Periodontal Disease And Older Adults
The proverbial way of referring to older people as being "long on the tooth" suggests that it is predetermined that as we get older our teeth get "longer" or "no longer." This is not true. Periodontal disease and loss of teeth is not an inevitable aspect of aging. Loss of attachment or bone support around a tooth is the result of a bacterial infection. What is true is that as we get older, we have more exposures to these infectious organisms, and more probability of being infected and developing periodontal disease. Half of the people over 55 have periodontal disease.
Risk factors that make older adults more susceptible to periodontal disease include:
Systemic diseases:
Certain systemic diseases such as diabetes may decrease the body's ability to fight infection and can result in more severe periodontal disease. Osteoporosis also can increase the amount and rate of bone loss around teeth. Systemic illnesses will affect periodontal disease if it is a pre-existing condition. To reduce the effects of systemic diseases on the oral cavity, maintain meticulous plaque control and visit your dental care provider routinely for examinations and professional cleanings.
Medications:
Heart medications can have a direct effect on the gums by creating an exaggerated response to plaque and resulting in gum overgrowth. Antidepressants may create dry mouth and reduce the saliva's ability to neutralize plaque. Immunosuppressants and other disease-fighting medications may reduce the body's ability to combat infection, increasing the risk for periodontal disease. The dental care provider needs to be aware of any medications you may be taking and you need to maintain meticulous plaque control and visit your dental care provider routinely for examinations and professional cleanings.
Dry mouth:
Lack of saliva can result from the use of certain medications or as a result of illness. If there is not enough saliva available to neutralize plaque it can result in more cavities and periodontal disease. Also, dry mouth, or xerostomia, can make dentures more difficult to wear and may also complicate eating, speaking, or swallowing of food. Oral rinses or artificial saliva can be very helpful with these problems. Frequent sips of water or eating candy may be helpful as long as it doesn't contain sugar. Fluoride rinses and gels are helpful in reducing or preventing the cavities that can be caused by having a dry mouth.
Dexterity problems:
Physical disabilities can reduce dexterity and the ability to remove plaque on a daily basis. Poor oral hygiene can increase the risk for cavities and periodontal disease. Electric toothbrushes and floss holders are helpful in improving plaque control. Frequent professional cleanings combined with oral anti-microbial or fluoride rinses also may be helpful in reducing the incidence of cavities and periodontal disease.
Estrogen deficiency:
Older women may have some special concerns in relation to periodontal disease. Scientific studies have suggested that the estrogen deficiency that occurs after menopause may increase the risk for severe periodontal disease and tooth loss. Estrogen replacement therapy may reverse these effects.
It is important to keep teeth as we age because every tooth has an important function in chewing and speaking. They affect our appearance and self esteem. Having dentures or loose or missing teeth can restrict our diets, resulting in poor nutrition and systemic complications. With the advances in modern dentistry and with current prevention and treatment techniques, we must count on keeping our teeth for a lifetime - no matter how "long" that may be!
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.
Metal Based Denture vs Plastic - Which is Best for You?
A metal-based denture is one in which a portion of the denture body is made of a substantial metal casting rather than all plastic (acrylic resin). This procedure is usually done on the lower denture.
There are two types of metal-based dentures.
Standard metal-based denture
The metal base portion of the denture is in direct contact with underlying supporting tissues.
The base is fabricated from a special medical grade alloy that is hypoallergenic and very biocompatible with tissues. Generally, tissues in contact with this type of material are very healthy in appearance.
Modified metal-based denture
The metal base portion of the denture is not in direct contact with underlying supporting tissues. A soft or hard plastic liner may be interposed between the metal and supporting tissues.
A soft liner is generally preferred to hard plastic since it is more comfortable to wear; however, the soft liner usually should be replaced on an annual basis.
The Rationale for a Metal-Based Denture
Facilitates the avoidance of disruptive forces
Sometimes it is necessary to construct a very narrow denture in order to avoid any structures that would loosen the prosthesis, such as muscles flexing, and so forth. In addition, necessary surgical procedures to reposition a muscle attachment (called a frenum) can sometimes be avoided with these narrow type dentures.
However, such narrow dentures are weak and tend to break quite easily when fabricated just from plastic. A metal base provides the needed strength to design a very narrow denture in order to follow the confines of a patient's lower resorbed alveolar ridge (the remaining bony ridge). In addition, the metal base provides long-term dimensional stability and strength that is not enjoyed with an all-plastic denture base.
Provides a more natural feeling
The added weight of the metal base provides a more natural perception for many patients. Many patients prefer the additional weight on the lower jaw.
A private study measured the actual weight of cadaver jaw ridges and teeth that would normally be lost after the extraction of teeth and associated natural shrinkage of the jawbones. It was found that the weight of these tissues closely approximated the weight of a metal base. Therefore, it is likely that the more natural feeling perceived by persons wearing metal-based dentures is probably real rather than imagined.
The additional weight of a metal base also contributes to lower denture stability by causing the denture to settle down onto a jaw ridge.
Advantages of Metal-Based Dentures
- Very biocompatible and hypoallergenic with healthy-appearing supporting tissues
- May include a soft liner
- Can be relined easily
- Provides added strength for easily broken narrow dentures
- Facilitates fabrication of stable narrow-based dentures that are designed to avoid contact with disrupting muscle forces
- Sometimes facilitates the avoidance of surgical procedures to reposition frenum
- Patients perceive a more natural feeling from the added weight
- Weight may contribute to additional denture stability
- Dimensionally very stable when compared to all-plastic-based dentures during fabrication and over time
Disadvantages of Metal-Based Dentures
- Generally difficult to reline standard metal-based dentures; modified metal-based dentures (described earlier above) are easier to reline
- More costly to fabricate
by Joseph J. Massad, D.D.S.
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.