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Why Your Teeth Are Suddenly Causing You Problems

Aging can make your mouth painful, but new treatments are often effective

It wasn’t even peanut brittle that broke Dennis Cedarholm’s front tooth in half. 
It was a “seemingly harmless little cracker” at a grocery store sample table, said the 57-year-old purchase manager from the Twin Cities. “It broke, of course, right along the plastic filling.”
Welcome to the dental dramas of the 50-plus crowd.
Like Cedarholm, most of us downed soda and candy as kids, and many of us didn’t have fluoridated water until we were past the age when dentists had begun pressing silver fillings into our cavity-pocked molars. Even if we took care of our teeth by brushing or flossing as adults, as he did, those fillings don’t last forever — nor even as long as we last. Often, they must be replaced with composites or crowns, which can also fill our calendars with dental appointments and drain our bank accounts.
Keeping Your Teeth, at a Cost
The good news is that technology is getting better and faster at replacing that early work and even in correcting problems that may have contributed to our dental woes. As a result, more of us are living our entire lives with our real teeth, even as life expectancy grows.

(MORE: The 7 Worst Foods for Your Teeth)
“When you look historically back two generations ago, the average life expectancy was into the 60s and most people had lost most of their teeth by that point and had dentures,” said Dr. Matthew Messina, a dentist in Cleveland, Ohio. “Now people are living very comfortably into their 80s or 90s and most of them are going to retain their natural teeth until the end.”
But the rosy outlook comes at a price. It’s often a question of whether we have the resources and the will to undergo the extra care — and the extra cost — when we need it, Messina said.
“We’re taking the same molars that came into your mouth when you were 6 years old and instead of trying to get 60 years out of them, we’re now trying to get 90 years out of those teeth,” he said. “So the level of maintenance is going to increase because our expectations are higher.”
The Brunt of Years
No doubt about it, age is tough on teeth.
For one thing, there’s the impact of the smashing and chewing on tooth enamel, which can weaken under that constant stress. Suddenly a tooth that has done its duty for decades will break a corner after biting into nothing harder than a rice cake.

(MORE: How to Keep Your Teeth for Life)
Another threat may be the medications prescribed for problems that tend to emerge later in life such as hypertension, arthritis, high cholesterol or gastro-intestinal maladies. Many of those drugs can reduce production of saliva — causing “dry mouth” — which can lead to the growth of destructive bacteria.
“Saliva has a tremendous washing action on the teeth,” Messina said. “It’s a buffer against acids that cause cavities and the bacteria that like a drier environment, which tend to be more aggressive from the standpoint of decay and gum recession.”
Medications aside, just getting older means we produce less saliva. Gum recession also comes with age, making it more difficult to clean plaque off the exposed and stickier root surface. When a drier mouth combines with those recessions, you get what Messina calls a “perfect storm of bacteria collection that can cause problems.”
Technology Terrific
The good news is there's now a range of options for addressing these breakdowns. Dentists can use bonded composites to fill resistant surfaces. Porcelains can be made on the spot, creating well-fitting crowns in a single visit.
Antibacterial washes and other strategies can more effectively fight plaque. Digital X-rays can peek inside teeth more frequently without harmful radiation. If we do lose a tooth, implants can secure directly into the bone with an excellent success rate, though they generally cost several thousand dollars per tooth.         
“There’s almost nothing that we can’t fix,” Messina said.
In Cedarholm’s case, the broken tooth was the impetus to make major changes. After his cracker crisis, his dentist looked at the fillings in every one of his teeth, along with his nine crowns, and suggested more than a quick patch.

(MORE: When You Don't Have Dental Insurance)
His front teeth had been crooked all his life. Putting a crown on the crowded teeth would be less stable, the dentist told him. The crooked bite also made it more difficult to keep his gums healthy despite his good flossing and brushing habits. 
When his dentist suggested straightening his teeth with Invisalign — a plastic retainer-type appliance that would be far less apparent than metal braces — he agreed. It took 18 months for the teeth to straighten enough for the dentist to slip on permanent crowns, but it paid off, Cedarholm said.
Dentures and Disparities
Such preemptive work is one reason the percentage of Americans needing dentures has declined by 10 percent a decade, a trend that’s likely to continue.
Even so, the expected tidal wave of aging Americans means dentures will still be in demand for the more than 37 million adults missing full sets of teeth today, according to the American College of Prosthodontists, the specialty that creates dentures.
Yet even the most perfectly crafted dentures generate only 20 percent the chewing power of natural teeth set into the bone, making it more difficult to get the good nutrition vital for health.
“Anyone who has lost their natural teeth will tell you they’d give anything to have them back,” Messina said.
Avoiding tooth loss, however, takes resources. And disturbing disparities remain regarding the dental health of adults over 65, with significantly higher rates of total tooth loss among African American seniors as well as those who smoke, have less education and lower incomes.
Even for those who live on a comfortable but limited income, the decision to invest in new procedures or even regular cleaning can be challenging. Medicare does not cover dental visits, supplemental dental policies can be pricey and most procedures are only covered partially.
Invest Today
Dentists argue that dental care during older adulthood may be the key to better health as you age. Tooth care doesn’t just benefit the mouth, said Messina. Studies have suggested a relationship between the gum inflammations and full-body conditions such as diabetes or possibly coronary artery disease and stroke.
So how can you keep your dental health sound?

  • Brush after meals and floss daily.
  • See your dentist at least every six months.
  • Be open to changing your teeth-cleaning habits by adding soft picks, fluoride toothpastes or washes.
  • Take care of problems immediately; they'l likely just get worse if you wait.
  • Drink lots of water. Avoid mints or sugared gums; sugarless gum can help moisten the mouth.
  • Talk to your dentist about realistic solutions that go beyond just quick fixes. Don’t be afraid to invest today for tooth health that can last.     

Gayle Golden is a writer and senior lecturer at the University of Minnesota's School of Journalism and Mass Communication. Follow her on Twitter @ggwriter   

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