What dental changes do we feel with age?

9th December 2024

The meaning of AGING, in human beings, is a process of wear and tear of the body (or cells) after reaching adulthood. The causes of aging are not yet fully known because there are theories that justify aging with the accumulation of damage (for example, mutations in DNA) that lead to an increase in failures of the organism. Other theories propose that aging may be genetically programmed.

Aging is part of a natural process and should be considered a biological and inevitable phenomenon. In Portugal, the average life expectancy until 1960 was 64 years and in 2015 it increased to 81 years. Aging leads to a series of oral changes that can seriously impair the quality of life of the elderly.

Aging leads to a lot of changes and changes in our body. This can be observed in the lines of the face and skin, in the decrease of our elastic capacity as well as in our ability to quickly perform an activity. Therefore, our mouth will not miss the aging process and the risk of gum disease, cavities and tooth loss increases.

In aesthetic dentistry, we have to take into account not only the desire of patients to have a younger appearance, but also the effects of aging must be taken into account in the aesthetic analysis. The effects of ageing manifest themselves not only on the teeth and periodontal tissues but also on the lips and surrounding soft tissues. The muscle tone of the muscles around the mouth decreases as we age, and these variations continually alter aesthetics.

The upper lip with aging becomes longer, drooping, which causes the exposure of the upper teeth to decrease during speech. The proportions of dental exposure through the upper and lower lip vary with age, that is, the exposure of the upper teeth decreases and the lower teeth increases.

The expectation on the part of patients to have a younger appearance is what leads them to seek aesthetic dental treatments and have their smile lifted.

Tooth Wear

The teeth are incredibly strong, but they are not indestructible. A lifetime of chewing leads to wear and tear of the outer layer of enamel and flattens the cusps of the teeth.

Tooth surfaces are also affected by exposure to acidic foods, such as citrus and carbonated drinks, which dissolve protective enamel. Worn enamel can set the stage for more serious dental problems. A crack or break in the outer surface of the tooth leaves the tooth more vulnerable to irritation and inflammation and can ultimately lead to tooth loss.

Medications, dry mouth and cavities

Many people have the idea that caries disease only affects younger people. The presence of cavities in older adults may not be directly related to poor oral health habits.

Often these cariogenic diseases are related to the daily taking of medication for chronic diseases. Many of these medications cause xerostomia (dry mouth) by creating an ideal environment for bacterial proliferation responsible for cariogenic diseases. However, dry mouth problems also result from changes in the salivary glands and salivary secretion, which decreases with aging, and the elderly also drink less water, which reduces salivary production.

Lack of saliva is more than just uncomfortable as it makes ingestion and ingestion difficult, causes bad breath, and causes irritation and infection of oral tissues. It also increases the risk of gum disease and tooth decay.

The ways that exist to control xerostomia are through an adjustment in the dose of medication or even a change in it (under medical advice), drink more water, and use artificial saliva. In these cases, it is recommended to place sealants in order to protect the teeth from caries.

Gum Disease in Aging

Gum disease has a higher prevalence in older people. About 70% of the population over 65 years of age has gum disease in some way, which can be mild to severe. Effective treatment can reverse this situation. The most appropriate treatment will depend on the severity of the gum disease. Some patients recover after deep oral hygiene, while other patients require surgical options such as gum grafts or bone grafts.

Tooth loss

Tooth loss is usually associated with aging. Although older people have more tooth loss and are more likely to have implant or denture treatment, there is no reason why a person should lose their teeth as they age.

One of the reasons why people are more likely to lose teeth as they age is because the teeth become less sensitive. The pulp of the tooth (where the innervation of the tooth is located) becomes smaller and is less able to cause pain due to the presence of cavities or periodontal diseases. Often these situations are only detected late, leading to tooth loss.

Fortunately, nowadays it is much easier to prevent tooth loss by having oral hygiene habits and making dental appointments as often as necessary. The solutions currently available to solve tooth loss, dental implants, are much more comfortable and natural than those existing in the past.

Smokers and ageing

Smoking makes a person more likely to suffer periodontal disease and other oral health problems such as oral cancer. Current smokers over the age of 65 had an average of just over 15 teeth, while non-smokers over the age of 65 have an average of 19 teeth. Nearly 50% of current smokers over the age of 65 do not have natural teeth.

In my personal view, the dentist must be able to identify the best treatment plan and what are the most important points of it and what is its order in order to obtain the desired aesthetic results. If there is a huge gap between the clinician and the expectations and desires of patients in aesthetic terms, irreversible procedures on the teeth and periodontal tissues can be called into question, and it is important that decisions are made together in order to be both in the same line of thought.