Tooth loss is not part of the normal aging
process. In fact, tooth loss is declining among older adults. Aging is not a gernal of cause oral diseases, according to dentists and other dentistry professionals, 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 dental 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 (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
and promote
tooth loss. Soft
tissue lesions are more common in older adults. 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.
