When age catches up with teeth

The global population is increasing at an annual rate of about 2 per cent, while the population of those over 65 years is increasing at a rate of 2.8 per cent. Both the developed as well as the underdeveloped countries are expected to experience significant shifts in the age distribution of the population by 2050. The fastest growing population segment in most countries is the adults older than 80 years, which according to the United Nations estimates will make up nearly 20 per cent of the world's population.

Incidence of oral cancer in India increases at an alarming rate, especially among the old and the male population. Various systemic diseases not only influence the patient's ability to maintain oral hygiene and promotion of oral health, but also lead to certain complications. Though impairments are not life threatening, they affect a person's quality of life. Some of the common oral problems are:

Root caries:  This is caused by exposure of the tooth root to decay producing acids. The tooth roots become exposed as gum tissue recedes from the tooth. Roots have no enamel to protect them and are more prone to decay than the crown part.

Periodontal diseases: They are caused by dental plaque and made worse by food left in teeth, use of tobacco products, poor-fitting removable dentures, fixed prosthesis and clasps and poor diet. Certain diseases such as anemia, cancer and diabetes also help their development. The ultimate complication is tooth loss.

Uneven jaw bone:  Failure to replace lost teeth may result in uneven jaw bone as the rest of the teeth could drift and shift into open space.

Residual ridge resorption:  There is rapid rate of ridge resorption as age advances. This process even increases three to four fold among patients with uncontrolled diabetic. Therefore artificial teeth or dentures may get loosened periodically and there will be need of frequent relining or refabrication.

Denture-induced stomatitis: Ill-fitting dentures, poor dental hygiene or a buildup of the fungus Candida albicans cause this condition, which is inflammation of the tissue underlying a denture. Oral Candidiasis other than dentures, diseases or drugs that affect the immune system can trigger the overgrowth of the fungus in the mouth.

Discolouration of teeth: It is caused to some extent by changes in dentin that underlies the tooth enamel and by a lifetime of consuming stain-causing foods and beverages. Thinning of the outer enamel layer can also let the darker yellower dentin show through.

Dry mouth:  Dry mouth is caused by reduced saliva flow, which can be a result of cancer treatments that use radiation to the head and neck area, as well as certain diseases, such as Sjögren's syndrome, and medication side effects. Many medicines can cause dry mouth.

Diminished taste sensation:  While advancing age impairs the sense of taste, diseases, medications, dentures can also contribute to this sensory loss.

Age by itself is not a dominant or sole factor in determining oral health. However, certain medical conditions such as arthritis in the hands and fingers and Parkins onism may make brushing or flossing teeth difficult or even impossible. Drugs can also affect oral health and may make a change in your dental treatment necessary. Patients with uncontrolled diabetes also have severe oral problems such as increased periodontal disease, poor wound healing and accelerated ridge resorption.

Daily brushing and flossing of natural teeth is essential to keeping them in good oral health. Plaque can build up quickly on the teeth of seniors, especially if oral hygiene is neglected, and lead to periodontal disease and dental caries.

(The writer is consultant periodontist, Thiruvananthapuram.