2700 West Grand River Avenue
Howell, MI 48843
6886 Cascade Rd. S.E.
Grand Rapids, MI 49546
5155 Dixie Hwy
Waterford, MI 48329
Sally A Stommen D.D.S.
11745 E Michigan Ave Po Box 275
Grass Lake, MI, 49240
Paul Dental Group Pc
14521 E 7 Mile Rd
Detroit, MI, 48205
Scott Robinson D.D.S. Pc
701 W Randall St Ste E
Coopersville, MI, 49404
Susan K Parkanzky D.D.S.
40400 Ann Arbor Rd E Ste 203
Plymouth, MI, 48170
Tooth loss is not part of the normal aging process. In fact, tooth loss is declining among older adults. Aging is not a general 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.
By Denise J. Fedele, DMD, MS
The answer should be an emphatic "YES!" Fortunately, dentistry has developed new techniques for delivering local anesthetics painlessly. These techniques also assure that the anesthetics act more rapidly and produce a more "profound" level of anesthesia. Additionally, modern dental procedures utilize better technologies that are generally much less traumatic and invasive than those of the past. The result of these advancements is that patients should have minimal or no discomfort during the tooth numbing and/or treatment procedures. Root canal treatment should not cause pain, but rather relieve it when present and keep it from reoccurring. Unfortunately, dental pain may also have a psychological component, possibly stemming from a negative past experience, a story in the media, or even the fear of the unknown. Sometimes these situations can prove challenging for the patient and the dentist to control. Examples include:
These and other distresses are real to the patient. Much of the time, however, the distress can be reduced or eliminated if the patient discusses it with the dentist and gets understanding and reassurance. The doctor and the patient must work together in these situations to make certain that the patient feels as comfortable, trusting, and informed as possible in the dental environment. Most individuals can do this satisfactorily. If patients continue to feel significant distress, even after having these discussions with the dentists, they should be aware that there are supplementary modalities for which they might be candidates. These modalities include:
These sedative techniques and medicines may also be helpful if particularly lengthy treatment procedures are necessary in specific situations.
With all of the advancements in pharmaceuticals and in their delivery, there should be no need for any patient to delay root canal treatment because of fear that the treatment will be painful.
By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS