Feeling long in the tooth? Your mouth is aging too….

As we age, our bodies change and our mouths are no exception. The changes in children’s mouths are most evident– babies start teething at around 6 months old, and continue to lose and gain new teeth all the way through teenage years. As we reach adulthood, however, the changes usually happen much more slowly. However, your teeth, gums and jawbone continuously undergo regular wear and tear and physiological changes that may only become evident when a problem arises in your mouth.

With the ever-growing body of research evidence pointing to the tight interrelationship between the mouth and body, it is important to be aware of the changes that your mouth is undergoing to ensure appropriate hygiene and timely oral assessments in order to maintain a healthy mouth— and body— through all stages of your life.

Babies & very young children

Baby teeth (from 6 months to 6 years) are important! Yet, a whopping 40% of children are affected by early childhood caries before the age of five (AAPD, 2010). This is because many people don’t provide appropriate oral care to babies and young children, thinking that baby teeth will simply fall out. However, decayed baby teeth can cause pain, difficulties eating and communicating, and may even lead to abscessed teeth, which may lead to potentially life-threatening infection spreading to other parts of the body.

Children & adolescents

Dental caries are the most common chronic disease of children aged 6 to 11 years and adolescents aged 12 to 19 years. Tooth decay is FOUR times more common than asthma among adolescents aged 14 to 17 years (CDC 2014). Irregular teeth growth is another common problem for this age group, as is the eruption of wisdom teeth, which may cause crowding and damaging of adjacent teeth, the jawbone, or nerves. Partial eruption of wisdom teeth allows an opening for bacteria to enter around the tooth and cause an infection, which can result in pain, swelling, jaw stiffness, gum disease and general illness.

Adults

Across the globe, nearly 100% of adults have dental cavities (WHO 2012). While the causes for tooth decay are the same for all ages, the nature of the decay problem does change somewhat as people age. Adults are more likely to have decay around older fillings, and because many adults grew up without the benefits of fluoride, they may have many more fillings. Furthermore, the average adult between the ages of 20 and 64 has three or more decayed or missing teeth (NIDCR 2014). This may affect speaking, eating and may even cause bone loss around the missing tooth.

Gums also begin to recede in adulthood, exposing the roots and causing your teeth to become sensitive and painful when eating something sweet, salty or spicy or drinking or eating things that are hot or cold. Gum diseases are due to a buildup of bacteria that can lead to infections that can break down tissues and bone. With age, pockets form at the gum line and create storage and breeding grounds for bacteria. The two stages of gum disease – gingivitis and periodontitis – affect over 80% of adults in the United States and advanced gum disease affects 4%–12% of U.S. adults (CDC 2011). Gum disease is not only THE leading cause of tooth loss, but is also linked to heart attacks and strokes.

Pregnant Women

While tooth loss is not a necessary side effect of pregnancy, it can be the consequence of poor or delayed oral health care, unnecessarily common to pregnant women. Pregnant women experience hormonal changes commonly leading to gingivitis, which can be associated with more serious periodontal disease (periodontitis) leading to tooth loss. Periodontitis is associated with preterm birth and low birth weight, and high levels of cavity-causing bacteria in mothers can lead to increased dental caries in infants.

Older Adults

As we age, wrinkles and gray hairs are not our only problems; our teeth become more susceptible to cavities too. Decay of the tooth root is common among older adults, and this occurs as the gums recede, exposing the softer root surface, which decays more easily than tooth enamel. A common cause of cavities in older adults is dry mouth, which is both a normal aging process and a side-effect of many medications, including those for Parkinson’s, Alzheimer’s and hypertension. Dry mouth causes food and bacteria to stay on the teeth longer, which increases the risk of decay. Physiological changes, difficulties brushing teeth, and lack of insurance have jointly resulted in one-fourth of U.S. adults aged 65 or older having lost all of their teeth (CDC 2011).

As gums recede, many older adults develop gum or periodontal disease, which are caused by the bacteria in plaque irritating the gums. Advanced gum disease can even destroy the gums, bone and ligaments supporting the teeth leading to tooth loss, as well as spread to other parts of the body leading to potentially life threatening infections. 70% of adults 65 and older have periodontitis, which can be related to insufficient oral care or genetic factors (Eke et al, 2012).

There are about 39,500 cases of oral cavity or oropharyngeal cancer diagnosed each year. More than 7,500 people, mostly older Americans, die from oral and pharyngeal cancers each year (American Cancer Society, 2015). Oral cancers are more likely to happen in people over age 40. Early stages of oral cancer typically do not cause pain, but do have symptoms such as open sores, white or reddish patches, and changes in the lips, tongue and lining of the mouth, that a healthcare professional can recognize and treat.

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Unfortunately, the mouth has many odds stacked against it! Poor diet, smoking and alcohol, teeth clenching, regular wear and tear, and many other factors lead to its aging. However, maintaining proper nutrition, oral hygiene and visiting the dentist regularly are vital to keeping your mouth happy and healthy–and having people continue guessing your age!

For tips on caring for your mouth visit the National Institute on Aging: http://www.nia.nih.gov/health/publication/taking-care-your-teeth-and-mouth

References:

American Academy of Pediatric Dentistry (2010). Celebrate National Children’s Dental Health Month by Taking Care of Tiny Teeth. Retrieved from http://www.aapd.org/celebrate_national_children%E2%80%99s_dental_health_month_by_taking_care_of_tiny_teeth/

American Cancer Society. (2015). What are the key statistics about oral cavity and oropharyngeal cancers? Retrieved from http://www.cancer.org/cancer/oralcavityandoropharyngealcancer/detailedguide/oral-cavity-and-oropharyngeal-cancer-key-statistics

Center for Disease Control (2014). Hygiene-Related Diseases. Retrieved from http://www.cdc.gov/healthywater/hygiene/disease/dental_caries.html

Center for Disease Control (2011). Oral Health. Preventing Cavities, Gum Disease, Tooth Loss, and Oral Cancers At A Glance 2011. Retrieved from http://www.cdc.gov/chronicdisease/resources/publications/aag/doh.htm

Eke, P. I., Dye, B. A., Wei, L., Thornton-Evans, G. O., & Genco, R. J. (2012). Prevalence of periodontitis in adults in the United States: 2009 and 2010. Journal of dental research, 91(10), 914-920.

National Institute of Dental and Cranofacial Research (2014). Dental Caries (Tooth Decay) in Adults (Age 20 to 64). Retrieved from http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/DentalCariesAdults20to64.htm

World Health Organization (2012). Oral Health. Fact Sheet No318. Retrieved from http://www.who.int/mediacentre/factsheets/fs318/en/

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