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Dental Diseases In The Elderly: 9 Important Changes

Enfermedades Dentales En Ancianos

Dr. Andreas

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Q.F. Nayibe Cubillos Morales

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Dr. Gustavo Assatourians D.D.S

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Dental Diseases in the Elderly

The significant increase in the elderly population is a global phenomenon in this century. This stage of life brings with it an increased risk of suffering from chronic diseases, including those related to oral health. Among the most common conditions in the elderly are xerostomia, usually a secondary consequence of the use of certain medications, and oral candidiasis.

It is common for dentists to receive elderly patients with multiple dental problems. These include tooth loss, deteriorated dental restorations, and the development of cavities. These problems are the result of the accumulation of damage to oral health over the years.

In this article, we will provide you with guidance to preserve optimal oral health in old age, identifying risk factors and differentiating the normal changes associated with aging, with the aim of improving quality of life.

 

Key Aspects About Oral Health in the Elderly

dental diseases in the elderly

It is important to recognize that, during old age, certain alterations in oral health may occur, even if a regular hygiene routine such as brushing and flossing is maintained. The use of dental prostheses, taking medications, and general health conditions are prevalent aspects of this period of life.

 

Common Oral Diseases and Changes in Older Adults

1. Dental changes

As we age, it is natural for teeth to change color and shape. Attrition and tooth wear can lead to a reduction in the length and thickness of the teeth, resulting in their yellow hue.

2. Dental cavities

Research from the American Dental Association (ADA) reveals an increase in the frequency and severity of cavities with age. This is due to three main factors: the presence of cariogenic bacteria in the mouth, a food source for these bacteria, and an environment conducive to their replication. In addition, many older people tend to consume diets rich in carbohydrates, which are more likely to generate cavities.

3. Periodontal disease and bone changes

In elderly people with periodontal disease, bone loss intensifies due to changes in the periodontal cells. Postmenopausal osteoporosis, characterized by a decrease in estrogen, causes an imbalance in bone remodeling, resulting in significant bone loss.

However, age itself is not a risk factor for periodontal disease; it is more related to a decline in oral hygiene, lifestyle habits, and nutritional deficiencies. It has been observed that bones in people between 35 and 70 years old become more fragile, affecting their strength and contributing to the increase in tooth loss in older adults.

4. Alterations in the Salivary Glands and Xerostomia

Research from the National Institute of Dental and Craniofacial Research indicates that saliva production decreases with age, leading to a prevalence of xerostomia in the elderly. This condition, characterized by dry mouth, can cause a loss of taste and difficulty swallowing. Both salivary flow and swallowing are essential protective mechanisms against pathogens in the oral cavity, and their effectiveness may be reduced in older people.

Xerostomia, or the feeling of dry mouth, affects between 29 and 57% of the elderly population. It is a common side effect of more than 500 types of medications, including those for allergies, asthma, hypertension, high cholesterol, pain, anxiety, depression, Parkinson’s, and Alzheimer’s. For this reason, it is crucial to inform your dentist about the medications you take in order to receive appropriate advice and prevent cavities related to dry mouth.

5. Loss of sense of taste

Pérdida del Sentido del Gusto

It has been shown that our senses sharpen with age, and taste is no exception. With aging, the number of taste buds and their size decrease, affecting sensitivity to flavors such as sweet, bitter, sour, salty, and umami. The reduction in saliva production also negatively affects the sense of taste.

6. Chewing difficulties

The absence of teeth interferes with the chewing function. With age, a loss of gum strength and the movement of healthy teeth, due to a lack of adjacent and opposing teeth, can cause problems with chewing certain foods.

7. Candidiasis oral

This condition is characterized by the appearance of whitish spots on the tongue and mouth. In the elderly, it is usually associated with the use of dental prostheses, poor oral hygiene, diabetes, dry mouth syndrome, or the prolonged consumption of certain medications.

8. Oral cancer

The probability of developing oral cancer increases with age and is more common in people over 55 years of age. Recent research also links the human papillomavirus (HPV) infection with some types of oral cancer. Early detection is crucial, as treatment is most effective in the initial stages. It is important to be aware of any changes in the mouth, especially in smokers and alcohol consumers.

Symptoms to look out for include sores, irritations, lumps, patches in the mouth, difficulty chewing or swallowing, numbness in the mouth, swelling of the jaw, and pain in one ear without hearing loss. Although these symptoms do not always indicate cancer, it is essential to consult a professional for a proper diagnosis.

9. Dental loss in the elderly

Approximately 20% of people over the age of 65 have lost all their teeth. This condition is twice as common in those 75 years and older, at 26% as compared to 13% in the 65 to 74 age group. The absence of natural teeth or the use of dentures can influence one’s diet, tilting these people toward diets of softer and easier-to-chew foods, rather than options such as fresh fruits and vegetables.

 

Keys to Preserving Oral Health in the Elderly

Preservar la Salud Bucal en Ancianos

Maintaining good oral hygiene in old age is essential for teeth and gums to remain healthy throughout life. It is essential to brush at least twice a day with toothpaste that contains fluoride and to use mouthwash. Additionally, daily flossing is crucial. Likewise, it is advisable to visit the dentist regularly for professional dental cleanings and periodic exams.

 

Conclusion

Maintaining good oral health in old age is essential for quality of life in the face of challenges such as xerostomia, a loss of taste, chewing difficulties, oral candidiasis, and an increased risk of oral cancer. A rigorous oral hygiene routine is vital, including brushing with fluoride toothpaste, rinsing and flossing, and regular visits to the dentist. Additionally, it is important to communicate with the dentist about medications and health conditions to effectively prevent and treat oral problems.

Frequently Asked Questions

Elderly people are at high risk for tooth root cavities. This increase is due to greater gum recession, which leaves the root surfaces exposed, and the frequent use of medications that cause xerostomia. It is estimated that around 50% of individuals over 75 years of age have root cavities that affect at least one tooth.

About one in six older adults in the United States suffer from root cavities (Badr and Sabbah 2020). This type of caries affects the area of ​​the tooth surface located at the junction between the coronal and root parts (cemento-enamel junction) or below it. With advancing age, the prevalence of root caries increases.

Periodontal disease is listed as one of the most common causes of tooth loss in older people. In addition, injuries and trauma to the oral-dental area can result in tooth loss. Risk factors associated with this loss include inadequate oral hygiene, tobacco use, xerostomia or dry mouth, gingivitis or other gum diseases, and the use of certain prescription medications.

Various factors contribute to poor oral health in older people. Difficulty in transportation, age-related memory loss, other cognitive problems, and physical limitations may prevent them from regularly attending dental appointments. Proper dental care is key to preventing common problems such as dental pain, gum disease, and tooth loss

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References

1. Razak, P. A., Richard, K. M., Thankachan, R. P., Hafiz, K. A., Kumar, K. N., & Sameer, K. M. (2014). Geriatric oral health: a review article. Journal of international oral health : JIOH, 6(6), 110–116. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295446/

2. Chan, A. K. Y., Tamrakar, M., Jiang, C. M., Lo, E. C. M., Leung, K. C. M., & Chu, C. H. (2021). Common Medical and Dental Problems of Older Adults: A Narrative Review. Geriatrics (Basel, Switzerland), 6(3), 76. https://doi.org/10.3390/geriatrics6030076

3. Center for Disease Control and Preventión (CDC). 2021. Older Adult Oral Health. Division of Oral Health. https://www.cdc.gov/oralhealth/basics/adult-oral-health/adult_older.htm

4. Gonsalves, W. C., Wrightson, A. S., & Henry, R. G. (2008). Common oral conditions in older persons. American family physician, 78(7), 845–852. https://www.aafp.org/pubs/afp/issues/2008/1001/p845.html

5. MedlinePlus.(2022). Aging changes in teeth and gums. https://medlineplus.gov/ency/patientinstructions/000951.htm

6. American Dental Association (ADA). (Agu, 2023).Aging and Dental Health. https://www.ada.org/en/resources/research/science-and-research-institute/oral-health-topics/aging-and-dental-health

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