The aging mouth: differentiating normal aging from disease

Abstract

Aging is the physiologic change that occurs over time. In humans, this change occurs at different rates and are related to lifestyle, environment and genetics. It can be challenging to differentiate normal aging from disease. In the oral cavity, with increasing age the teeth demonstrate wearing of the enamel, chipping and fracture lines, and a darker color. The pulp chamber and canals are reduced in size as a result of the deposition of secondary dentin. Coronal or root caries, however, represent disease. A limited amount of periodontal attachment loss occurs in association with aging, usually manifesting as recession on the buccal surface of teeth. Severe periodontitis occurs in 10.5-12% of the population, with the peak incidence being observed at 35-40 years of age. Changes to the mucosal tissue that occur with age include reduced wound-healing capacity. However, environmental factors, such as smoking, dramatically increase the risk of mucosal pathology. Reduced salivary gland function is often seen in association with medication usage, as well as with disorders such as diabetes mellitus. Both medication use and chronic disorders are more common in older adults. Masticatory function is of particular importance for older adults. Maintenance of a nutritionally complete diet is important for avoiding sarcopenia and the frailty syndrome. Successful oral aging is associated with adequate function and comfort. A reduced, but functional, dentition of 20 teeth in occlusion has been proposed as a measure of successful oral aging. Healthy oral aging is important to healthy aging from both biological and social perspectives.

Herpesvirus‐bacteria synergistic interaction in periodontitis

“…Periodontitis is a polymicrobial infectious disease characterized by loss of the periodontal ligament and alveolar bone. Most periodontitis starts in the third decade of life but can debut at any age . Severe periodontitis is estimated to affect 8.9% of US adults and 11% of the global population .…”

“…Maintaining a healthy periodontium depends on proper self‐care, but current methods of oral hygiene require considerable patient commitment, and are often inadequately implemented . Oral rinsing twice‐weekly with 0.25% sodium hypochlorite (dilute household bleach) can markedly improve the subgingival microbiota and the periodontal status, even in unscaled deep pockets, and constitutes a valuable adjunct to traditional patient self‐care …”

Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

“…These findings may be explained by the patterns of need amongst adults described by successive epidemiological surveys highlighting trends in dental caries and periodontal disease by age [4,40,41], sex [4,42], and socioeconomic status [4,43,44], greater tooth loss and reliance on dentures in older people [4,45–47], and the contemporary approach to care within the service [48]. Socio-economic deprivation is well accepted as predicting self-reported dental need [4,49], and higher requests for tooth extraction have been demonstrated among deprived groups [50].…”

Geriatric periodontology: how the need to care for the aging population can influence the future of the dental profession

“…Lamster et al. present the concept that changes occur in the oral cavity as a consequence of aging, and these must be differentiated from true oral/dental disease. In association with aging, changes occur in all organ systems.…”