Unfortunately, few people consider their teeth to be as important to their health as other parts of their body. It is surprising just how little time many people put into dental care, although they will spend great sums of money and enormous amounts of time taking care of their “health.” A recent cover of a national magazine showed a famous singer smiling and revealing teeth that were plagued by diseased gums. Without good dental care his singing career could eventually be jeopardized.
Your dentist should be selected with as much care as your physician. You may have had the same dentist for many years and you may want to continue with him as you grow older. Should you have to find a new dentist, it is worthwhile locating one who has a special interest in the care of the elderly. The advice of friends or the local dental society can be of value in finding a suitable dentist.
In many dental schools the curriculum is similar to medical school for the first few years; then the dentist specializes in diseases of the gums and teeth. Therefore, your dentist should be concerned with your general medical condition and aware of any health problems you may have. When you go to a dentist for the first time, he will take a medical and dental history from you. Major medical problems will influence the choice of anesthetic used, whether antibiotics will be needed, and what kind of pain relievers might be required after treatment.
Your dentist and physician should communicate about your medical problems, and you should inform your dentist of your illnesses. With your physician’s help, he can treat you without danger to your health.
Your teeth are very important. Even though you are no longer growing physically, proper nutrition is still paramount. A balanced diet ensures normal bodily functions and repair after injury, and it maintains your body’s defenses against disease. Without good teeth and gums, it is difficult to achieve good nutrition. Foods cannot be chewed properly and digestion may be impaired. Your teeth are important for other reasons too. They help the tongue in the process of swallowing food, and they are essential in speaking properly. People without good teeth are often poorly understood. A speech problem may be misinterpreted as psychological or neurological.
Your teeth are also important to your appearance. When teeth are lost, facial muscles may lose tone and without dentures you may look older than your age.
Older people tend to have poor dental health for numerous reasons. For many, unfortunately, poor dental care is a lifelong habit. As a child and young adult, you may not have been taught good dental care and therefore may have gradually lost your teeth. For many people, visits to a dentist were expensive and few and far between, so proper instruction and treatment were never received. If you do not know about proper dental hygiene, it may seem easier and cheaper to have your teeth removed rather than restored. For some, having “artificial” teeth may seem to be a welcome relief from the repairs needed to keep their own.
After the age of twenty-five or thirty, the number of dental caries (cavities) decreases, so it is unlikely that you will lose your teeth because of this. As you get older, there is often a thinning and decrease in calcium in the bones in your face and jaw. Along with the loss of bone, the health of your gums may deteriorate. Strong bones and sound gums are needed to support your teeth.
Poor gum care is a common problem. Lack of proper dental hygiene often leads to the formation of debris and calcium deposits (plaque and calculus) at the base of your teeth. This eventually causes gum inflammation and infection, and eventually the gums may no longer be able to hold your teeth in place. The end result may be loosening of your teeth and their eventual loss. If you still have some of your own teeth, it is preferable to try and keep them. Sometimes this requires dental restoration (rebuilding) and treatment of the surrounding gums.
Natural teeth form an excellent support for dentures. Even one or two teeth that are stable and firmly implanted in the bones of your mouth can make a good base for partial dentures. Rather than extracting teeth, it is sometimes preferable to grind the remaining teeth down to the surface of the gums and use them for denture supports. Missing teeth should be replaced in order to allow proper chewing and digestion of food.
When partial dentures are made, they must be designed for easy removal. Your dentist should take into account any physical disability you may have. A special design may be necessary to permit you to take care of your dentures, especially if you have a handicap such as arthritis. But the most important step in maintaining your dentures is good oral hygiene. You should learn to clean your dentures as well as your own teeth and keep up the condition of your gums. Inflammation and infections should always receive immediate attention.
During the past few years, dental implants have become available. Supports are fixed to the jaw and a bridge or artificial teeth attached to the supports. For some people this procedure may be more suitable and appropriate than traditional dentures. However, the technique is time consuming, is not readily available, and may be quite expensive. Discuss the topic carefully with your dentist before undertaking such a treatment.
Occasionally, your gums may become irritated by poorly fitting dentures. This should be treated by removing your dentures until your gums recover. If irritation recurs, your dentist should examine your dentures and gums. He may be able to modify your dentures so that you can enjoy your food.
As facial bones and the shape of your gums change with age, it may be necessary to adjust your dentures. In many situations where dentures have not fitted properly for many years, it might be almost impossible to repair them or to make new, better-fitting dentures. With well-designed, properly fitting dentures, the use of adhesives is rarely necessary.
Certain precautions should be taken when going for dental care. Remember that your dentist should be informed of all the medications that you are taking. This is especially the case if you are taking sedatives, tranquilizers, or anticoagulants (blood thinners). Major dental surgery should not be done if you are taking anticoagulants because serious bleeding may occur. It is essential also to remind your dentist of medical problems, such as heart disease, high blood pressure, and diabetes mellitus. Allergies to medications such as analgesics (pain relievers) and antibiotics should be noted in your dental record.
A serious illness that may affect you if precautions are not taken is bacterial endocarditis (see chapter 12). If you have a heart murmur, you must inform your dentist because antibiotic treatment is frequently necessary. It is given just before the dental treatment is begun and continued for a short period after the work is completed. If he is not sure of the appropriate antibiotic treatment, he should ask your physician before working on your teeth. Overlooking this problem can lead to serious consequences, such as an infection of the heart valves which can spread to the rest of your body.
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