The Aging Smile: 7 Causes of Tooth Loss in Older Adults

As we age, our pearly whites naturally weaken and become more prone to damage, disease, and tooth loss. Gums also recede with age, exposing more of the tooth surface to potential damage and loss.

Losing teeth was once an inevitable part of growing older. But today, we are lucky to have ways to preserve teeth and gums for a lifetime of brilliant smiles.

What causes tooth loss in the first place?

To learn how to prevent tooth loss, we need to know why it happens.

1. Tooth decay

Tooth decay is one of the leading risk factors for tooth loss. Also known as cavities or caries, it occurs when plaque builds up on teeth, eventually causing damage to the enamel and dentin. Plaque is a sticky film containing bacteria. When it comes in contact with sugar or starch in your mouth, the bacteria release acids that attack tooth enamel. Cavities form holes in your teeth and require fillings, or possibly tooth extractions, if left untreated.

Seniors have a higher risk of tooth decay for several reasons. For example, dry mouth (more on this dental problem below) is a common side effect of medications. It reduces saliva flow, which helps wash away plaque and neutralize mouth acid. In addition, mobility and cognitive issues can make proper brushing and flossing difficult.

2. Gum disease

Gum disease, or periodontitis, is an infection of the tissues and bone supporting your teeth. Plaque buildup along and under the gum line causes this oral disease. The bacteria in plaque damage the gums and supporting bone, causing the soft tissue to pull away from teeth. This results in pockets that become infected and swollen, causing teeth to loosen or fall out over time.

Periodontitis is preventable with good oral care, but the risks increase with age due to the same factors contributing to tooth decay. Treatment may involve deep cleanings, oral surgery, and, in severe cases, tooth extractions, when teeth can no longer be saved.

Maintaining a regular dental checkup schedule, brushing teeth twice daily, flossing, limiting sugary foods, and not smoking can help reduce risks significantly.

3. Dry mouth

Saliva naturally helps wash away food and neutralize plaque acids. However, many prescriptions and maintenance drugs reduce saliva flow, causing dry mouth and making teeth more prone to cavities and gum disease.

Chewing sugar-free gum, avoiding sugary and acidic foods, drinking plenty of water, and using over-the-counter saliva substitutes can help.

Additional resources: Why Your Mouth Is Always Dry and How to Get Rid of Dry Mouth

4. Grinding and clenching

Grinding or clenching teeth, known as bruxism, can crack, fracture, and loosen teeth over time.

A family dentist in Chandler, Arizona, may fit you with a mouthguard to prevent damage from these involuntary habits. Managing stress through exercise, meditation, or counseling may also help, along with diligent at-home care, regular dental checkups, and treatment for any underlying conditions.

5. Poor dental care habits

Taking good care of your teeth and gums, especially as you age, is worth the effort to maintain not only the health and appearance of your smile, but to enjoy the ability to chew good food.

Many seniors experience accelerated oral health issues and tooth loss due to improper dental care during their younger years. Developing good dental habits from an early age can help teeth last well into older adulthood. Having said that, note the following:

• Neglecting to brush twice daily with a fluoride toothpaste can lead to plaque buildup, caries, gum disease, and tooth loss.
• Not flossing once a day turns the nooks and crannies of your teeth into ideal breeding grounds for bacteria.
• Not seeing a dentist for professional cleanings and oral exams contributes to oral health problems and tooth loss. Dentists can detect issues early, provide preventive treatments, and advise you on the best ways to care for teeth between visits. Even if your smile is a 10/10, a dental visit at least twice annually is recommended for all, especially if you are over 60.
• A diet high in sugars and acids (e.g., desserts, candy, juice, coffee, alcohol, carbonated drinks, processed meats, etc.) erodes enamel and feeds the bacteria that cause decay. Consume these examples in moderation and remember to brush your teeth 30-60 minutes after to minimize damage. Acidic foods and beverages also weaken teeth gradually.
• Smoking increases your risk of developing oral cancer, cavities, and gum problems. This bad-for-your-oral-health habit also puts you at risk of complications after oral surgery or any invasive dental procedure.
• Using your teeth as tools, like how Hailey B. uses hers to open beer bottles, can lead to cracking and breakage. Teeth are for chewing food, not for opening things or performing party tricks. Misusing your teeth in such dangerous ways can result in costly repairs or extractions.

6. Health Conditions

The following health conditions can increase the risk of tooth loss in seniors:

• Diabetes: If you have diabetes, you have a higher chance of developing gum disease, dry mouth, and other dental problems that can lead to tooth loss. If your blood sugar level is high, it’s also high in your saliva, providing an ideal environment for bacteria to grow and multiply. In fact, people aged 50 or older with diabetes are 56% more likely to have fewer than eight teeth than adults without diabetes. Be sure to manage your blood sugar, brush your teeth and floss daily, and see a dentist regularly for a professional cleaning and exam.

• Osteoporosis: Osteoporosis makes teeth more prone to loosening or falling out. As bone density decreases, the jawbone supporting your teeth may also weaken. Some of the medications prescribed to treat bone loss may also cause dry mouth, another risk factor for tooth loss. Ask your healthcare provider about calcium and vitamin D supplements to help strengthen your bones. Also, use a soft-bristled toothbrush and fluoride toothpaste to prevent damage to weakening teeth.

• Respiratory disease: Chronic lung conditions, like chronic obstructive pulmonary disease (COPD), raise the risk of gum disease and eventual tooth loss. In one meta-analysis, the researchers found that many COPD patients have severe gum disease. They have fewer remaining teeth, more inflammation and gingival bleeding, deeper periodontal pockets, and poor oral hygiene. If you have COPD, collaborate with your dentist and pulmonologist to manage your oral and lung health.

Ensure to schedule regular dental and overall health checkups so your doctors can detect signs of disease and take early action.

7. Medications

Certain medications can impact oral health and raise the risk of tooth loss. For instance, many classes of drugs typically prescribed to older adults can cause dry mouth, which, as mentioned, can make teeth more likely to develop cavities and gum disease. These medications include:

• Antihypertensives (for high blood pressure) like diuretics
• Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)
• Antihistamines (for allergies) like diphenhydramine
• Narcotic pain relievers, including hydrocodone and oxycodone

Other classes of drugs have additional oral side effects:

• Bisphosphonates, commonly used to treat osteoporosis and other bone conditions, may lead to osteonecrosis of the jaw. This rare but serious condition causes bone cells in the jawbone to die and poke through an opening in the gums.
• Oral steroids like prednisone, often prescribed for autoimmune diseases, can lead to oral infections and delayed healing.
• Chemotherapy drugs used to address cancer may harm cells within the mouth, causing side effects like painful teeth and gums. Radiation therapy directed at the head or neck region also puts patients at high risk for dry mouth, tooth decay, and osteoradionecrosis, which causes bone loss in the jaws.

Close collaboration between medical and dental providers is key to maintaining good oral health and avoiding tooth loss from medications or treatments. Preventive care and early detection of problems can help teeth last a lifetime, even with health conditions and prescription drugs.

A Final Word

Many adults born in the early to mid-1900s did not have the privilege of fluoride toothpaste and education about proper hygiene as children, contributing to a lifetime of dental problems. But it’s never too late to develop good dental habits. Reading this guide and getting a family dentist is the first step to improving a smile at any age.

For specialized dental care tailored to your needs as you age, visit Kyrene Family Dentistry. Our team of dentists and hygienists have extensive experience helping patients of all ages maintain excellent oral health and quality of life. Contact us to schedule your appointment.