Oral Health for Seniors: 6 Tips For Keeping Your Teeth and Mouth Healthy as You Age

• Oral health is important for all ages, but elderly individuals are at a higher risk of developing oral health issues than younger populations.
• Oral health issues that affect geriatric health often occur due to the effects of aging, as well as chronic conditions and medications that contribute to oral health issues.
• Prevention is key to avoiding oral health issues by flossing and brushing your teeth daily, as well as managing any chronic conditions that impact oral health.

Oral health is essential for everyone, regardless of age. Failing to care for our teeth, gums, and mouth can not only cause oral health issues but also impact our overall health. What most people don’t realize is that oral health impacts the well-being of our entire body, specifically our stomachs and our hearts. If we are poor at maintaining our teeth and oral hygiene, it can lead to other health complications such as endocarditis, cardiovascular disease, and more.

Older adults, in particular, may have more difficulty maintaining their oral hygiene, often due to the effects of aging and their current health status regarding any chronic conditions or obstacles in their everyday care.

As we age, there is also an increased risk of oral health problems due to a lack of maintaining proper oral hygiene routines, including cavities, gum disease, tooth decay, tooth loss, oral cancer, and more. Studies show that older adults are twice as likely to have cavities as younger adults. Reasons for this can include dry mouth, as well as certain chronic diseases that can impact your oral health. 

However, many of these oral health problems can be prevented with simple, everyday maintenance and care. Even recent research shows that older adults are able to keep their natural teeth longer and maintain better oral health than even two decades ago; they just have to be willing to put in the work with their oral care.

As stated above, there are a variety of reasons linked to poor oral health for seniors that range from lack of basic maintenance to chronic health conditions that impact their hygiene. Some of the most common causes include dry mouth and chronic illnesses like diabetes.

Dry Mouth

One cause of poor oral health in seniors is a lack of saliva production, commonly referred to as ​‘dry mouth’. Dry mouth typically occurs when you’re dehydrated, but it can also be a side effect of certain medications or treatments you may be taking for other illnesses (some common medications/​treatments linked to this side effect include Benadryl for allergies and radiation for head or neck cancer). 

Dry mouth can also occur due to a condition called salivary gland dysfunction, which affects the salivary glands and disrupts saliva production. According to the American Dental Association, dry mouth is one of the most common conditions dentists see in the older adult population. The reason it leads to oral health problems is that saliva not only keeps your mouth wet, but it also helps to neutralize acids, kill germs, and prevent bad breath. It plays an important role in preventing gum disease and tooth decay by protecting your enamel. Not to mention, dry mouth can make it difficult to chew, swallow, and even speak.

Staying hydrated can go a long way to preventing dry mouth; taking small sips of water throughout the day is ideal. However, if your dry mouth is caused by a medication or medical condition, you should consult a dentist or healthcare provider, who may recommend fluoride treatments or using a fluoride toothpaste to help combat future oral health issues.

Chronic Illnesses

Older adults run a higher risk of developing certain chronic conditions, with the more frequently occurring conditions being diabetes, heart disease, cancer, or rheumatoid arthritis. Studies suggest a possible connection between poor oral health and certain conditions. People who have a chronic disease are more likely to develop gum disease and tooth decay. Gum disease can cause inflammation and infection that affects other parts of the body, including the heart, brain, and kidneys. Research also shows that chronic conditions can increase the likelihood of developing oral health issues.

Due to the higher likelihood of experiencing chronic illness, older adults are also more likely to take multiple medications at once, which can contribute to dry mouth. The Centers for Disease Control and Prevention (CDC) reported in 2019 that 1 in 5 adults between the ages of 60 and 79 take at least five prescription drugs in the United States.

Joint conditions, such as arthritis, can make it difficult for seniors to hold a toothbrush or floss regularly without experiencing pain. Options like using an electric toothbrush, water picks, or having a caregiver assist with oral hygiene tasks can be helpful.

Mild cognitive impairment from illnesses such as dementia or Alzheimer’s can also make it difficult to care for oral health, often due to memory loss that disrupts the ability to keep an oral hygiene routine. For seniors struggling with cognitive conditions, it’s imperative to have a caregiver close by or a loved one to help them maintain their hygiene and day-to-day tasks.

There are multiple dental diseases seniors can develop, such as gum disease, tooth decay, and more.

Gum Disease

Gum disease, also known as periodontal disease, occurs when bacteria and plaque buildup enter through the gum line, causing inflammation and infection. Typically, gum bleeding and swelling of the gums can indicate signs of gum disease. Seniors who struggle to maintain daily oral health care may be at a higher risk for gum disease.

Tooth Decay

Tooth decay, also known as dental caries, occurs when the enamel (the hard outer layer that protects your teeth) begins to erode due to plaque buildup over time. Dental caries often lead to issues such as cavities. 

Brushing and flossing regularly can help prevent tooth decay, but once a cavity forms, a dentist will need to fill it in to prevent further damage. While cavities may seem small, untreated tooth decay can lead to more severe issues later on, such as tooth pain or tooth loss.

Tooth Loss

Tooth loss occurs when another oral condition, such as gum disease or tooth decay, remains untreated for a prolonged period. This can result in the erosion of the gums and supportive bone, causing teeth to loosen and fall out. To address this, a dentist may recommend using crowns, bridges, dental implants, or dentures to prevent tooth loss or replace missing teeth.

While aging does have effects on your dental health, it’s not inevitable to experience tooth loss because you’re getting older. Taking care of your oral health can help you retain your natural teeth without needing to wear dentures.

Oral Cancer

Oral cancer, also called mouth cancer, is a type of cancer that can develop on the lips, mouth, tongue, cheek, or throat. Squamous cells in your oral cavity can change and begin to multiply rapidly, causing symptoms such as sores, gray or white patches in your mouth, excessive bleeding in the mouth without apparent reason, numbness, or difficulty chewing and swallowing.

Oral cancer is diagnosed at a much higher rate in older adults, and the most common cause is due to smoking cigarettes or using smokeless/​chewing tobacco. Other causes include drinking alcohol excessively, having a family history of oral cancer, or having HPV (Human Papillomavirus).

If you find any abnormal sores or patches in your mouth or experience any of the symptoms outlined above, it’s critical to speak with your dentist immediately so you can be diagnosed and treated.

#1: Floss Daily

Flossing between your teeth is a crucial way to prevent dental plaque buildup that brushing your teeth alone can’t reach. Strive to floss at least once a day.

If you have trouble flossing, consider trying alternatives to make flossing easier, such as:

• Waterpik: a device that forcefully shoots water to help dislodge plaque and buildup
• Floss picks: small handheld picks with floss pre-strung
• Interdental brushes: small, pointed brushes that can help clean between teeth

#2: Brush Twice a Day

While it may seem obvious, brushing your teeth daily is essential for keeping your teeth and gums healthy. The typical recommendation is to brush twice a day, in the morning and at night before sleeping.

Using a manual toothbrush can be challenging if you have certain chronic conditions, such as arthritis. Using an electric, battery-operated toothbrush can make the process easier, as its bristles may be able to remove plaque more effectively than those of a manual option.

Your choice of toothpaste is also important to consider. Toothpaste with fluoride helps protect your enamel, preventing cavities, gum disease, and other dental issues.

#3: Attend Your Dental Checkups

You should strive to have a professional dental checkup and teeth cleaning at least once a year, performed by a dentist or dental hygienist. In fact, it’s recommended to see the dentist every six months for a regular cleaning. 

Checkups can help detect potential issues like cavities and gum disease early, allowing them to be treated before the conditions worsen. Getting a professional cleaning can also help remove plaque and buildup that you may have missed on your own.

#4: Stop Smoking and Using Tobacco Products

Smoking not only increases your risk for chronic diseases, but it can also significantly impact your oral health. Smoking often causes dry mouth, which can lead to tooth decay and an increased risk of tooth loss. Smokeless tobacco products can also affect tooth and gum health. Smoking and smokeless tobacco products are also among the leading causes of oral cancer in older adults.

Additionally, if you drink alcohol, consider abstaining or reducing your consumption, as it can also cause significant dehydration and dry mouth.

#5: Clean Dentures Daily

If you wear dentures, it’s still essential to maintain your oral health. Whether you have a full set of dentures or a partial, you can still experience gum disease, fungal infections, and more if you aren’t properly cleaning your dentures. Brushing with a denture-care product and placing them in a denture-approved care liquid can help prevent stains and buildup that can cause bad breath. Be sure not to wear dentures overnight, as this can cause swelling in your gums.

It’s also important to note that nightguards, mouth-guards, retainers, and other dental gear can lead to oral health problems if not properly cleaned. Similar to dentures, be sure to brush your dental gear daily to ensure it doesn’t lead to buildup on your teeth and cause cavities to form.

#6: Stay Hydrated

To keep your mouth from drying out, staying hydrated is important. Keeping a water bottle nearby or being intentional about taking small sips of water throughout the day can help keep your mouth hydrated. If a medication or medical condition is causing dry mouth, consult a healthcare professional or dentist for advice on how to keep your mouth hydrated.

# 7: Avoid Sugary and Sticky Foods When Possible

It’s no secret that sugary foods can lead to cavities and other oral health issues. Cavities and tooth decay occur when acid produced by bacteria attacks your enamel. Sugar often feeds and energizes the bacteria, resulting in further acid production. Similarly, sticky foods cling to teeth for longer periods, allowing bacteria to feed, which in turn results in more acid. 

While you can’t avoid all sugar, doing your best to limit sugar consumption and sticky foods, like candy, sodas, and gum, can help protect your teeth from tooth decay. However, switching to sugar-free versions can be beneficial, particularly sugar-free gum, which can stimulate salivary production and help with dry mouth symptoms. 

Here are a few recommended guidelines by dentists for a daily oral health care routine:

Floss Daily

You can’t reach food and plaque buildup between your teeth by brushing alone, so it’s important to floss once a day at least. Here’s a step-by-step flossing guide:

1. Use a piece of floss approximately 18 inches long and wrap the ends around your middle fingers. 
2. Use your forefingers and thumbs to wrap the floss in a C‑shape around one of your teeth. 
3. Then, proceed to clean the tooth by moving the floss in strokes up and down, approximately ten times. 
4. Repeat this process with each of your teeth.

Brush Twice a Day

It’s recommended to brush your teeth twice a day, typically once in the morning and once at night before bedtime. Using a soft-bristled toothbrush and fluoride toothpaste, angle your brush at a 45-degree angle toward your gum line to ensure you’re removing plaque along the gums. Brush your teeth on both sides for about two minutes to ensure you’ve covered all the surface area.

Brush Your Tongue

Your tongue can be an easily overlooked area when brushing, but it harbors a significant amount of bacteria. You can brush your tongue using your toothbrush, or you can purchase a tongue scraper to help remove the bacteria.

Use an Antibacterial Mouthwash

Using an antibacterial mouthwash once a day can help remove remaining food and plaque buildup, as well as eliminate oral bacteria. It’s recommended to use a mouthwash without alcohol, since alcohol can cause dry mouth.

Clean Dental Gear

Cleaning dental gear daily helps ensure no buildup is lingering on your teeth or gums. Purchasing cleansing tablets that can eliminate bacteria in a matter of hours in addition to brushing your dental gear daily, can help them remain clean and ready to use.

Unfortunately, Original Medicare (Parts A and B) does not cover routine dental care. In some cases, Medicare may cover certain dental services if they are medically necessary and part of a comprehensive treatment plan, such as dental work required before cancer treatments or organ transplants. However, typical dental procedures, such as cleanings, checkups, fillings, and dentures, are not covered by Original Medicare.

Some Medicare Advantage Plans (Part C) may include dental coverage; however, the specific coverage details vary, so it’s best to consult your insurance provider to determine what is covered.

Does Medicaid?

Medicaid plans may have some dental coverage options or the ability to add adult dental benefits to an existing Medicaid plan. However, the coverage variability differs from state to state, so you’ll want to determine if options are available in your area.

Ways to Find Affordable Dental Care

If you don’t have coverage through a different source, it’s worth considering private dental insurance. Dental insurance plans can be sold as standalone options, though you will want to do your research regarding what the plan covers and the costs associated (such as premiums, deductibles, and co-pays).

Dental care can become expensive, especially if you’re low-income, live in a rural area, or have pre-existing dental issues or oral diseases. While overall dental health has improved since the 1960s, disparities persist that contribute to a lack of health equity in dental care. However, there are some ways to find affordable dental care if you don’t have coverage, such as:

• Dental School Clinics: Some dental clinics offer dental services performed by dental students for a reduced cost. Experienced dentists are present to supervise students while they perform the services. Use the NIDCR database to find dental clinics in your area that offer these services.
• Dental Hygiene Schools: Like clinics, some dental hygiene schools offer discounted services performed by dental hygienists in training. Contact your local school or university to see if they offer any of these programs near you.
• Income-Based Dental Clinics: Depending on where you live, there may be dental offices or clinics that provide services and charge based on your income. Visit this resource for a list of state oral health programs to see if any exist near you.
• Community Health Centers: Some community health centers offer dental services at a lower rate. Contact your local community health center to see if they offer these services.

As loved ones age, certain medical conditions and physical limitations can make it difficult to maintain good oral hygiene. Caregivers are responsible for maintaining the dental health of their loved ones, which is crucial in preventing them from developing oral health issues. Additionally, other chronic diseases can result in poor oral health, such as cardiovascular disease, diabetes mellitus, and dementia. Taking medication for medical conditions can also cause chronic dry mouth, making it crucial to take care of the gums and teeth from bacteria and infection.

Caregivers can provide support by reminding their loved ones to brush their teeth and floss, assisting them with brushing and flossing, arranging and accompanying them to dental checkups and cleanings, and more. Here are some resources to help caregivers support their loved ones in maintaining a healthy mouth, gums, and teeth.

• The National Institute of Dental and Craniofacial Research offers resources and tips to help caregivers ensure their patients or loved ones maintain good oral health. They also provide a resource list for finding affordable dental care.
• The Family Caregiver Alliance has a webinar and other resources about oral health for caregivers.
• The Alzheimer’s Association has recommendations for dental care for those with Alzheimer’s or dementia.