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Seniors -- Age Brings Changes In Dental Care Treatment

It's an indisputable fact - our bodies change as we get older and so does our need for dentistry. These changes take different forms in different people, depending on our inherited physical traits, our lifestyle and nutritional habits, and our medical conditions.

Age brings changes in oral health and your need for dental care, too. There are some specific areas where seniors need to pay close attention to protect and extend their oral health.

• Tooth Color: Plaque is an invisible layer of bacteria that forms on our teeth, and can trap stains at any age. But as we get older, plaque builds up more quickly and is harder to remove. At the same time, the tissue that lies underneath the tooth enamel, called "dentin," is changing, and those changes can make teeth appear darker. Finally, decades of consuming coffee, tea, or tobacco leave stains that build up over time.

Daily brushing and flossing are important, particularly first thing in the morning and just before bed, to combat the plaque that builds up overnight. You may also want to consult your dentist about using commercial rinses that remove plaque.

• Dry Mouth: Many seniors experience a reduced flow of saliva, sometimes as a side effect of medications such as painkillers or decongestants. For some, the lack of moisture inside the mouth can lead to sore throats, a burning sensation, hoarseness, or difficulty swallowing. In addition, if you leave dry mouth unattended, it can damage teeth, since saliva's natural rinsing keeps bacteria washed away from teeth and gums. Sugar-free chewing gum and hard candy will stimulate natural saliva, and artificial saliva and oral rinses will provide much-needed relief. Ask your dentist which commercial products are the best for you.
• Cavities: If your gums begin to recede, the portion of the tooth that used to be below the gum line is now exposed. Roots are softer than tooth surfaces and are susceptible to decay; they are also likely to be sensitive to hot and cold beverages and food. Most people over age 50 suffer from some form of dental care disease. Make sure you take good care of teeth and gums with daily brushing and flossing. A word of caution: your gums may be starting to thin. Brush thoroughly but gently to keep from tearing your gums.
• Fillings: Your fillings are getting older, too. They can weaken or crack, or your tooth may decay around the edges of the filling. As a result, bacteria can seep into your tooth, causing more decay. Regular check-ups will give your dentist the chance to keep an eye on your existing fillings.
• Gum Disease: Daily cleaning and good nutrition are critical for healthy gums. When gums become infected and diseased, they set off a chain reaction that can result in losing teeth or weakening the jawbone. Either condition creates more problems for your health and increases your medical costs. Contact your dentist if your gums become red or you have bleeding gums.
• Good Nutrition: What you put into your mouth has a direct impact on the health of your mouth -- and the health of the rest of your body. As you age and your lifestyle changes, keep your nutritional goals in mind. Balanced meals are one the best ways you can contribute to your own good health.
• Regular Exams: The dentist will check your mouth, teeth, and jaw for any problems. You should also mention any sores, swelling, or pain you might be experiencing or if you have diabetes or other medical conditions. Regular checkups enable the dentist to spot problems early. Early resolution of problems will help you keep your natural teeth.

Good dental care, regular check-ups, and good nutrition are the keys to really keep you smiling in your golden years!

By Brian J. Gray, DDS, MAGD, FICO

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Find a Dentist To Evaluate Your Risk Factors For Oral Cancer

Oral and oropharyngeal cancers are malignancies that include the lips, tongue, lining of the cheeks (buccal mucosa), floor of the mouth, gum (gingiva), the area behind the lower wisdom teeth (retromolar trigone), the roof of the mouth (hard and soft palates), the back of mouth and throat (oropharynx), and the sides of the throat (tonsil areas).

Oral and oropharyngeal cancers are most often diagnosed in older adults (average age at diagnosis is between 60 and 63), with over 95% of the oral cancer cases occurring after the age of 45. Men are diagnosed with oral and oropharyngeal cancer twice as often as women. Over the past several decades, the overall number of oral and oropharyngeal cancers has not changed; however, the number of men being diagnosed with the disease is decreasing and the number of women with the disease is increasing.

All forms of tobacco and excessive use of alcohol have been identified as major risks factors for oral and oropharyngeal cancers, and are suspected to account for 75% of all oral and oropharyngeal cancers in the United States. Sun exposure is a risk factor for lip cancer, while smokeless (snuff or spit) tobacco increases the risk for cancers inside the lips and cheek. Other risk factors for oral and oropharyngeal cancer are vitamin A deficiency and Plummer-Vinson Syndrome (a very rare iron deficiency).

The American Cancer Society estimates that 7,800 people will die because of oral or oropharyngeal cancer in the year 2000. Overall, people surviving five years after a diagnosis of oral and oropharyngeal cancer have shown little improvement; half of the people diagnosed with this disease survive five years. Deaths due to oral and oropharyngeal cancer vary greatly with the stage (spread) of the cancer at diagnosis. Oral and oropharyngeal cancers that are detected and treated early, and are localized, have greatly improved survival compared to those that have spread.

Early localized oral and pharyngeal cancers often are not bothersome and therefore go undetected until the cancer has spread. About half of oral and oropharyngeal cancers have spread to the lymph nodes (spread to the neck) at the time of diagnosis or treatment. Three sites within the mouth are high-risk for the development of oral and oropharyngeal cancer: the floor of the mouth, the sides of the tongue, and the soft palate complex (soft palate, inside the retromolar trigone, and tonsil area).

Detection of an oral and oropharyngeal cancer also identifies an individual who is at high risk for developing or having a cancer of the respiratory system and upper digestive tract (larynx, lung, and esophagus).

Warning signs and symptoms of oral and oropharyngeal cancer:

• A mouth sore that does not heal
• A lump or thickened mass in mouth or neck
• A red or white patch in mouth
• A sore throat or feeling that something is caught
• Voice change
• Difficulty chewing or swallowing
• Difficulty moving the jaw or tongue
• Numbness
• Swelling
• Loosening of teeth
• Weight loss

Pain may not be present with early oral and oropharyngeal lesions. Traumatic oral lesions will resolve or greatly improve after the cause of the trauma is removed (such as a sharp tooth or denture). A biopsy, to rule out or confirm a malignancy, is indicated if an oral lesion persists after two weeks. A dentist and/or physician should evaluate all suspicious lesions.

By Denise J. Fedele, DMD, MS