Dental problems in mid to later life

I will often see adult patients for an exam and have to tell them that several teeth require treatment. Many times it is a healthy adult with good hygiene and a healthy diet who comes to the dentist twice a year. So why are there cavities? Why am I recommending replacement fillings? And why now, when they’ve had no problems for years? There are a few things I see quite often that lead to this. But these are the top two.

1. Most Americans in their 40’s, 50’s and 60’s begin taking medications for high blood pressure, high cholesterol, and a myriad of other conditions. Although necessary, many of these medications have several side effects, including dry mouth. With less salivary flow, your body’s natural defense against tooth decay is lowered. When you have a dry mouth, food and plaque sticks to the teeth easily. It also becomes more difficult to clean your teeth. If you combine this with receding gums which happens commonly around the same time in life, the problem can be even worse. If your gums have receded, there are larger spaces between the teeth that catch food, and there is exposure of root surfaces. Root surfaces are not as hard as tooth enamel and far more likely to have decay. If you experience dry mouth there are several things you can do. For one, you can ask your physician about an alternative medication which may not decrease your saliva as much. Make sure that you are drinking an adequate amount of water each day. There are also moisturizing mouthrinses like Biotene and Oasis that help keep the plaque from sticking. If you have exposed root surfaces, utilizing toothpastes and rinses with increased Fluoride to help harden these areas and make them more resistant to decay. A few products I like for this are Arm and Hammer Age Defying Toothpaste, Sensodyne ProNamel toothpaste, and ACT anticavity mouthrinse.

2. I often find myself explaining that nothing man made lasts forever. Amalgam “silver” fillings have been a great product for many years and really have held up through the test of time. That being said, I spend a good amount of time replacing silver fillings each day. I have nothing against silver fillings, I think it’s a great material. But I see a lot of adults in need of new restorations. Often these silver fillings were placed in teenage years all around the same time. So they all start to fail within a few years of each other. After years of service even the best filling will start to break down. When the edges of the filling no longer create a seal against the tooth structure, there is room for bacteria to seep in under the filling and begin the process of decay. Taking good care of your teeth will help your dental work last as long as possible. Daily flossing and brushing and regular professional cleanings help you get the longest lifetime from these restorations.

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