5409 Maryland Way Suite 210
Brentwood, TN 37027
4141 Ringgold Road PO Box 9373
Chattanooga, TN 37412
7584 Barnett Way
Powell, TN 37849
Milholm, Joseph B D.D.S.
2222 Chambliss Ave Nw
Cleveland, TN, 37311-3895
Dr. Cara Riley, D.D.S. DMD PC
2400 Paterson Street Suite 316
Nashville , TN, 37203
Scott, Benjamin D D.D.S.
8029 Ray Mears Blvd
Knoxville, TN, 37919-2707
Davis, Adam D.D.S.
303 N Willow Ave
Cookeville, TN, 38501-2336
The proverbial way of referring to older people as being "long on the tooth" suggests that it is predetermined that as we get older our teeth get "longer" or "no longer." This is not true.
Periodontal disease, plaque and loss of teeth is not an inevitable aspect of aging. Loss of attachment or bone support around a tooth is the result of a bacterial infection. What is true is that as we get older, we have more exposures to these infectious organisms, and more probability of being infected and developing periodontal disease. Half of the people over 55 have periodontal disease.
Risk factors that make older adults more susceptible to periodontal disease include:
Systemic diseases: Certain systemic diseases such as diabetes may decrease the body's ability to fight infection and can result in more severe periodontal disease. Osteoporosis also can increase the amount and rate of bone loss around teeth. Systemic illnesses will affect periodontal disease if it is a pre-existing condition. To reduce the effects of systemic diseases on the oral cavity, maintain meticulous plaque control and visit your dental care provider routinely for examinations and professional cleanings.
Medications: Heart medications can have a direct effect on the gums by creating an exaggerated response to plaque and resulting in gum overgrowth. Antidepressants may create dry mouth and reduce the saliva's ability to neutralize plaque.
Immunosuppressants and other disease-fighting medications may reduce the body's ability to combat infection, increasing the risk for periodontal disease. The dental care provider needs to be aware of any medications you may be taking and you need to maintain meticulous plaque control and visit your dental care provider routinely for examinations and professional cleanings.
Dry mouth: Lack of saliva can result from the use of certain medications or as a result of illness. If there is not enough saliva available to neutralize plaque it can result in more cavities and periodontal disease.
Also, dry mouth, or xerostomia, can make dentures more difficult to wear and may also complicate eating, speaking, or swallowing of food. Oral rinses or artificial saliva can be very helpful with these problems.
Frequent sips of water or eating candy may be helpful as long as it doesn't contain sugar. Fluoride rinses and gels are helpful in reducing or preventing the cavities that can be caused by having a dry mouth.
Dexterity problems: Physical disabilities can reduce dexterity and the ability to remove plaque on a daily basis. Poor oral hygiene can increase the risk for cavities and periodontal disease.
Electric toothbrushes and floss holders are helpful in improving plaque control. Frequent professional cleanings combined with oral anti-microbial or fluoride rinses also may be helpful in reducing the incidence of cavities and periodontal disease.
Estrogen deficiency: Older women may have some special concerns in relation to periodontal disease. Scientific studies have suggested that the estrogen deficiency that occurs after menopause may increase the risk for severe periodontal disease and tooth loss. Estrogen replacement therapy may reverse these effects.
It is important to keep teeth as we age because every tooth has an important function in chewing and speaking. They affect our appearance and self esteem.
Having dentures or loose or missing teeth can restrict our diets, resulting in poor nutrition and systemic complications. With the advances in modern dentistry and with current prevention and treatment techniques, we must count on keeping our teeth for a lifetime -- no matter how "long" that may be!
During a dental examination, the dentist examines the soft tissues of the mouth for any abnormalities or pathology (including oral cancer), the teeth for tooth decay or defects, the gum tissues for periodontal (gum) disease, the neck for swollen lymph nodes, the amount of plaque, tartar, and debris on teeth, as well as the need to replace any missing teeth or dental prostheses. Regular examinations by a dentistry professional are crucial to maintaining your dental health and are a necessity in any dental care plan.
Dentists begin the dental examination with a complete dental and medical history, including medications the patient is currently taking. The skin of the face and neck is examined for any abnormalities, especially pigment changes. The lymph nodes in front and behind the ears, under the floor of the mouth and chin, and the midline of the neck, sides, and back of the neck are palpated to determine if any swelling or tenderness is present.
Inside of the mouth, the lips, cheeks, gums, and roof of the mouth are inspected and palpated. During this process, the tip of the tongue is placed on the roof of the mouth just behind the upper teeth for inspection of the front floor of the mouth and sides of the tongue.
The back floor of the mouth, the area behind the lower wisdom teeth, and the back sides of the tongue are inspected by grasping the tip of the tongue with a small gauze sponge and pulling the tongue forward and toward the opposite side of the mouth.
To inspect the back of the throat, soft palate, and tonsil area (sides of the throat), the tongue is depressed with a dental mirror or tongue blade and then a deep breath is taken by the patient.
To detect swelling on the floor of the mouth, the area inside the mouth is felt with the finger of one hand while a finger of the other hand feels below the chin. Salivary gland enlargement, saliva flow, or xerostomia (dry mouth) are determined by milking the major salivary glands to assess the quantity and consistency of saliva.
Today's dentist has many analytic tools available to pinpoint dental and oral diseases. The basic tools are the dental instruments, lights, and radiographs (X-rays). Depending upon the dentist and the individual's dentistry needs, additional diagnostic tests are available. Testing for essential proteins and buffering capacity can evaluate the protective ability of saliva.
To determine tooth decay risks, microbiological testing of saliva can measure the level of decay-producing organisms. Periodontal susceptibility tests, which test for the DNA of gum disease-producing organisms, can be performed to assess an individual's risk for gum disease.
If removable dentures are present, dentists check them for bite, retention, stability, and overall fit. Dental impressions or models also may be taken to study the mouth and tooth structures to initiate fabrication of prostheses. Photographs may be exposed for a variety of reasons, including before and after treatment comparisons.
The level of oral hygiene and home dental care practices are assessed and reviewed. Recommendations for home care devices and products may be made. Instruction and methods for maintaining a good oral hygiene regimen can also take place.
Once basic information about dental health status is gathered, the dentist will be better able to discuss dental care plans that are available.
By Denise J. Fedele, DMD, MS