5 Common Dental Problems After Age 65

Learn the most common dental issues older adults face, plus what you can do to prevent them.

It's normal to feel a bit nervous about visiting the dentist. Things like needles, drills, and sharp tools are enough to unnerve anyone, regardless of their age.

But if you're 65 or older, it can be especially hard to smile when thinking about your teeth. That's because older adults are at higher risk for certain dental issues.

Maybe your mouth feels dryer than it used to. Perhaps your dentist has recommended some procedures you’ve never heard of. And you might find out you have cavities, which you thought didn’t happen to older folks. Is there any way to keep your teeth healthy as you age?

Fortunately, yes! Here are the most common dental issues older adults face, along with tips for keeping your teeth healthy and strong.

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Dental Problem #1: Cavities

If you thought cavities were only for kids who eat too much candy, think again.

"As you get older, you enter a second round of cavity-prone years," says Sally Cram, D.D.S., a Washington, D.C.-based dentist and spokesperson for the American Dental Association. "Many older adults lacked the benefits of fluoride and modern preventative dental care growing up, making dental problems like cavities more common."

Over time, existing fillings can weaken and fracture. This allows decay to build and bacteria to accumulate in the tiny fractures and crevices, says Dr. Cram.

What you can do: Brush your teeth twice a day with a fluoride toothpaste, Dr. Cram advises.  Visit your dentist for professional cleaning twice a year, or as often as they recommend.

Dental Problem #2: Gum Disease

The most common dental problem for individuals ages 65 and older is periodontal, or gum, disease, says David Okano, D.D.S., M.S., spokesperson for the American Academy of Periodontology and professor at the University of Utah School of Dentistry.

Gum disease is caused by bacteria that occur in the buildup of plaque on the teeth. These bacteria irritate the gums, making them red and swollen. It can also put you at higher risk for developing cavities.

This condition is usually painless until it is in the advanced stage, so many people don’t even know they have it.

The first stage of gum disease is called gingivitis. Gingivitis is also the only reversible form of gum disease. If not treated, it can lead to periodontal disease, a condition that is more serious.

Around 42% of Americans 30 and older have periodontitis, according to the American Dental Association, and severe periodontitis is most common in people ages 65 and older.

Periodontal disease is classified by stage and grade, Dr. Okano explains. Treatment depends on how far it has progressed.

"A non-surgical treatment includes scaling and root planning, which is a deep cleaning of the tooth root surfaces," he says. "In more advanced cases, surgical treatments like gum graft surgery, dental crown lengthening, and periodontal pocket procedures may be needed."

In dental crown lengthening, excess gum and bone tissue is reshaped, which exposes more of the natural tooth. In periodontal pocket procedures, gum tissue is folded back, bacteria are removed, and the tissue is secured back into place.

What you can do: “The good news is that practicing good oral hygiene and going to the dentist regularly can treat gum disease or even prevent it entirely,” says Dr. Cram.

The best prevention technique is to use floss every day to clean between your teeth. You can use string floss or flossing sticks, whichever is more comfortable for you. Brush twice daily, go to the dentist regularly, and eat a balanced diet. Use a toothbrush with fluoride.

"Toothpastes with fluoride, especially stannous fluoride, prevent and treat gingivitis," says Dr. Okano. Stannous fluoride is a type of fluoride that has antimicrobial properties that can kill the bacteria found in plaque that cause cavities and gum disease. It also helps address teeth sensitivity.

Recommended reading: 5 Reasons to Get Your Wisdom Teeth Removed at 65+

Dental Problem #3: Dry Mouth

Saliva helps prevent tooth decay. If you don't make enough, you may have a condition called xerostomia, or dry mouth. If not treated, dry mouth can lead to an increased risk of cavities.

Dry mouth affects 30% of people older than 65, and up to 40% of people older than 80, says Dr. Cram.

One reason why older adults are more affected? Dry mouth is often a side effect of more than 500 medications, including those for high blood pressure, high cholesterol, Parkinson's disease, anxiety, and depression.

Luckily, while dry mouth is common, it is not inevitable, says Dr. Cram.

What you can do: Drink water throughout the day, recommends Dr. Cram, and limit your intake of alcoholic beverages. Also limit drinks that are high in sugar and caffeine, such as coffee, tea, juice, and soda.

"And discuss your concerns with your dentist," she says. "Be sure to tell the dentist all the medications you are taking so they can make a recommendation to help relieve your dry mouth symptoms."

Your dentist may suggest using an over-the-counter oral moisturizer, such as a spray or mouthwash, says Dr. Cram. Chewing on sugar-free candy and sugar-free gum stimulates saliva flow. You also may be able to compensate for low saliva production with artificial saliva and oral rinses.

Dental Problem #4: Root Decay

This condition sounds scarier than it is, but it’s still something you should be aware of as you age.

Root decay occurs when a person's gums start to recede, exposing the tooth roots to bacteria. This can lead to tooth decay.

What you can do: Practice good oral hygiene habits, says Dr. Cram. “This means using a topical fluoride product like a daily mouth rinse, high fluoride toothpaste, and regular fluoride varnish applications,” she says.

A good diet makes a difference, too, she says. To promote good oral health, integrate fruits, vegetables, whole grains, low-fat dairy products and lean proteins like turkey, chicken, and fish into your diet.

Recommended FREE SilverSneakers On-Demand Class: Eating a Varied Diet

Dental Problem #5: Oral Cancer

The risk for oral cancer increases with age, and the average age of people diagnosed with mouth, throat, and tongue cancer is 62, says Dr. Cram. Oral cancer can start anywhere in the mouth or throat, including the tongue.

Keep an eye out for open sores, white or reddish patches, and changes in the lips, tongue and lining of the mouth that last for more than two weeks. These symptoms should be checked out by your dentist, says Dr. Cram.

Oral cancer typically does not cause pain in the early stages, so schedule regular dental checkups. Your dentist will examine your mouth and tongue to make sure everything looks OK.

What you can do: Reduce your risk of oral cancer by avoiding tobacco (both smoking and smokeless). If you drink alcohol, do so moderately. Oral cancers that are found early may be treated with surgery or radiation therapy, says Dr. Cram.  Make regular visits to your dentist so you can be screened for oral cancer.

See our sources:
How older adults can care for their teeth and mouth: National Institute on Aging
Common dental concerns in adults: American Dental Association
Periodontitis overview: American Dental Association
Surgical dental procedures: American Academy of Periodontology

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