For many seniors, regular trips to the dentist weren’t common when they were growing up. Dental disease was widespread, and in a time before water fluoridation, floss and dental implants, many people had dentures at a relatively young age. Dentures are used to replace teeth damaged by decay and periodontitis (gum disease). Due to advances in dentistry, a focus on preventative maintenance and widespread use of fluoride, the number of people with “false teeth” has declined. But even today, nearly one out of four people age 65 and older have experienced complete tooth loss, according to a survey conducted by the Centers for Disease Control (CDC).
“Younger generations are maintaining better oral hygiene and keeping their natural teeth longer,” explains Dr. James Rodriguez, a dentist based in Staten Island, New York. “However, improper dental care still leads to extensive tooth decay and gum disease, and dentures may be used to replace teeth that have been lost.”
Who Needs Dentures?
Tooth decay and gum disease typically occur when people don’t care for their teeth and gums properly at home or see a dentist for routine cleanings and exams. Many seniors don’t have dental insurance, and Original Medicare (Parts A and B) doesn’t cover dental treatment or dentures. Furthermore, certain medical conditions and prescription medications can cause oral health problems like dry mouth that make teeth and gums more susceptible to cavities and infections and accelerate tooth loss.
Even people who take excellent care of their teeth may one day experience tooth loss and need partial or full dentures. It isn’t always evident that it’s time to consider dentures, which is why paying close attention to a loved one’s oral health and ensuring they attend regular dental check-ups is so important. Common symptoms of tooth decay include pain, gum tenderness and bleeding, difficulty eating, and shifting or loose-feeling teeth.
Ill-Fitting Dentures Can Affect One’s Health and Quality of Life
A common problem among seniors is dentures that fit poorly. This can cause a great deal of pain and discomfort. A properly fitted denture should rest snugly against the gums, remain in place without sliding around and cause no pain. Of course, it takes some time to get used to wearing this new appliance, but it should not cause any irritation. When dentures don’t fit well, they may rub against the gums, causing soreness and swelling that only exacerbates the problem further. Left untreated, this can make wearing dentures and everyday activities like eating and talking intolerable.
“If dentures don’t fit well and seniors experience pain, they are likely to eat less or gravitate toward softer foods,” says Dr. Rodriguez. “They also don’t swallow the same way they used to. Not eating foods that they used to enjoy is another sign of unstable or uncomfortable dentures.” Poor diet and lower nutritional intake could lead to a variety of health and digestive problems. Furthermore, when ill-fitting dentures constantly rub on the gums, it can create a callus or growth in the mouth called an epulis. Oral surgery may be needed to remove epulides and ensure a better fit.
Natural changes in the gums and jaw can be another factor that causes increasing pain over time, even if a denture fit well initially. Over the years, our gums change and so does the bone and connective tissue underneath. These changes are especially pronounced in individuals who have experienced significant tooth loss, because the entire foundation of the mouth has been severely compromised. Most seniors don’t notice the changes to their mouth because they happen so gradually, but eventually their dentures no longer fit properly and begin to cause problems.
Health Conditions Can Affect Denture Fit
“Health conditions that are common among elderly people can affect dentures, gums and overall oral health,” says Dr. Rodriguez. The following health problems are common in seniors and can impact denture wearers.
Elevated Blood Sugar Can Impact Seniors’ Oral Health
Diabetics are at significantly greater risk for severe, progressive gum disease, which can cause painful, chronic inflammation that prevents dentures from fitting properly. Carefully managing blood sugar levels is important for overall health as well as that of the mouth.
Osteoporosis Accelerates Jaw Deterioration
When a senior has osteoporosis, the lower jaw bone can shrink significantly. Not only will this affect how dentures fit, but it can also change the shape of a person’s mouth and face. As the jawbone shrinks, so do gum tissues that support dentures, which are sometimes referred to as ridges. Ridges can shrink up to a quarter-inch over the course of 10 years, compromising the stability of dental appliances.
Medications Can Wreak Havoc on Your Mouth
There are approximately 500 commonly prescribed medications, including blood pressure drugs and anti-depressants, that cause dry mouth (xerostomia). Decreased saliva production has greater consequences than discomfort and seemingly insatiable thirst. Saliva aids in the consumption and digestion of food, rinses food particles out of the mouth, and prevents bacterial growth. Without enough of it, tooth decay and gum disease can develop more easily. Some medications can also have a direct effect on the gums by creating an exaggerated response to plaque and resulting in gum overgrowth. Immunosuppressants and other disease-fighting medications may reduce the body’s ability to combat infection, compounding the risks even further.
The Aftermath of Cancer Treatment
Certain chemotherapy drugs and radiation therapy of the head and neck can have serious oral side effects, including dry mouth, altered sense of taste, mucositis (inflammation of the insides of the cheeks and lips), gum swelling (which can interfere with the fit of dentures) and jaw stiffness.
Preventing Denture Discomfort
Ill-fitting dentures can be fixed by a dentist. Minor adjustments are likely to be necessary initially and as needed over the years, but Dr. Rodriguez says that three techniques are typically used to remedy more significant fit issues.
A new acrylic layer is added to the denture base so that it more closely fits the shape of the gums. If gum irritation is an issue, a softer, more flexible acrylic may be used for resurfacing instead of traditional hard acrylic.
A denture rebase is a good idea if the shape of a senior’s mouth has changed significantly. This is a cheaper option than starting from scratch because the artificial teeth have already been created and the base only needs to be remade to ensure a better fit.
Using implants to help secure dentures has become more common, and Dr. Rodriguez finds it to be an extremely effective solution. There are various types of implants that can be used to provide a solid foundation for dentures to attach to. This adds stabilization and prevents movement while eating and talking. Dr. Rodriguez recommends mini dental implants, which are smaller than basic implants. They are inserted into the bone using a minimally invasive procedure that usually involves only one or two visits to the dentist.
How to Care for Dentures Properly
It is a common misconception that false teeth require less maintenance than natural teeth. Seniors must still care for their mouths and their dental appliances to promote oral health. Dr. Rodriguez recommends the following tips for denture wearers:
- Clean and brush dentures every day. Plaque and tartar can still build up on denture surfaces just like they do on natural teeth.
- Use a toothpaste and toothbrush that are specially designed for dentures. Regular toothpaste and brushes are abrasive enough to scratch the surface of dentures.
- Soak dentures at night so they do not dry out and lose their shape. After removing and cleaning them, soak them in special denture cleanser overnight.
- Visit your dentist for regular hygiene checkups. Even seniors who have no natural teeth and wear full dentures should attend annual examinations for signs of gum disease and oral cancer. The dentist will also ensure proper denture fit.
- Store dentures in a safe place. These appliances are delicate and may break if dropped even a few inches. When they’re not in use, store them away from children and pets.