How to head off dental problems linked to heart issues, dry mouth

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If you are 65 or older, you are probably familiar with dental problems such as cavities and gum recession. About 20 percent of people in this age group have untreated tooth decay, and more than two-thirds have severe gum disease, according to the Centers for Disease Control and Prevention.

“Older teeth are more brittle, which makes them more susceptible to breakage and wear,” says Olivia Sheridan, professor of clinical preventive and restorative sciences at the University of Pennsylvania School of Dentistry. Diseases that are more common with age, such as type 2 diabetes, It may also play a role.

While dental problems can certainly cause pain, they can also have other negative effects. Loose or missing teeth can make chewing more difficult, especially foods like hard produce, said Athanasios Zavras, chair of the Department of Public Health and Community Services at Tufts University School of Dentistry in Boston.

Dental problems can even damage your heart. For example, a 2021 study in the Journal of Periodontology found that people with inflamed gums were more likely to have inflammation of their arteries, which increases the risk of vascular disease. “Gum disease creates gum pockets where anaerobic bacteria can multiply and spread to vulnerable parts of the body, such as the heart,” Zafras said.

All of this makes it important to get good dental care as you age. But it can be challenging. Traditional Medicare does not cover most dental services (although some Medicare Advantage plans offer some coverage). Here, experts weigh in on how to deal with three common dental problems, including what you can do and what help you need from your dentist.

When you have a toothache:

Tooth decay, one of the most common causes of tooth discomfort, occurs when bacteria in plaque turn sugars and starches in food into acids and eat away at enamel.

Gum recession is often part of the problem. “When the gums recede, the roots of the teeth are exposed, which makes them more susceptible to decay,” says Sally Crum, a dentist and spokesperson for the American Dental Association. If a filling breaks down over time, bacteria can accumulate in the cracks and cause more cavities underneath the old filling.

Conditions such as dry mouth can also make teeth more susceptible to decay. “When your mouth becomes dry, its pH decreases and the environment becomes more acidic, which is a breeding ground for bacteria,” Crum says.

Best Steps: To reduce the likelihood of cavities, brush and floss twice a day as recommended, and be especially diligent before bed, especially if you snack in the evening. “saliva [which helps protect teeth] It naturally decreases when you sleep,” said Edmond Hewlett, a professor in the Department of Restorative Dentistry at the UCLA School of Dentistry. “Anything you eat before bed β€” even just a cookie β€” leaves residue in your mouth that bacteria can feast on during the night.”

If you are in pain, see your dentist as soon as possible. If you're particularly prone to cavities, ask about a prescription high-fluoride toothpaste for extra protection, Sheridan says. Your dentist may also recommend a custom-made tray that you fill with fluoride gel and then place on your teeth for five minutes each night.

For swollen and bleeding gums:

Gum (or periodontal) disease is an infection of the tissue that surrounds and supports teeth and is the leading cause of tooth loss in adults. It is caused by dental plaque, a sticky film of bacteria that forms on the teeth. Not having a strong immune system can increase the risk of gum disease, but difficulty brushing and flossing, dry mouth and not seeing the dentist promptly can also play a role, Crum said.

Best Step: To prevent swollen, bleeding gums, make sure to be alert when brushing. But remember to take it easy: too much pressure can cause your gums to recede further. And floss as recommended below. Older adults who floss regularly have a lower risk of developing gum disease, according to a 2020 study published in the Journal of Dental Research.

It helps remove bacteria and food trapped between the teeth that can cause gum inflammation,” says Tomas Ballesteros, professor of dentistry at Rutgers University School of Dental Medicine. If problems like arthritis in your wrists make flossing difficult, try a water flosser, a device that shoots water between your teeth.

For existing gum problems, in addition to good dental hygiene, you may need treatment to prevent tooth loss. For mild disease, the dentist will usually perform a deep cleaning called scaling and root planing. This usually requires multiple visits and often requires local anesthesia. More extensive gum disease may require surgery to remove damaged bone and stubborn bacteria.

If your mouth is always dry:

As you age, your mouth produces less saliva, Crum says. This can lead to xerostomia, which affects 30 percent of people over 65 and 40 percent of people over 80, and increases the risk of tooth decay and gum disease, according to the ADA. Certain medications can also make the problem worse. Dry mouth is sometimes accompanied by a burning or stinging sensation (called burning mouth syndrome), which can be caused by a B vitamin or iron deficiency, Cram says.

Best step: The first and easiest thing to do is stay hydrated, Hewlett says. “Carry a bottle of water with you and drink water frequently to keep your mouth moist and hydrated,” he said. Other drinks without added sugar, such as milk or herbal tea, will also work, but alcohol and caffeine can dry out your mouth. The ADA recommends smoking borneol if needed.

Sheridan says chewing sugar-free gum or sucking on sugar-free candies containing xylitol can help relieve the condition. If you think your dry mouth may be related to your medication, talk to your doctor to see if you can switch to another medication. For a burning sensation in your mouth, you may want your primary care provider to check your iron and B vitamin levels, Cram says. They may recommend supplements if you are deficient.

You already know it's important to floss and brush gently with fluoride toothpaste every day, at least twice a day for two minutes each time.

But which toothbrush is best? Ballesteros says that while a manual toothbrush can do a fine job, you may want to consider an electric toothbrush. A 2019 study in the Journal of Clinical Periodontology found that its use reduced gum recession (a risk factor for gum disease) by 22% and tooth decay by 18%.

Visit your dentist regularly. There's no hard and fast rule; it varies from person to person, but “it should be done at least once a year,” Hewlett says. As you age and dental risk factors increase, your dentist may recommend professional cleanings at least twice a year.

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