Dental Disorders

General Information
Dental problems have a great impact on the quality of life. Besides the pain and discomfort associated with cavities (caries), the loss of teeth makes it difficult to chew food properly. This in turn may lead to poor nutrition. Prevention is always better than treatment. Prevention of caries even in teeth already damaged can slow or arrest further progression of tooth problems.

Tooth Loss
Most of the traditional images of elderly people are of people without teeth. However, tooth loss, although not uncommon, is not an essential element of aging. Some teeth are lost to changes in the bones of the jaw. Osteoporosis may occur in the bones supporting the teeth, and, when it does, these teeth are more vulnerable to loss. Many more teeth are lost to periodontal disease, or inflammation of the gums, which exposes the roots of the teeth and facilitates decay. Most teeth are lost to decay.

Tooth Decay
Most people are surprised to learn that cavities are a kind of infectious disease. When bits of food remain in the mouth, bacteria attack the sugars in the food and convert them into acids. These acids in turn erode the calcium that makes up the teeth.

Careful after-meal cleaning can remarkably reduce the occurrence of tooth decay. When it is not possible to brush after meals, chewing a stick of sugarless gum can help clean the teeth and remove the acids. Careful cleaning before bedtime is important as well. Overnight, the tiny amounts of calcium that were removed from the teeth during the day are replaced from calcium in the saliva.

Periodontal Disease
Periodontal disease is inflammation of the gums. This inflammation causes the gums to recede and exposes the roots of the teeth to possible decay. The roots of the teeth are much less resistant to the effects of acid. Periodontal disease is a major predisposer to tooth loss and decay.

Prevention of periodontal disease requires careful cleaning of the teeth and the areas between the teeth. Your dentist can best advise you concerning the selection of a cleaning method. Dental floss, tiny brushes for between the teeth, and water jet cleaners are useful tools.

Important Points in Treatment
Regular visits to your dentist and dental hygienist permit cleaning the teeth of plaque that is not removed by simple brushing or flossing. Preventive dentistry is the best safeguard against tooth problems. Careful brushing after meals and before bed also can help.

Many people note that with aging they begin to develop a thick white coat on the tongue. This is most noticeable on rising in the morning. A bacterium that seems to be more common in the elderly causes this. It has been associated with the development of some forms of tooth decay. Tongue brushing can remove much of this coat. Coarse foods such as toast also may remove it. People who skip breakfast or have only a cup of coffee should consider tongue brushing at the time of tooth brushing as a regular part of their dental hygiene.

Gingivitis

General Information
Gingivitis is the most visible sign of periodontal disease. It is a disease of the supporting structures of the teeth. Gum disease, like dental caries (cavities), is not a necessary consequence of the aging process. Yet any break in dental hygiene can permit gingivitis or dental caries to gain a foothold. With the passage of time, these problems accumulate, and thus there is an apparent increase in occurrence in elderly patients. Most tooth loss in elderly patients is a result of periodontal disease, not cavities.

Gingivitis, like dental caries, is a result of mouth bacteria infecting normal tissues. These bacteria form plaque that can cling to the teeth. If plaque is left and accumulates, it can irritate the gums, causing them to become inflamed. The inflamed gums bleed and swell. It is these bleeding and swollen gums that we recognize as gingivitis. If permitted to persist, it may lead to the loss of bone and loss of ligamentous support for the teeth. In turn, the teeth may loosen and fall out.

Important Points in Treatment
Control and reversal of gingivitis and the associated periodontal disease are as important as prevention of its occurrence.

Prevention rests with good dental hygiene. Regular brushing and flossing minimize the development of plaque. If disease or disability impairs cleaning and flossing, plaque accumulation and gingivitis may result.

Several diseases may cause or exacerbate gingivitis and the underlying periodontal disease. Diabetes, for example, can slow healing and prolong the inflammation and swelling, even after hygiene is restored. Some drugs can irritate gums directly or indirectly by causing dry mouth. A few drugs can simulate gingivitis by causing noninflammatory swelling of the gums. It is important to give your physician and your dentist a complete list of your prescription and nonprescription medications.

If you have trouble maintaining regular brushing and flossing, it is possible to control plaque buildup by using a plaque-dissolving mouthwash. These mouthwashes contain chlorhexidine. Some cause staining of plastic tooth restoration material, and the advice of your dentist is important in the selection of the proper mouthwash for you.

Flossing requires two-handed dexterity. The use of water jet cleaners requires only one-handed dexterity. These cleaners are useful for maintaining oral hygiene in patients with arthritis, stroke, or other problems that limit two-handed dexterity. Your dentist can best advise you concerning the appropriateness of daily cleaning with water jet cleaners.

Often an increase in the frequency of visits to your dental hygienist can compensate in part for any diffi- culties with cleaning that you might have.

Notify Our Office If ...

• You have sore or bleeding gums.