From Baby Teeth to Senior Years: How Dental Care Needs Change at Every Stage of Life
The dental problems that can come with every decade of life don’t just affect our teeth – they affect our general health. Detecting, addressing and preventing oral problems early contributes to a future with fewer chronic, painful – and expensive – dental conditions.
The first teeth are more important than many parents know
Dental decay can often start as early as the first teeth erupt, which is sometimes before the child turns one year old. One condition, known as baby bottle tooth decay, happens when sugary liquid clings to erupted teeth during night-time feedings. It is one of the simplest dental conditions to prevent, yet it is shockingly common.
The first teeth play important roles – helping with speech and saving space for the permanent teeth. The loss of a primary tooth due to decay leads to a shift in the neighbouring teeth, permanently damaging the alignment of the dentition. The first dental appointment should ideally happen at the age of one, or six months after the first tooth erupts. The fluoride varnish, which the dentist will paint on the teeth, has an incredible ability to protect the young enamel from the onslaught of bacteria and sugar that it will be exposed to in the following years.
Childhood and the prevention window
Children between the ages of four and twelve years have a very dynamic oral development. The primary dentition is lost and replaced by permanent teeth, while the first and second molars erupt – and they have deep pits and fissures that are prime locations for bacterial plaque to accumulate.
The fissures and pits on the chewing surfaces of the first and second molars are prime sites for cavities to develop. Sealing these grooves with dental sealants – especially when the teeth have just erupted – is one of the simplest preventive procedures available. It is also extremely effective, as it creates a barrier that the bacteria cannot penetrate. It is critical, however, to apply fissure sealants when the teeth are free from decay.
It is in childhood that dietary habits often develop that will stay with the person for life. The frequent consumption of highly-sugared juice and sports drinks throughout the day exposes teeth to continuous acid attacks. Such eating patterns create a cascade of physiological events that will almost certainly lead to tooth decay.
Adolescence: hormones, hardware and new onset conditions
Hormonal flares during puberty can make gingival tissues more sensitive to plaque accumulation, leading to increased inflammation and bleeding. Orthodontic appliances, which are often placed during adolescence, also create additional challenges for oral hygiene maintenance, as food particles and bacteria tend to accumulate in the bracket and wire area. Sports and energy drinks that are popular among adolescents have an extremely acidic pH that accelerates demineralization when combined with the effects of the pubertal hormone surge.
Wisdom teeth erupt between the ages of seventeen and twenty-five and often cause numerous problems for the owner, including impaction, crowding, infection and more.
Stress and the mouth in early adulthood
The period between the ages of twenty and forty is often defined by stress, and many people who suffer from it subconsciously grind their teeth. Often, this condition, known as bruxism, presents with excessive tooth wear and flattened tooth surfaces. It can also give the teeth a flattened appearance if the grinding occurs on specific areas of the tooth surface. The enamel can wear thin enough to expose the yellowish dentin underneath. Left untreated, bruxism causes temporomandibular joint syndrome, characterized by pain in the joint and muscles of the jaw, with radiating pains in the ear and neck area.
A nightguard is often all that is needed to alleviate the symptoms – while it does not stop the grinding, it prevents the teeth from wearing down and creates a barrier that protects the enamel. If you wake up with a dull pain in your jaw area, regularly get headaches around the temple region, or notice unusual tooth wear, we recommend that you contact a Dentist in Cannington to fabricate a nightguard and assess your condition.
The biology of stress and periodontal disease
Stress suppresses the immune system on a systemic level, rendering the body unable to combat common illnesses as efficiently as under normal conditions. The same mechanism explains the effect of stress on the gums – the stress hormones decrease the ability of the immune system to control the bacteria present in the gum pockets. The increase in concentration of proinflammatory cytokines suppresses the breakdown of connective tissue and bone – but only temporarily.
As a result, chronically stressed adults are more likely to develop periodontitis, even with adequate oral hygiene, compared to their peers. Stress also causes decreased salivation, which leaves the teeth more prone to bacterial infections – saliva is the number one ally in the continuous fight against tooth decay. For the same reason, stress reduces remineralisation and causes dry mouth conditions.
There is a very high likelihood that at least some of the people close to you have untreated decay – approximately 30% of Australians between 25 and 44 have untreated tooth decay, compared to approximately 18% of the general population. A large part of this disconnect can be explained by the fact that stress often goes hand in hand with the formation and maintenance of poor oral hygiene. People who suffer from it often believe, incorrectly, that they have taken all possible measures to avoid dental disease – while neglecting the crucial role their stress levels play in the process.
Pregnancy and the mouth
Hormonal fluctuations that occur during pregnancy make pregnant women more susceptible to periodontal disease, just like teenagers. Pregnancy gingivitis affects the majority of pregnant women, often persisting after the pregnancy ends. Left untreated, it progresses to periodontitis.
Pregnancy can sometimes see the occurrence of pregnancy epulis or granuloma – a benign overgrowth of the gum tissue caused by local irritation. It can be quite a nuisance, often presenting with pain and easy bleeding, though rarely does it persist after birth. The oral health of the mother directly affects the wellbeing of the child; periodontitis has been linked to preterm birth, fetal distress and low-birth-weight deliveries. The oral flora of the mother can also be passed to the child – in particular, the bacteria that cause tooth decay have been successfully isolated and transmitted through shared utensils or kisses. Oral health throughout pregnancy is an important part of maternal health.
Middle age and the consequences
In your forties and fifties, the damage that was done starts to show. Composite fillings and crowns begin to show signs of wear as the result of the continuous mechanical stresses to which they are subjected. They can fracture, develop secondary caries at the borders or simply become worn down, becoming a liability for the tooth structure.
In middle age, the early stages of periodontitis – which steadily progressed since the early stages of adulthood – become apparent on the X-ray. The effects of continuous acid exposure – decades of consuming soft drinks and sour foods – start to show in a dramatic loss of both hard and soft tissues. This is also the age when periodontitis can begin – it is most common to observe its onset in menopausal women.
It is in middle age that the preventative dentistry really pays off, as saving a failing restoration or predicting periodontitis before it reaches the late stages is comparatively cheap and simple compared to the alternative.
Dentistry in older adults is a specialty in itself, with its own set of challenges
Many older adults have different requirements stemming from the difficulties associated with age. The most common challenge is presented by the medications that many seniors take – a common side-effect of which is xerostomia, or dry mouth. The reduced flow of saliva compromises the protective function of the mouth fluids, which increases the risk of tooth decay, especially root caries. Compared to the crown, the root dentin is much more prone to bacterial attack and decay.
Prosthetic treatments such as implants, bridges or dentures become necessary for many seniors, and the procedures associated with their maintenance become more involved as the patient ages. Conditions such as arthritis often prevent seniors from using a standard toothbrush, making alternative methods of plaque control necessary. Declining mental sharpness often prevents seniors from reporting the discomfort that they feel in their mouths, while delirium can prevent them from cooperating with standard dental procedures. Many conditions that are relevant to seniors can have dramatic consequences for oral health – and if not addressed, they can become life-threatening.
Preventive maintenance and the importance of every stage in life
Every step that was discussed above has one simple idea behind it: conditions that often develop in later life and are expensive to treat can often be prevented or delayed if diagnosed early enough.
A professional oral cleaning at every stage in life not only removes calculus but also acts as an important diagnostic tool. At every stage, the dentist can identify developing carious lesions, assess the degree of gingival inflammation and attachment level, evaluate the bite and make recommendations that go beyond general oral hygiene.
The oral hygiene needs change every ten years, on average. The mouth at thirty-five is not the same as the mouth at sixty – and a dentist who knows the difference can provide more tailored dental care than a general practitioner.
The oral health is never static – it changes with time, with hormones, with stresses and with medications. It is in the hands of the individual to take proactive steps in managing it – and such steps, when taken on time, can prevent small issues from becoming big ones.