Laura J. Martin, MD
Disembodied dentures smiling back at you from a glass. A sunken-in, toothless face. Hours in a dental chair, awaiting expensive implants.
If images like these give you the heebie-jeebies, take heart. Although tooth loss is common, it's not an inevitable part of aging, says Richard H. Price, DDS, a retired dentist in Newton, Mass., and spokesman for the American Dental Association.
"Teeth do not die a natural death -- we kill them," Price says. Exactly how do we do that? In short, by disease or trauma, Price says.
"When an irresistible force meets the immovable object, something gives," Price says. Trauma might be anything from getting hit by a baseball to biting on a frozen candy bar.
Your teeth are great tools. But not for things like:
Clenching and grinding - often done in response to stress -- can also put too much stress on your teeth. It can also mean a bite is unbalanced, Price says. Both deserve your attention.
Plaque -- bacterial buildup that resides in sticky stuff on your teeth -- causes decay and can lead to periodontal disease, which inflames gums and destroys supporting tissues such as ligaments and bones. And with their demise can come loose -- and eventually lost -- teeth.
Poor oral hygiene and lack of professional care are big contributors.
Other factors that put you at greater risk for periodontal disease and potential tooth loss include:
Changing hormones during pregnancy can also affect a woman's response to disease. So it's especially important to get regular professional care throughout pregnancy.
People with developmental and other disabilities are at greater risk as well, due to the challenges of home care. This means caregivers need to be creative about helping with this task.
Early onset of periodontal disease is another concern. "If I see a patient under 40 with periodontal disease, that's worrisome to me because I know this person will be particularly susceptible," says Donald S. Clem III, DDS, a periodontist in Fullerton, Calif., and the 2010-2011 president of the American Academy of Periodontology.
Dental care to prevent tooth loss is a partnership between you and your dentist. Make those routine appointments and keep them.
How often you need to go depends on your particular case. Twice a year is typical, but if you have gum disease, you may need to go more often.
Make sure your dentist is doing a complete periodontal evaluation at least yearly, Clem says. This includes measuring spaces under gums with a periodontal probe and getting a complete set of X-rays to assess bone levels.
First, wash your hands. Brush twice a day with a soft-bristled toothbrush and floss once a day.
"You wouldn't have to floss if you could reach all the parts of your mouth with a toothbrush, but you can't -- no more than you can vacuum a whole house without certain attachments for getting into corners," Price says. If you don't know how, ask your hygienist or dentist.
Other tips to prevent bacterial growth:
Clenching and grinding can wear down your teeth. Stress control and relaxation techniques can greatly help. Also, if you clench and grind at night, your dentist can make a bite guard to even out the stresses on your teeth.
Whether it's stress management, a healthy weight, getting enough sleep, or nutritious food, many healthy lifestyle habits can cut your odds of periodontal disease or slow its progression.
"The better you take care of your body, the broader the health benefits," Clem says.
You don't need a special diet. Sound nutritional habits will do the trick. However, meeting your daily requirements for calcium and vitamin C, plus plenty of water, may be especially helpful for your teeth and gums.
"We know that sugar is a super fuel for bacteria that produces acids and enzymes," Price says. "So either cut down on the sugar or get it out of your mouth before it produces harm."
If you do lose your teeth, it may limit your diet.
"People who don't have their teeth tend to eat soft, high-carbohydrate diets," Clem says. "They are not able to eat high-protein, high-fiber foods, which are even more important as they age." And that could contribute to a whole host of other problems, such as heart disease or diabetes.
Smoking affects the blood supply that feeds your gums, increasing the incidence and severity of periodontal disease.
"Smokeless tobacco has an even more deleterious [harmful] effect on gums," Price says.
Smokers are harder to treat, says Clem, and their response to treatment is less predictable. But if you quit smoking, you'll cut your odds of heart disease, as well as periodontal disease.
If you have a chronic disease, you may need to take extra care of your teeth.
People with poorly managed diabetes, for instance, may have difficulty with fighting infection and wound healing.
If you have diabetes, you need to pay special attention to blood glucose control, as well as dental care and regular checkups.
Contact your dentist if you see signs of periodontal disease: red, sore, or bleeding gums.
Attention, parents: Just as with other aspects of early development, good prenatal care and nutrition can promote healthy tooth development. It even matters during pregnancy. "Teeth start erupting in the third to fifth month of pregnancy," Price says.
A few reminders for parents:
SOURCES:Richard H. Price, DDS, retired dentist, Newton, Mass.; spokesman, American Dental Association.Donald S. Clem III, DDS, periodontist, Fullerton, Calif; 2010-2011 president, American Academy of Periodontology.American Academy of Periodontology: "Survivors May Have 32 Endangered Species Living in Their Mouths," "Gum Disease Found to Be Significant Public Health Concern," "Researchers Find Nine Risk Indicators for Tooth Loss," "What the Most Important Item to Bring on Vacation?" "Another Reason to Stay in Shape: Healthy Teeth and Gums," "Smoking and Sleep Top the List of Lifestyle Factors Impacting Oral Health," "Nourish Your Smile with a Well-Balanced Diet," and "Controlled Diabetics Have Reason to Smile."National Institute of Dental and Craniofacial Research: "Dental Care Every Day: A Caregiver's Guide" and "Diabetes: Dental Tips."
National Diabetes Information Clearinghouse: "Prevent diabetes problems: Keep your teeth and gums healthy."
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