Older People & Oral Health

Your mouth ages as you become older. Teeth, gums and the oral cavity need care and attention as we age. Decades ago it was commonplace for people to have full dentures. Fortunately, this has been on the decrease with more than 75% of adults over 65 years of age keeping some of their permanent teeth. Wear and tear, staining of the teeth, receding gums and tooth loss are some of the issues that older people face.

Oral Health is an essential part of active ageing and enhances quality of life as we age. Maintenance of healthy, and functional teeth, contributes to healthier longer life in older adults by reducing the risk of suffering from non-communicable diseases (NCDs) such as diabetes, cancer and heart disease. Tooth loss, can affect your quality of life. Ill fitting dentures can affect your ability to eat and speak properly. Older people in long-term care facilities are at particular risk of complications from poor oral health due to risk factors such as poor health, general frailty and increased dependence on others for personal care.

Most older Irish people only attend the dentist when they require treatment. Be wise about your oral health and visit your dental team once a year (even if you have no teeth of your own or if you wear dentures) for advice and a check-up to prevent tooth decay, gum disease, bad breath and for a mouth cancer examination. Some interesting key findings from the TILDA Study Oral Health and Wellbeing in Older Adults in Ireland (2017) can be found here.

A lifetime of use can show wear and tear on the hardiest of molars. Think of the grinding and gnawing, flattening edges over decades of use, causing weakened enamel or more serious issues. Receding gum tissue also occurs naturally with age. However, brushing and flossing daily is good at any age, as is a visit to the dentist. Older people may also suffer with dieases like arthritis making it more difficult to brush the teeth. If so, think about using an electric toothbrush, which may be easier to handle for reaching into the back area of the mouth.

Diet and Older people

Loss of natural teeth is associated with poor nutritional status in the elderly. Consumption of sugars seems to be higher in older adults than in younger adults, this may be due to habits like adding sugar to tea or coffee or frequently eating biscuits with tea/coffee.

Many medications cause dry mouth. Talk to your doctor to see if another medication is available that doesn't cause a dry mouth. Read more here about dry mouth and how to manage it. If you have severe dry mouth, speak with your dentist for advice as your teeth may need extra protection to prevent tooth decay. 

A combination of a reduced saliva flow/dry mouth together with a higher sugar intake and increased gum recession, places the older person with natural teeth at greater risk of dental caries (root caries) than younger adults.

Older adults also tend to use a lot of over the counter medicines, e.g. cough drops, laxatives, antacids and various tonics, which are generally high in sugar. Use sugar free alternatives if they are available.

Dental (tooth) erosion occurs when acids eat away at the enamel on the surface of your teeth. It is usually caused by acidic drinks or medicines (dry mouth), excessive vomiting or acid reflux. Tooth erosion is different to tooth decay as it is not caused by bacteria or poor oral hygiene. It can occur at any age but can be worse in older people who suffer with dry mouths because they don’t produce enough saliva to dilute or neutralise acid in the mouth.

Dietary advice for dental health for adults with natural teeth should be consistent with general health dietary guidelines.

Practical tips:

Food and drink

  • Older people should be encouraged to eat a variety of healthy foods (e.g bananas, nuts, berries, yoghurts, vegetables and wholegrains) as snacks from the food pyramid and limit foods from the top level of the Food Pyramid that are high in sugar, fats and salts but low in nutrients such as cakes, sweets, biscuits and soft drinks.
  • The consumption of 8-10 cups of fluid a day is important for this age group, but avoid sugary drinks or sugary tea.