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How do I save my teeth after retirement?

December 16, 2018

 

America is aging. People live longer nowadays and it has become more crucial for me as a dentist to find a way to help my elderly patients to save their teeth. At my dental school – Boston University I had the opportunity to work with the elderly population in the geriatric dentistry department. It was a great experience for me as a student to treat patients by visiting their home and making dentures. All clinical steps to denture impressions were done at patient’s home. This experience influenced me to work with the elderly population in my own practice. Seeing my patients on a daily basis inspired me to think about the program and some steps that could be done to protect my patients from cavities or gum disease.

Every day we faced several teeth conditions and our patients concerns.

To save every tooth in your mouth is a priority because various studies have determined that a minimum of 20 functional teeth are necessary to guarantee good digestion of food.

Caries remains a major oral health problem among the elderly for various reasons: age-related salivary changes, a poor diet, exposure of the root surface by gingival recession, and a greater likely hood of drug treatment with xerostomia as a side effect all can cause the decay of teeth. The 6 month cleaning and checkups help diagnose early stages of cavities and treat them with less damage to the tooth.

Root decay may cause the potential loss of the whole tooth. The tooth roots become exposed as gum tissue recedes from the tooth. Roots do not have any enamel to protect them and are more prone to decay than the crown part of the tooth.

Studies demonstrate that the topical effect of fluoride in an adult’s mouth during the early stages of decay can not only stop the decay process but also make the teeth more resistant to future decay and cavities.

Dental decay is reduced by 27% in adults who use toothpaste with fluoride and drink fluoridated water.

Fluoridation conserves natural tooth structure by preventing the need for initial fillings and subsequent replacement of fillings. The fluoride varnish should be applied twice a year during the routine teeth cleanings.

In 2015, the Department of Health and Human Services recommended a then-newly calibrated ratio of fluoride to water at .7 mg/L, or parts per million. The American Dental Association DA supported this recommendation. According to the Weymouth Department of Public Work water quality summary report of 2016 states that Fluoride level is 0.45 - 0.73 ppm in tap water of Weymouth. 

When the cavities or gum diseases are not treated the tooth has to be extracted. The loss a lot of teeth in a mouth can cause the rest of the teeth to drift and shift into the open spaces. That is why the denture placement should be considered after tooth extraction. The immediate denture – is a denture inserted same day at teeth extraction one of the solutions. Unfortunately, the bone present today may be gone tomorrow. If the immediate denture is placed into the mouth this denture needs to be relined (add additional lacer of acrylic) after 4-6 months of the teeth extractions. Sometimes a patient too tired to visit a dentist and does not wants to have extra expenses so the patient skips the steps of relining the denture. As a result the denture becomes lose and fits poorly this can cause more bone resorption.

Another option to save the bone structure is to place the implants the day of extraction.  Recently I placed two implants for one of our patients due to severe decay of all his lower teeth. The implants were placed the same day of teeth extraction and covered 100 % by DentaQuest dental insurance because this patient is older than 65.

The immediate insertions the implant on lower jaw more beneficial because it cause less resorption and more denture stability. Also it is an easy procedure compared to placement of implants after a few years of all teeth extraction when the bone “shrinks”.

Dry mouth is caused by reduced saliva flow, which can be as a result of cancer treatments that use radiation to the head and neck area, as well as certain diseases, and medication side effects. There are different mouth sprays, rinse or tablets to reduce the dry mouth symptoms.

Age in and of itself is not a dominant or sole factor in determining oral health. However, certain medical conditions, such as arthritis in the hands and fingers, may make brushing or flossing teeth difficult to impossible to perform. The one of solution is an electrical tooth brush. In our office you can test-drive – the Oral B electrical tooth brush. Our hygienists will help match the tooth brush to patient’s needs. 

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