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Taking Care of Your Teeth and Mouth A healthy smile is a bonus at any age. Too often older people-especially those who wear false teeth (or dentures)-feel they no longer need dental checkups. If you haven't learned the basics of oral health care, it is not too late to start. And even if you have, it's a good time to review. Tooth Decay (Cavities) Tooth decay is not just a children's disease; it can happen as long as natural teeth are in the mouth. Tooth decay is caused by bacteria that normally live in the mouth. The bacteria cling to teeth and form a sticky, colorless film called dental plaque. The bacteria in plaque live on sugars and produce decay causing acids that dissolve minerals on tooth surfaces. Tooth decay can also develop on the exposed roots of the teeth if you have gum disease or receding gums (where gums pull away from the teeth, exposing the roots). Just as with children, fluoride is important for adult teeth. Research has shown that adding fluoride to the water supply is the best and least costly way to prevent tooth decay. In addition, using fluoride toothpastes and mouth rinses can add protection. Daily fluoride rinses can be bought at most drug stores without a prescription. If you have a problem with cavities, your dentist or dental hygienist may give you a fluoride treatment during the office visit. The dentist may prescribe a fluoride gel or mouth rinse for you to use at home. Gum (Periodontal) Disease A common cause of tooth loss after age 35 is gum (periodontal) disease. These are infections of the gum and bone that hold the teeth in place. Gum diseases are also caused by dental plaque. The bacteria in plaque causes the gums to become inflamed and bleed easily. If left untreated, the disease gets worse as pockets of infection form between the teeth and gums. This causes receding gums and loss of supporting bone. You may lose enough bone to cause your teeth to become loose and fall out. You can prevent gum disease by removing plaque. Thoroughly brush and floss your teeth each day. Carefully check your mouth for early signs of disease such as red, swollen, or bleeding gums. See your dentist regularly every 6-12 months - or at once if these signs are present. Cleaning Your Teeth and Gums An important part of good oral health is knowing how to brush and floss correctly. Thorough brushing each day removes plaque. Gently brush the teeth on all sides with a soft bristle brush using a fluoride toothpaste. Circular and short back-and-forth strokes work best. Take the time to brush carefully along the gum line. Lightly brushing your tongue also helps to remove plaque and food debris and makes your mouth feel fresh. In addition to brushing, using dental floss is necessary to keep the gums healthy. Proper flossing is important because it removes plaque and leftover food that a toothbrush cannot reach. Your dentist or dental hygienist can show you the best way to brush and floss your teeth. If brushing or flossing results in bleeding gums, pain, or irritation, see your dentist at once. An antibacterial mouthrinse, approved for the control of plaque and swollen gums, may be prescribed by your dentist. The mouthrinse is used in addition to careful daily brushing and flossing. Some people (with arthritis or other conditions that limit motion) may find it hard to hold a toothbrush. To overcome this, the toothbrush handle can be attached to the hand with a wide elastic band or may be enlarged by attaching it to a sponge, styrofoam ball, or similar object. People with limited shoulder movement may find brushing easier if the handle of the brush is lengthened by attaching a long piece of wood or plastic. Electric toothbrushes are helpful to many. Other Conditions of the Mouth Dry mouth (xerostomia) is common in many adults and may make it hard to eat, swallow, taste, and speak. The condition happens when salivary glands fail to work properly as a result of various diseases or medical treatments, such as chemotherapy or radiation therapy to the head and neck area. Dry mouth is also a side effect of more than 400 commonly used medicines, including drugs for high blood pressure, antidepressants, and antihistamines. Dry mouth can affect oral health by adding to tooth decay and infection. Until recently, dry mouth was regarded as a normal part of aging. We now know that healthy older adults produce as much saliva as younger adults. So, if you think you have dry mouth, talk with your dentist or doctor. To relieve the dryness, drink extra water and avoid sugary snacks, beverages with caffeine, tobacco, and alcohol - all of which increase dryness in the mouth. Cancer therapies, such as radiation to the head and neck or chemotherapy, can cause oral problems, including dry mouth, tooth decay, painful mouth sores, and cracked and peeling lips. Before starting cancer treatment, it is important to see a dentist and take care of any necessary dental work. Your dentist will also show you how to care for your teeth and mouth before, during, and after your cancer treatment to prevent or reduce the oral problems that can occur. Oral cancer (mouth cancer) most often occurs in people over age 40. The disease frequently goes unnoticed in its early, curable stages. This is true in part because many older people, particularly those wearing full dentures, do not visit their dentists often enough and because pain is usually not an early symptom of the disease. People who smoke cigarettes, use other tobacco products, or drink excessive amounts of alcohol are at increased risk for oral cancer. It is important to spot oral cancer as early as possible, since treatment works best before the disease has spread. If you notice any red or white patches on the gums or tongue, sores that do not heal within 2 weeks, or if you have difficulty chewing or swallowing, be sure to see a dentist. A head and neck exam, which should be a part of every dental check-up, will allow your dentist to detect early signs of oral cancer. Dentures If you wear false teeth (dentures), keep them clean and free from food that can cause stains, bad breath, and gum irritation. Once a day, brush all surfaces of the dentures with a denture care product. Remove your dentures from your mouth and place them in water or a denture cleansing liquid while you sleep. It is also helpful to rinse your mouth with a warm salt water solution in the morning, after meals, and at bedtime. Partial dentures should be cared for in the same way as full dentures. Because bacteria tend to collect under the clasps of partial dentures, it is especially important to clean this area. Dentures will seem awkward at first. When learning to eat with false teeth, select soft nonsticky food, cut food into small pieces, and chew slowly using both sides of the mouth. Dentures may make your mouth less sensitive to hot foods and liquids, and lower your ability to detect harmful objects such as bones. If problems in eating, talking, or simply wearing dentures continue after the first few weeks, see your dentist about making adjustments. In time, dentures need to be replaced or readjusted because of changes that occur in tissues of your mouth. Do not try to repair dentures at home since this may damage the dentures which in turn may further hurt your mouth. Dental Implants Dental implants are anchors that permanently hold replacement teeth. There are several different types of implants, but the most popular are metal screws surgically placed into the jaw bones. If there isn't enough bone, a separate surgical procedure to add bone may be needed. Because bone heals slowly, treatment with implants can often take longer (4 months to 1 year or more) than bridges or dentures. If you are considering dental implants, it is important to select an experienced dentist with whom you can discuss your concerns frankly beforehand to be certain the procedure is right for you. Professional Care In addition to practicing good oral hygiene, it is important to have regular check-ups by the dentist whether you have natural teeth or dentures. It is also important to follow through with any special treatments that are necessary to ensure good oral health. For instance, if you have sensitive teeth caused by receding gums, your dentist may suggest using a special toothpaste for a few months. Teeth are meant to last a lifetime. By taking good care of your teeth and gums, you can protect them for years to come. Additional Dental Health Information More information about general dental care is available from:
NIDR publishes information on oral research and general dental care. Some publications available are: Fever Blisters and Canker Sores Fluoride to Protect the Teeth of Adults Rx for Sound Teeth What You Need to Know About Periodontal (Gum) Disease
NIDR also offers publications on oral health for special care patients through the National Oral Health Information Clearinghouse. Special care patients are people whose medical conditions or treatments affect oral health. Publications available include: Dry Mouth (Xerostomia) Chemotherapy and Oral Health Periodontal Disease and Diabetes - A Guide for Patients Radiation Therapy and Oral Health TMD (Temporomandibular Disorders) What You Need to Know About Oral Cancer
ADA distributes educational materials on dental health and sponsors the National Senior Smile Week.
The Food AND Nutrition Center offers the bibliography Nutri-Topics Series: Nutrition and Dental Health. This bibliography lists information available to consumers. NIA publishes fact sheets on various health related topics of interest to older people and their families. For a complete listing of publications, call or write to the above address. National Institute on Aging U. S. Department of Health and Human Services Public Health Service National Institutes of Health 1994 About the NIA : News & Events : Health Information : Research Programs Funding & Training : National Advisory Council on Aging Search : Site Index : NIA Home We welcome your questions and comments. Please send general questions and comments to the NIA Webmaster. Please read our Web site Disclaimer and Privacy Statement. Shots for Safety Shots - or immunizations - are not just for children! Adults also need to be vaccinated from time to time to protect themselves against serious infectious diseases. In fact, some shots are more important for adults than for children. Every year, thousands of older people die needlessly. The Federal Government's Centers for Disease Control and Prevention (CDC) strongly encourage older adults to be immunized against flu, pneumococcal disease, tetanus and diphtheria, and chickenpox, as well as measles, mumps, and rubella. Flu Flu - the short name for influenza - is a highly contagious infection that causes fever, chills, dry cough, sore throat, runny or stuffy nose, as well as headache, muscle aches, and often extreme fatigue. Flu usually is a mild disease in healthy children, young adults, and middle-aged people. However, it can be life threatening in older adults. Flu viruses change all the time. For this reason, you need to get a flu shot every year. To give your body time to build the proper defense, it's important to get a flu shot between September and mid-November, before the flu season usually starts. Although side effects from the flu shot are slight for most people, some soreness, redness, or swelling may occur on the arm where the shot was given. About 5 to 10 percent of people have mild side effects such as headache or low-grade fever, which last for about a day after vaccination. The flu shot is the primary method of preventing and controlling the flu. However, four drugs have been approved to treat people who get the flu: amantadine (Symmetrel), rimantadine (Flumadine), zanamivir (Relenza), and oseltamivir (Tamiflu). When taken within 48 hours after the onset of illness, these drugs reduce the duration of fever and other symptoms. These drugs are available only by prescription. Pneumococcal Disease Pneumococcal disease is a serious infection. Many people are familiar with pneumo-coccal pneumonia, which affects the lungs. But the bacteria that cause this form of pneumonia also can attack other parts of the body. When the same bacteria invade the lining of the brain, they cause meningitis. When they enter the bloodstream, they cause bacteremia. They also can cause middle ear and sinus infections. The CDC recommends that people 65 and older get the pneumococcal vaccine. The shot is safe and can be given at the same time as the flu shot. Most people only need a single dose. However, the CDC advises people 65 and older to have a second dose of the pneumococcal vaccine if they received the shot more than 5 years previously and were younger than 65 when they were vaccinated the first time. No one should receive more than 2 total doses of the pneumococcal vaccine available now. About half of the people who get the shot have minor side effects - temporary swelling, redness, and soreness at the place on the arm where the shot was given. A few people (less than 1 percent) have fever, muscle pain, or more serious swelling and pain on the arm. Pneumococcal disease is treated with antibiotics. However, in recent years the bacteria that cause pneumococcal disease have become more and more resistant to penicillin. This is one reason why prevention and the development of newer, more effective vaccines are so important. Tetanus and Diphtheria Tetanus (sometimes called lockjaw) is caused by the toxin (poison) of a bacterium. The bacteria can enter the body through a tiny pinprick or scratch but prefer deep puncture wounds or cuts like those made by nails or knives. Tetanus bacteria commonly are found in soil, dust, and manure. Tetanus is not spread from person to person. Common first signs of tetanus are headache and muscle stiffness in the jaw, followed by stiffness of the neck, difficulty swallowing, muscle spasms, sweating, and fever. Diphtheria usually affects the tonsils, throat, nose, or skin. Like tetanus, it is caused by the toxin, or poison, of a bacterium, but it can spread from an infected person to the nose or throat of others. It can lead to breathing problems, heart failure, paralysis, and sometimes death. Diphtheria may be mistaken for a severe sore throat. Other symptoms include a low-grade fever and enlarged lymph nodes in the neck. A second form of diphtheria causes sores on the skin that may be painful, red, and swollen. Vaccination is the best way to protect yourself against tetanus and diphtheria. Most people receive their first vaccine as children in the form of a combined diphtheria-tetanus-pertussis vaccine or DTP. For adults, a combination shot, called a Td booster, protects against both tetanus and diphtheria. You need a Td shot every 10 years through-out life to protect yourself against these rare, but dangerous, illnesses. During everyday activities (such as gardening), the tetanus bacteria can enter a break in the skin and cause infection. It's particularly important to have a booster shot if you have a severe cut or puncture wound and haven't had a booster in the past 5 to 10 years. The Td vaccine is safe and effective. Most people have no problems with it. When side effects do occur, they usually are minor and include soreness, redness, or swelling on the arm where the shot was given. Chickenpox Chickenpox - also known as varicella - is a very contagious disease that is caused by a virus. It is spread easily through the air by infected people when they sneeze or cough. The disease also spreads through contact with an infected person's chickenpox sores. People who have never had chickenpox can get infected just by being in the room with someone who has the disease. While chickenpox is a mild disease for children, adults usually get much sicker. Early symptoms include aching, tiredness, fever, and sore throat. Then, an itchy, blister-like rash appears. People who have had chickenpox are protected from getting it again. A vaccine is available to protect people who have not had chickenpox. Two doses of the vaccine are recommended for people 13 years of age and older. Most people who get chickenpox vaccine don't have problems with it. The most common side effects are mild and include pain and swelling on the arm where the shot was given. Fever or a mild rash may develop. Some people who have had chickenpox may develop shingles later in life. Shingles is caused by a reactivation of the same virus that produces chickenpox. The National Institute of Allergy and Infectious Diseases currently is testing a shingles vaccine at the National Institutes of Health in Bethesda, Maryland. The vaccine they are testing is similar to the one used to immunize against chickenpox. After the shot, some people have had some discomfort around the area of the injection. In addition, a few people have had a low-grade fever. For more information about this study, call 1-800-411-1222. Measles, Mumps, and Rubella Measles, mumps, and rubella were once very common diseases in the United States, but they have become rare because of the use of vaccines to prevent them. As with many other diseases, measles, mumps, and rubella generally are more severe in adults than in children. Most adults are immune to all three infections because they had them (or a vaccine) as children. Everyone born in or after 1957 should have received at least one dose of the measles-mumps-rubella (MMR) vaccine sometime after their first birthday. Some adults - such as health care workers and people who travel out of the U.S. - may need a second dose. People born before 1957 may be vaccinated if they believe they've never had one of these diseases. There's no harm in receiving the vaccine if you already are immune to the infection. Travel If you are planning to travel abroad, check with your doctor or local health department about the shots that you need. Sometimes a series of shots is needed, so it's best to get them well in advance of your trip. For information about specific vaccines required by different countries, general health measures for travelers, and reported outbreaks, call the CDC information line for international travelers at 1-877-394-8747. The Web site address is http://www.cdc.gov/travel. Keeping a Shot Record It's helpful to keep a personal immunization record with the types and dates of shots you've received, as well as any side effects or problems that you had. The medical record in your doctor's office also should be kept up to date. Widespread use of vaccines can reduce the risk of developing a number of contagious diseases that seriously affect older people. You can protect yourself against these illnesses by including vaccinations as part of your regular health care. Resources For more information about health and aging, contact the National Institute on Aging Information Center at 1-800-222-2225 or 1-800-222-4225 (TTY). The Internet Web site address is http://www.nih.gov/nia/ The NIA distributes a number of other free Age Pages, including "What to do About the Flu." Information about adult immunizations also is available from the following groups.
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