth from opening.

A dentist with training in oral appliance therapy can help you choose the right type of appliance. It can take weeks or months for the examination, evaluation to choose the best type of appliance, fitting, adaptation, and function of the appliance. It is important to receive ongoing care and follow-ups.

Most people find that oral appliances are comfortable and get used to them in a couple of weeks. They are small and convenient, and treatment is non-invasive and reversible.

What Is a Diastema?

diastema before afterA diastema is a gap between teeth. The most common type is a midline diastema, or gap between the two upper front teeth.

Diastemas are extremely common. It is estimated that up to 97 percent of children have diastemas. They are a natural part of development that are often corrected naturally. However, if a child still has a diastema after adult teeth have erupted, it will be permanent and will require professional treatment to be closed.

A diastema can form for several reasons. It is often caused by a discrepancy between the sizes of the jaws and teeth, such as teeth that are too small in proportion to the jaw. A diastema can also be caused by missing or undersized teeth or habits such as excessive thumb sucking in children.

A diastema can be caused by an incorrect swallowing reflex. In most people, the tongue presses against the roof of the mouth when swallowing. Some people press their tongues against their front teeth when swallowing, which can cause a space to develop.

Periodontal disease can lead to loss of bone that supports the teeth. This can cause teeth to become loose and shift.

A midline diastema can also be caused by a large labial frenum, the tissue that connects the lip to the gums. If the frenum is too large, too wide, or too tight, it can cause a gap to form between the top two front teeth.

For a person who is genetically predisposed to a diastema, there is no way to prevent it.

A diastema usually does not cause any dental problems. People who choose to have their gaps closed generally do so for cosmetic reasons. Several treatment options are available.

In most cases, a diastema needs to be treated with a full set of braces followed by retainer therapy because moving one tooth can cause others to shift. If the gap is small, a less invasive treatment such as Invisalign can be used.

If a patient has a midline diastema and no other dental problems, veneers or dental bonding can be used to cover the gap. If a tooth is missing, a dental bridge or implant may be needed.

If the diastema is caused by a large labial frenum, it may be necessary to undergo a frenectomy, a dental surgery that removes or loosens the tissue, prior to beginning orthodontic treatment.

If your child has a diastema between his or her baby teeth, it is likely that it will close on its own. The American Dental Association recommends that children be examined by an orthodontist by the age of 7 to identify any potential problems. It is also important to take care of baby teeth because decay can cause them to fall out too early, which can cause adult teeth to shift and lead to a permanent diastema.

Could a Dental Problem Be Causing Your Headaches?

headacheAccording to the American Academy of Craniofacial Pain, about one in eight Americans suffers from chronic headaches that interfere with daily life. An estimated 80 percent of headaches are caused by muscle tension. A misaligned bite is a common cause of muscle tension that leads to headaches. Muscle tension headaches caused by dental stress can cause pain on one or both sides of the head or around the entire head.

Tension headaches are caused when muscles are strained and contracted for long periods of time. When you swallow, your upper and lower teeth come together to brace your jaw against your skull. If your bite is unstable because of poorly aligned teeth or a missing tooth, your muscles work harder to bring your teeth together, which can lead to muscle strain and pain.

An unstable bite can cause muscles in the neck to lengthen or shorten, which throws the head off balance and causes other muscles to strain to continue to support the head. The muscles become painful, which causes you to feel tense. That in turn makes the muscle spasms worse, which contributes to more pain.

The pain that you experience from muscle tension in your jaw can be referred to other parts of your head. If you have pain behind your eyes, sore or tired jaw muscles when you wake up, teeth grinding, clicking or popping jaw joints, or a head or scalp that are painful to the touch, these are signs that your headaches could have a dental origin.

If you think your headaches might be caused by a misaligned bite, contact your dentist. He or she will examine your teeth, muscles, and jaw joints to figure out if that is the cause of your headaches and recommend treatment to correct your bite and ease the strain on your muscles.

Headaches could have other non-dental causes. Seek immediate medical attention if your headache leads to weakness in an arm or leg, loss of vision, disorientation, or loss of consciousness.