June is Oral Health Month—a great time to take a look at misconceptions about tooth and gum care.
Myth #1: I’ll lose all my teeth if I live long enough.
While tooth loss and gum problems are more common as we grow older, they’re far from inevitable. The National Council on Aging reports that almost one-fourth of people older than 65 have lost all their teeth, and many more have broken or decayed teeth or chronic gum disease. However, modern dentistry has come a long way in helping seniors keep a healthy smile. Crowns, bridges, implants and other restorative work yield great results. Modern dentures are more comfortable.
Myth #2: Oral health is only about a nice smile.
Keeping our teeth healthy and cared for is important. Yet tooth problems are only part of the picture. As we grow older, we’re more likely to experience other oral health problems, such as:
Periodontal (gum) disease—Infection of the gum tissues and bones can cause sore, bleeding gums; gums that recede; and loss of teeth and bone. In the earliest stage, gingivitis, the gums may be swollen and red. The more serious form, periodontitis, can lead to tooth loss.
Dry mouth—This condition occurs when we don’t have enough saliva to keep the mouth wet. It raises the risk of tooth decay and makes dentures uncomfortable.
Temporomandibular joint (TMJ) dysfunction—The bones, joints and muscles of our jaw can become irritated, tender and misaligned due to injuries, arthritis or grinding our teeth when we’re under stress.
Oral cancers—The risk of cancers of the mouth increases with age. Using tobacco is the top risk factor. Some oral cancers are caused by a virus.
Myth #3: Only kids get cavities.
In fact, according to a study from the University of Connecticut, older adults are twice as likely to get cavities in their teeth as younger people. The National Institute of Dental and Craniofacial Research says, “Even teeth that already have fillings are at risk. Plaque can build up underneath a chipped filling and cause new decay. And if gums have pulled away from the teeth (called gum recession), the exposed tooth roots also are vulnerable to decay.”
This increased risk can be due to:
- Health conditions such as diabetes, kidney disease and acid reflux, which change the oral environment in ways that promote increased tooth decay and gum disease
- Other health conditions such as dementia, arthritis, stroke and Parkinson’s disease, which make it harder to brush and floss
- Medications seniors take, which can cause dry mouth and increase the risk of gum disease and tooth decay
Myth #4: The effects of gum disease are confined to the mouth.
Here’s where there’s been a big change in thinking over the years! We’ve long known that oral health problems increase the risk of malnutrition and social isolation, both of which can harm our health. And experts now agree that oral health and overall health are closely interrelated. Dr. Chad P. Gehani, president of the American Dental Association, said, “Beyond teeth and gums, the mouth also serves as a window to the rest of the body and can show signs of infection, nutritional deficiencies and systemic diseases.”
The germs that cause gum disease can travel in the bloodstream, raising the risk of problems such as:
Hypertension—The European Society of Cardiology reported that periodontitis can up to double the risk of high blood pressure, sharply increasing the risk of death from heart attack or stroke. The American Heart Association noted that blood pressure medications don’t work as well in patients who have gum disease.
Hardened arteries—The American Heart Association also says the bacteria that cause gum disease can cause chronic inflammation throughout the body, doubling the risk of atherosclerosis and raising the risk of stroke caused by blocked arteries in the brain.
Alzheimer’s disease—The National Institute on Aging says that oral bacteria from poor mouth hygiene are linked to brain tissue degeneration, brain inflammation, Alzheimer’s disease and stroke.
Problems with joint replacements or heart valve replacement—The American Geriatrics Society urges patients who have had these procedures to talk to their doctor before undergoing dental procedures, as bacteria from the mouth could cause a serious infection.
Myth #5: Brushing and flossing are all I need to do to preserve good oral health.
Brushing and flossing correctly are definitely important, so follow your dentist’s instructions. Seniors with arthritis, Parkinson’s disease, stroke or dementia may need help from family or a professional caregiver.
But that’s not all we can do. The American Geriatrics Society offers these suggestions:
- Don’t smoke or chew tobacco.
- Don’t eat sticky, high-sugar foods or candies.
- Ask your dentist about a prescription-strength mouth rinse or mouthwash.
- Have a dental exam and cleaning at least twice a year, more often if recommended.
- Have medications reviewed for side effects, such as dry mouth.
The American College of Prosthodontists reminds us that dental implants, crowns, fillings and other restorations also need regular examination and care. Dentures, too, should be regularly checked.
Myth #6: Oral health isn’t an important part of retirement planning.
Most people keep health care costs in mind as they budget for their later years—yet they forget that they’re likely to have an increased need for dental care. A recent study from the University of Michigan (UM) showed that 20% of seniors skip dental care because of the cost, and only half of people older than 65 have any dental insurance. Original Medicare doesn’t pay for dental cleanings, fillings, restorations, implants or dentures, and the UM team said this has been a big motivator driving a shift to Medicare Advantage plans that include dental coverage.
Many public health advocates and consumer groups are calling for expanded Medicare oral health benefits, showing that the cost of regular dental and periodontal care would result in significant savings on treatment for cardiovascular and dementia care as our population ages. But for now, individuals should be sure to budget for oral health costs while making financial plans for retirement.