What dentists are doing to improve services for older adults

As people are living longer and enjoying good health for many years, dentists are increasingly offering improved services to recognize the special needs of older adults.

This growing segment of the population is wearing fewer dentures and they are keeping their natural teeth longer. They are also concerned to maintain good health and a great smile for many years.

However, patients in this group sometimes require special consideration because reduced mobility and dexterity may make daily oral hygiene difficult.

And certain medical conditions and impairment may make them more anxious when visiting the dentist.

For example, problems with vision or hearing loss may cause worry. Always let the dentist and staff know if you have any concerns so that they can adjust their treatment and their pace to meet your needs.

Older patients can sometimes put up with problems such as toothaches, bleeding gums and clicking dentures because they are not aware of the wide range of treatments and techniques now available.

Dentists are increasingly sensitive to the special needs of and the importance of dental health in the older patient.

As many older patients are more health conscious than ever before, regular visits to the dentist ensure their oral health is an important part of their overall health.

Different types of fillings and restorations

Nowadays, thanks to advances in dental techniques and materials, patients have a much wider range of choices when they have to repair missing, worn, damaged or decayed teeth.

For example, materials such as ceramics and polymer compounds that look more like natural teeth help dentists create pleasing, natural-looking smiles.

The traditional materials such as gold, base metal alloys and dental amalgam are still widely used as they have many advantages.

The strength and durability of traditional dental materials continues to make them useful in many situations. For example, they are good when fillings are required in the back teeth because the pressure of chewing is high in that area.

The choice of the best option will depend on several factors such as the patient’s oral and general health, where and how the filling is placed and the number of visits needed to prepare and adjust the restored tooth.

The choice about which option is best depends on each individuals needs so you should discuss the options with your dentist.

Diabetes and your dental health: How your dentist can help

If you’ve been diagnosed with diabetes, it’s important that you let your dentist know so that they can give you the best care possible.

As more than 15 million Americans have diabetes, your dentist will be familiar with the issues and will give you the specialist care you need.

This is important because diabetes can lower your resistance to infection and slow the healing process.

It’s important to tell your dentist:

– If you have been diagnosed with .diabetes
– If the disease is under control
– If there has been any other change in your medical history
– Names of all prescription and over-the-counter drugs you are taking

The most common oral health problems associated with diabetes are:

– Tooth decay
– Periodontal (gum) disease
– Salivary gland dysfunction
– Fungal infections
– Infection and delayed healing
– Taste impairment

If you have regular dental checkups – and keep your dentist informed about your status – they’ll be able to help you reduce and manage these risks.

Why a dental abscess should be treated quickly

If you have any kind of swelling in your gum, it almost certainly indicates a serious infection that should be treated urgently.

Dental abscesses result from a bacterial infection in the teeth or gums.

For example, it may come from an untreated cavity. Cavities result when some of the bacteria in our mouths mix with sugars and starches in our diet to produce acid.

This acid attacks the hard enamel coating of our teeth and, as the cavity gets deeper, it eventually infects the nerve and blood supply of the tooth.

In some cases, a dental abscess is caused by an infection of the gum. Bone loss from gum disease can create a pocket between the tooth, gum and bone.

When bacteria and other debris get into this pocket, an abscess can form.

The treatment for an abscess depends on how severe the infection is.

If the abscess has been caused by decay, root canal treatment may be needed or the tooth may even have to be removed.

If the abscess has been caused by the gum, the gum will need deep cleaning or surgical treatment. Again the tooth may need to be removed.

Sometimes, a small incision may be made into the gum to drain the abscess. If this happens, antibiotics and pain medication may be used to relieve discomfort.

If you wait until the gum is severely swollen before seeking treatment, the situation can become very serious.

The abscess at this stage can prevent you breathing properly and can be life-threatening.

So if you have any signs of swelling in your gum, contact your dentist immediately.

How medication and anesthesia can help make your visit to the dentist easier

Your dentist will do everything possible to make your visit as relaxed and comfortable as possible.

Depending on the treatment you are receiving, there are several medications available to help.

Some drugs control pain, some help you relax and others put you into a deep sleep during dental treatment.

The best approach will depend on the type of procedure being undertaken, your overall health – including any history of allergies – and the degree of anxiety you feel.

Some of the options your dentist might discuss include:

Analgesics: These are the most commonly used drugs for relief of toothache or pain following dental treatment. They includes aspirin, acetaminophen and anti-inflammatory drugs such as Ibuprofen. There is a separate category of narcotic analgesics – such as those containing codeine – which are used for more severe pain.

Local anesthesia: Topical anesthetics are applied to mouth tissues with a swab to prevent pain on the surface level. They may also be used to soothe mouth sores. Injectable local anesthetics prevent pain in a specific area of your mouth during treatment by blocking the nerves that sense or transmit pain and numbing mouth tissues.

In other cases, your dentist many recommend sedation or general anesthesia.

Your dentist will discuss the best approach to suit your needs.

Making the most of your smile

Your smile is a major factor in the impression people get when they meet you.

And the good news is that you now don’t have to settle for a smile spoiled by stained, chipped, or misshapen teeth.

Advances in dental treatment mean there is a wide range of choices to help you get the smile that you want. Here are some of the options:
– Tooth whitening (bleaching) can help brighten teeth that have become discolored or stained. It can be done in the dental office or with a system the dentist can give you to use at home
– Bonding improves the appearance of teeth that have become chipped, broken, cracked or stained. This is done by bonding tooth-colored materials to the tooth surface
– Enamel shaping involves modifying teeth to improve their appearance by removing or contouring enamel
– Veneers are thin custom-made shells of tooth-colored materials designed to cover the front side of teeth. They are used to treat spaces between teeth and teeth that are chipped, stained or poorly shaped.
– Braces may be needed if teeth are crooked, crowded or do not meet properly – and not just for kids

Even small changes can have a big impact on your smile and so make a huge difference to how you look and how you feel about yourself.

If you’d like an even better smile, your dentist will be able to give you information about the options available.

Diabetes and your dental health: How your diet can affect your teeth

When diabetes is not controlled properly, high glucose levels in saliva may create problems that lead to an increased risk of tooth decay.

Your teeth are covered with plaque, a sticky film of bacteria. After you eat food that contains sugars or starches, the bacteria react with these sugars to release acids that attack tooth enamel. This can cause the enamel to break down and may eventually result in cavities.

Brushing twice a day with fluoride toothpaste and cleaning between your teeth with floss or an interdental cleaner helps remove decay-causing plaque.

Plaque that is not removed can eventually harden into calculus, or tartar. When tartar collects above the gumline, it becomes more difficult to clean thoroughly between teeth. This can lead to chronic inflammation and infection in the mouth.

Because diabetes reduces the body's resistance to infection, the gums are among the tissues likely to be affected.
Periodontal diseases are infections of the gum and bone that hold your teeth in place. Patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than those who have good control of their diabetes.

Because of the lower resistance and longer healing process, periodontal diseases often appear to be more frequent and more severe among persons with diabetes.

You can help reduce these risks through good maintenance of blood sugar levels, a well-balanced diet, good oral care at home and regular dental checkups.

How smoking affects your teeth

While the general effects of smoking on your health are well-known, it can also have significant effects on your oral health.

Here are some of the ways smoking can harm your oral health and hygiene:

– Oral Cancer
– Periodontal (gum) disease
– Delayed healing after a tooth extraction or other oral surgery
– Bad breath
– Stained teeth and tongue
– Diminished sense of taste and smell

Research suggests that smoking may be responsible for almost 75% of adult gum disease.

Tobacco products damage your gum tissue by affecting the attachment of bone and soft tissue to your teeth. One effect is receding gums which expose the tooth roots and increase your risk of tooth decay or to sensitivity to hot and cold in these unprotected areas.

Cigar smoking is equally a major risk and even smokeless tobacco products contain a variety of toxins associated with cancer. Smokeless tobacco can also irritate your gum tissue.

Giving up smoking will provide a significant boost to your oral health as well as giving you the chance to live longer.

Treating Sensitive Teeth

Sensitive teeth is a common problem that causes many people to feel discomfort with hot or cold foods and drinks.

It can also make it uncomfortable to brush or floss the teeth and therefore can lead to further oral problems.

However, sensitive teeth can be treated.

If you suffer from this, your dentist may suggest that you try a desensitizing toothpaste, which contains compounds that help block transmission of sensation from the tooth surface to the nerve.

For desensitizing toothpaste to work, you normally have to make several applications.

If the desensitizing toothpaste does not help, your dentist may suggest further solutions.

For example, fluoride gel – which strengthens tooth enamel and reduces the transmission of sensations – may be applied to the sensitive areas of the teeth.

If the sensitivity is caused by receding gums, your dentist may use bonding agents that “seal” the sensitive teeth.

The sealer is usually made of a plastic material.

If there is severe hypersensitivity which cannot be treated by other means, there is the option of endodontic (root canal) treatment.

Sensitive teeth is a problem that can stop you enjoying your food but is one that can often be solved.

The risks of oral piercing

Young people today choose to make a variety of fashion statements affecting not just the clothes they wear but also their bodies through tattoos and piercing, for example.

Oral piercing may be something they feel looks good but it can lead to problems where they end up needing medical or dental treatment.

Oral piercing can often lead to symptoms such as pain, swelling, infection, increased saliva flow and injuries to the gum tissue.

There can be severe bleeding if a blood vessel is in the path of the needle during the piercing.

Swelling of the tongue is also a common side effect and, in extreme cases, this can block the airway and lead to breathing difficulties.

Other possible problems include chipped or cracked teeth, blood poisoning or even blood clots.

Infection is a very common complication of oral piercing because of the millions of bacteria in your mouth.

Of course, the jewelry itself also causes risk. It can be swallowed or cause damage to your teeth.

So, while young people may feel piercings in the mouth look cool, a great smile will look a lot better in the years to come.

Your saliva and why its so important

You probably don’t give too much thought to the saliva in your mouth but, if you think of it like a bloodstream you’ll realize how important it is.

Like blood, saliva helps build and maintain the health of the soft and hard tissues.

It removes waste products from the mouth and offers first-line protection against microbial invasion that might lead to disease.

Saliva is derived from blood and therefore can also be used to detect disease.

Saliva enhances enamel protection by providing high levels of calcium and phosphate ions. It contains the minerals that maintain the integrity of the enamel surface and helps protect against caries.

When salivary flow is reduced, oral health deteriorates – much in the same way body tissues suffer if blood circulation is disrupted.

Patients with dry mouths (xerostomia) experience difficulty chewing, speaking and swallowing. A major cause of dry mouth is medication – almost eighty percent of the most commonly prescribed medications lead to dry mouth.

Chewing gum after a snack or meal stimulates salivary flow, clearing food from the mouth and neutralizing plaque acid.

Your saliva is important to your oral health both for preventing disease and in helping to diagnose problems.

What is plaque and how does it affect your teeth?

Plaque is a sticky film of bacteria that covers our teeth and, when we eat something, these bacteria release acids that attack the tooth enamel.

When these attacks are repeated over time, the enamel will break down and this will eventually lead to cavities.

When plaque is not removed through daily brushing and cleaning it hardens into calculus or tartar. When tartar collects above the gum line, brushing and cleaning between the teeth becomes more difficult.

The gum tissue can become swollen or may bleed. This is called gingivitis and it is the early stage of periodontal (gum) disease.

There are several steps you can take to protect yourself against this happening:

– Brush your teeth twice a day with fluoride toothpaste
– Clean between teeth daily with floss or an interdental cleaner
– Eat a balanced diet and limit the number of snacks between meals
– Visit your dentist regularly for professional cleanings and oral exams
– Ask your dentist about sealants these are protective coatings that can be applied to the back teeth where decay often starts.

If you take steps to remove the plaque each day, you have a greater chance of avoiding tooth and gum problems.

Root canal treatment

Root canal therapy is an important treatment that can save a tooth with a diseased nerve and which in the past would probably have needed to be removed.

Inside each tooth is the ‘pulp’ which runs like a thread down through the root and provides nutrients and nerves to the tooth. It is the soft tissue that contains nerves, blood vessels and connective tissue.

If the pulp is diseased or injured, the pulp tissue dies.

The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp.

So, if you don’t remove it, your tooth gets infected and you could lose it.

After the dentist – or endodontist (a dentist who specializes in problems of the pulp) – removes the pulp, the root canal is cleaned and sealed off to protect it. Then your dentist places a crown over the tooth to help make it stronger.

Most of the time, a root canal is a relatively simple procedure involving one to three visits with little or no discomfort.

Your restored tooth could last a lifetime, if you continue to care for your teeth and gums and enjoy regular checkups.

How dental implants can give you a better smile

If you have missing teeth, you don't just have to rely on crowns, conventional bridges and dentures.

Many people are now choosing dental implants as the best way to restore their smile and solve dental problems.

Implants are placed below the gums during a series of appointments. They fuse to the jawbone and provide a base for individual replacement teeth, bridges or a denture.

As they are fused to the bone, they offer greater stability. And, because they are integrated into your jaw, your replacement teeth will feel more natural.

This secure fit often also makes them more comfortable than other solutions.

In order to have implants, you need to have healthy gums and adequate bone to support the implant.

To find out whether you could be a candidate for dental implants, talk to your dentist about what they could do for you.

How a healthy diet can help you have healthy teeth

Eating the right food plays an important role in developing healthy teeth and gums.

If your diet lacks certain nutrients, it may be more difficult for tissues in your mouth to fight infection and this can contribute to gum disease.

Although poor nutrition does not cause gum disease directly, the disease may progress faster and could be more severe in people with diets which are low in nutrients.

The U.S. Department of Agriculture makes recommendations on the nutrients, vitamins and minerals needed by your body – including your teeth and gums – to promote health and prevent disease.

We have different needs at various stages life and depending on our physical activity. The DOA website provides more information and your dentist will be able to discuss how your diet affects your teeth.

Here are some steps you can take to make sure what you eat doesn’t harm your teeth.
– Maintain a healthy diet
– Drink plenty water
– Limit the number of between-meal snacks. When you must snack, choose nutritious foods that are low in sugar
– Keep a food diary for a week recording every item you eat and drink

It will also help if you brush your teeth twice a day and floss regularly. Schedule regular dental checkups and professional cleanings and talk to your dentist about how your diet affects your teeth.

What to do if your tooth cracks

While our teeth are normally very strong, they can crack for a number of reasons.

Reasons could include tooth decay, trauma/injury, grinding of the teeth or a stress fracture.

Sometimes, our jaw may be stronger than our teeth and the teeth can fracture when we bite heavily on food.

We can protect our teeth in some circumstances – for example it may be advisable to wear a mouthguard during sports.

Taking proper care of the teeth and regular visits to the dentist will help keep your teeth in good shape.

If a tooth cracks, it may become painful if the nerve is exposed and the area can become tender.

If this happens, rinse your mouth with warm water to clean the area and apply a cold compress to reduce swelling. Then call your dentist immediately.

Treatment will depend on where the tooth has fractured, how close it is to the nerve and the overall condition of the tooth.

A cracked tooth may be repaired with silver alloy, gold, porcelain or plastic. Or it may require a crown or overlay or bonding, which applies porcelain or enamel to the fractured tooth.

If you contact your dentist quickly, they will be able to take the most appropriate action to preserve the tooth as much as possible.

How scaling and planning can help clean your teeth properly

Dental plaque is a film that builds up on your teeth and, if it is not removed through good oral hygiene, it can lead to tooth decay and gum problems.

Over time it can ultimately form a hard, rough sediment known as dental tartar or calculus, which attracts further plaque buildup.

Calculus has to be removed by a trained professional such as a hygienist or dentist.

They may do this by manual tooth scaling or using an ultrasonic device.

If the buildup is light or moderate, the dentist or hygienist may use manual scaling instruments of various shapes and sizes.

If the buildup of tartar and stains is heavy, an ultrasonic cleaner may be used. This may be followed by hand scaling.

Build up of plaque can cause inflammation of the gums leading to breakdown of the connection between the teeth and the supporting structures.

Root planning is a procedure to treat gum disease by thoroughly scaling the roots of teeth to establish a smooth, calculus-free surface.

This treatment may require local anesthesia to prevent pain. Thorough periodontal scaling customarily involves several dental visits

If conditions are more advanced, surgery may be needed for complete debridement of the roots to arrest the disease process.

Some people tend to have more buildup of calculus than others and some may be more prone to periodontal inflammation or the development of tooth decay.

It’s therefore important to follow your hygienist’s advice on how often to return for regular cleanings – even if your insurance only covers two a year.

How your oral health links with your general health

Research has shown strong links between periodontitis (advanced form of gum disease) and other health problems such as cardiovascular disease, stroke and bacterial pneumonia.

And pregnant women with periodontitis may be at increased risk of delivering pre-term and/or having babies with low birth weight.

However, just because two conditions occur at the same time, doesn’t necessarily mean that one condition causes the other. The relationship could work the other way.

For example, there is evidence that diabetics are more likely to develop periodontitis and have more severe periodontitis than non-diabetics.

Alternatively, two conditions that occur together may be caused by something else.

In addition, people who smoke or use alcohol have a higher than average risk of developing periodontitis and other conditions, including oral cancer.

Research is looking at what happens when periodontitis is treated in individuals with these problems.

The aim is to find out whether periodontitis does have an effect on other health problems.

If one caused the other, improvement in periodontal health would also improve other health problems.

While the research is not yet conclusive, the potential link between periodontitis and systemic health problems, means that preventing periodontitis may be an important step in maintaining overall health.

In most cases, good oral health can be maintained by brushing and flossing every day and receiving regular professional dental care.

How dentures can replace your smile

If you’ve lost all of your natural teeth, whether from gum disease, tooth decay or injury, complete dentures can replace your missing teeth and your smile.

Replacing missing teeth will benefit your appearance and your health.

Without support from the denture, facial muscles sag, making a person look older. You’ll also find it harder to eat and speak things that people often take for granted until their natural teeth are lost.

There are various types of complete dentures.

A conventional full denture is made and placed in the patient’s mouth after the remaining teeth are removed and tissues have healed which may take several months.

An immediate complete denture is inserted as soon as the remaining teeth are removed. The dentist takes measurements and makes models of the patient’s jaws during a preliminary visit. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.

Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

And even if you wear full dentures, it’s important to visit your dentist regularly to maintain your overall oral health and get early warning of serious issues such as oral cancer.

What will it be like living with dentures?

People who are new to wearing dentures naturally have many questions about how their life will change.

New dentures may feel awkward for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place.

During this time, its not unusual to experience minor irritation or soreness. You may find that saliva flow temporarily increases.

As your mouth becomes accustomed to the dentures, these problems should diminish.

Dentures can be made to closely resemble your natural teeth so that little change in appearance will be noticeable. Dentures may even improve the look of your smile and help fill out the appearance of your face and profile.

Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.

Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.

Initially you may also find that wearing dentures changes how you speak. Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures “click” while you’re talking, speak more slowly.

You may find that your dentures occasionally slip when you laugh, cough or smile.

After your dentures are fitted, you'll have a few follow-up appointments with your dentist to take care of any initial issues and to answer any questions you have.