How common is periodontal disease and periodontitis?
Periodontitis is considered to be the most common cause of tooth loss in elderly and senior adults, and affects around 3 in 5 people aged 65 years and over.
There are 2 stages of periodontal disease. The first is gingivitis, and the second is periodontitis. Periodontitis is an infection of the gums. It damages the soft tissue holding your teeth in place, causing teeth to become loose.
Left untreated, the infection can travel deep and eat away the underlying bone in your jaw. With neither gum nor bone to hold them secure, your teeth fall out.
Symptoms of periodontitis
Periodontitis has several symptoms. If you have any of the signs below, it’s time to go for a dental checkup ASAP.
- An odd color to the gums
Healthy gums range in color from light to medium pink. In people with darker, melanin-rich complexions, healthy gums may be pale to dark brown. Periodontitis turns gums bright red, dark red, or purple.
- Swollen, puffy gums
Healthy gums are firm to the touch and snug around your teeth. Periodontitis makes gum tissue swell and if the swelling is only in one or two sections, the puffiness is glaringly obvious. Pressing down on the swollen gum feels like pressing a sponge. Puffy gums may also leak blood or pus when pressed.
- Gums are tender and painful to touch
Pain from periodontitis isn’t always constant. But if you feel soreness, tingling, or burning when you touch your gums, it is a strong indicator that the gums are infected. Pain when chewing your food can also point toward periodontitis.
- The sink turns pink
A yellow or pink tinge on your toothbrush, in the toothpaste foam you spit out, in the water from rinsing your mouth, or smeared on your dental floss, is a clear sign that your gums are bleeding and quite likely infected.
- Metallic taste in the mouth
Blood seeping from infected gums may not always be visible, but a metallic taste in your mouth is a sure sign that you have developed periodontitis.
- Bad breath
While it is possible to clean away some amount of damaged surface tissue through regular brushing and flossing, especially in the early stages of the disease, any areas your toothbrush cannot reach will continue to decompose and ooze blood and pus, giving rise to bad breath. No amount of brushing and flossing can clean underlying decay.
- Black triangles between teeth
In a perfect set, teeth sit with their sides touching. Toward the gumline, most teeth tend to curve into an arch. The rounded arches don’t touch each other, and the space between them is tightly packed with gum tissue. There are no gaps, and you cannot blow air ‘through’ your teeth.
Periodontitis makes gums recede and pull away from teeth. This leaves triangular gaps between the arches and as they’re essentially giving a peek into your mouth, these triangular gaps look black.
- Teeth look longer
Everyone’s teeth are sized differently according to their height and genetics. But it is generally understood that regardless of length, only about half of a tooth is visible above the gumline.
Periodontitis causes gums to detach and recede, exposing more of the tooth and giving teeth an unnaturally long appearance.
What causes gum disease in adults
The main reason for periodontitis in senior adults is improper cleaning of teeth and gums that leads to a buildup of dental plaque and dental tartar. Other reasons include:
- Smoking
- Hormonal changes because of menopause
- Chronic diseases like cancer or diabetes that increase susceptibility to infections
- Medications that cause dry mouth
What is dental plaque?
When you chew food, any sugars and starches mix with saliva and normal bacteria present in the mouth to create a thin, colorless, sticky film on the surface of teeth. This is dental plaque. It’s almost impossible to see, but it feels fuzzy when you run your tongue over your teeth.
Dental plaque is a regular, everyday occurrence. It begins forming as soon as you eat or drink, and it also collects on your teeth while you are asleep.
What is dental tartar?
Dental experts estimate that it takes as little as 24 hours for plaque to harden into dental tartar. Solidified tartar tends to collect at the gumline and in the spaces between teeth. Tartar can irritate soft gum tissue, cause bleeding at the gumline, and trap harmful bacteria that may rapidly progress into an infection.
How do I check for dental tartar?
Dental tartar looks like a creamy-white, yellow, brown, or even black stain or deposit on your teeth, especially near the gumline. If you can’t see it, try gently feeling around the base of your gums with the tip of your fingernail. The rough, gritty stuff that refuses to budge is dental tartar.
Removing tartar from teeth
It’s not possible to remove hardened dental tartar yourself, and neither is it recommended as you might scratch or injure the gumline, giving bacteria access to inner tissue. You could also scratch or chip away tooth enamel which is irreplaceable naturally.
Dental tartar should only be removed by a qualified and skilled dentist or dental hygienist.
Why do older people stop cleaning their teeth?
A good dental care routine includes brushing and flossing teeth twice a day. The morning session removes plaque that collects on your teeth while you sleep. The bedtime brush clears away plaque that forms from eating and drinking during the day.
Brushing twice a day also breaks up the 24-hour period during which plaque hardens into tartar.
But there are several reasons why senior adults may not be able to take correct care of their teeth.
- They forget
Illnesses like Alzheimer’s disease, and other forms of dementia that cause cognitive decline, make it difficult for patients to perform basic self-care tasks. From losing track of ‘when’ to brush teeth, they may reach a point where they don’t even remember ‘how’ to brush.
Fix: For persons still able to manage by themselves, set reminders or alarms on phones, or stick a notice on the bathroom mirror. Caregivers can also brush their own teeth alongside the senior, encouraging the senior to copy the caregiver’s actions.
- Tooth sensitivity
Our permanent teeth start coming in around the age of 6 or 7, and we use those same teeth for the next 60, 70, or more years. A lifetime of wear and tear makes teeth sensitive. It physically hurts to clean teeth, so seniors avoid it.
Fix: Use a soft-bristled toothbrush and toothpaste specially formulated for sensitive teeth. Take your time with slow, gentle, circular movements, remembering to massage both teeth and gums.
- They can’t hold a toothbrush or floss string
Senior adults with Parkinson’s disease or arthritis may find it challenging to hold toothbrushes and floss properly, or for long enough to thoroughly clean their teeth.
Fix: Battery-operated or rechargeable electric toothbrushes make it easier. If your fingers refuse to curl around the brush, slip on an arthritis-friendly grip handle. As for flossing, floss picks get the job done just as well as string.
Also, no one said you had to stand at the bathroom sink to brush your teeth. Squeeze a pea-sized blob of toothpaste on your brush, find a comfortable place to sit, put on some music, and clean your teeth at your own pace. Follow up with a leisurely flossing session.
- They can’t afford it
Generally, Original Medicare (Part A and Part B) and Medicare Supplement plans do not cover routine dental care services such as cleanings, fillings, or extractions.
Fix: Most Medicare Advantage (Part C) plans do cover routine dental procedures. You should check your plan details and if dental care is included, make it a point to actively take advantage of it and catch a potential periodontic infection in time.
Prevention of periodontal disease and treatment for periodontitis
Periodontitis cannot be cured, but it can be prevented and treated. Annual dental exams and dental cleanings are enormously helpful in catching infections before they occur, or slowing down damage in case the infection has already happened.
In the earlier stages, oral or topical antibiotics may be enough to fight the infection. Your dentist may also perform a deep dental scaling to clean bacteria from below the gumline.
If the disease has progressed to an advanced stage, surgical intervention may be needed.
Can teeth recover from periodontitis?
Successfully recovering from periodontitis depends on how early the infection is caught, because bone tissue in senior adults does not regenerate well. The only way to replace lost bone tissue is through a surgical graft.
It may also not be possible to save or replace natural teeth. Patients may need to wear dentures instead.
Your doctor’s input
If you have been diagnosed with periodontitis or any form of infectious gum disease, make sure to let your doctor know. According to recent research, people with gum disease double their risk of having a stroke. Knowing your dental history will let your doctor keep a closer and better eye on your health.