Aging Teeth: Unveiling Cause and Effect

My name is Dr. Stephen Abbaticchio and this May will be my 21^st year of practicing dentistry. After graduating from NYU College of Dentistry in 2000, I immediately started a GP-R program in Staten Island University Hospital to prepare me for the real world and to further enhance my education. Finally, I started practicing for an experienced and well-known dentist in Staten Island. Working in both NJ and NY, I landed primarily in NJ and that is where I work now.

I have treated thousands of patients from all walks of life. I am a general dentist, which means that I can perform many procedures including root canals, extractions, implant placements, dentures, fixed bridges, and cosmetic veneers. I continue to take classes to perfect my skills and to stay abreast of the ever-evolving technology. Having much experience and seeing many patients allows me to make certain observations that put me in a good position to educate my patient base. I especially have a soft spot for the elderly population who suffer from tooth loss and decay.

Although there are many benefits to aging such as experience and wisdom, our teeth do not improve as we age. As a matter of fact, they start to wear down and root recession becomes more frequent with each passing year. Teeth are like onions and have layers. The outside is enamel and under this, is dentin. Enamel is what creates a white appearance of teeth and is the hardest part of the human body. Dentin is brown, gray, and yellow. Dentin is also much softer than enamel. Physical wear from tooth-to-tooth contact starts to strip the enamel of the teeth. Years and years of brushing the teeth often cause them to also, lose tooth enamel near the gum line. This wear makes the teeth darker in appearance as the dentin becomes exposed. Years of abrasive brushing causes caves on the sides of the teeth. Acidity in citrus foods, teas, and wines also contributes to this. This is the physical aspect of teeth and how they tend to change with age. This is a general statement and applies to most but not all patients.

Now, the other critical change that occurs often with age is our medical conditions. Many of us start to develop underlying diseases that need to be treated with medications.  Both the disease and the medications cause the teeth to become prone to disease. Without making this too complicated I will give only a few examples of how this affects the teeth. High blood pressure, diabetes, high cholesterol, autoimmune diseases, mental disorders, and sleep disorders all contribute. I will give an example of a patient who develops depression and anxiety. The psychosocial aspect varies way too much to show how the mental aspect of this will affect the frequency of brushing the teeth.

Let us just say that it may become more frequent or less. The main point is that medications to treat both will adversely affect the teeth and make them prone to decay. Almost all anxiety medications that are required to control patients who suffer from anxiety disorders, cause xerostomia. Pronounced zee-ruh-stow-mee-uh, meaning dry mouth. Drugs that treat psychological ailments also similarly cause dry mouth. Why is dry mouth concerning? 

1.  A dry mouth has less immune support because saliva does have immune support.
2. Less swallowing, as a result, means you will not self-cleanse the teeth.
3. Teeth are no longer slippery and are now sticky. This keeps food particles stuck on the tooth for longer periods of time.
4. The gums become tender and result in people not brushing as frequently if it hurts.

These are just 4 reasons why dry mouth will cause problems for the teeth and gums. Decay and gum disease develops from both genetic and environmental factors. These environmental changes will leave the teeth more prone to decay and gum disease. Decay is caused by bacteria that feed on organic matter. Acids that develop will cause teeth to deteriorate and rot. The plaque will cause the body to respond at the gum level causing bone loss to occur around the tooth. Another interesting fact is that cavities often do not hurt. This sometimes causes the patient to question our diagnosis

Without going over thousands of cases I want to make a few key points here. As we age, we often need to take medication. These medications are unavoidable most of the time. Many of these medications help in one way but often negatively affect our teeth. What can we do?

Ways To Combat Tooth Loss:

1. Eat healthily, stay hydrated, stay fit, and visit your dentist and healthcare providers.
2. Speak with your dentist about dry mouth and the causes.
3. Brush your teeth at least 2x daily and floss before bedtime.

Your dentist may prescribe a prescription toothpaste with high amounts of fluoride. They may also suggest an electric brush that has a sensor to avoid brushing too hard.  Your healthcare provider may suggest fluoride varnish as well. Another way to combat wearing teeth is to discuss with your dentist about fabricating a mouthguard. Having more frequent visits and cleaning is another way to keep out of trouble.