Tooth Loss in Seniors: Causes, Effects, and Solutions

Tooth Loss in Seniors

Everyone is born with one set of adult teeth that allow them to eat, influence how they speak, and shape their face. The longer an adult lives, the more wear and tear their teeth experience. In addition, natural anatomical changes to the jaw and chronic oral diseases influence the stability and integrity of teeth.

While advancements in dentistry and expanding hygiene practices over the last several decades have increased the number of natural teeth adults retain, tooth loss remains a problem for seniors. Adults over 65 have an average of 21 of their 32 natural teeth. The number decreases as age rises.

Dental health is a significant indicator of an individual’s overall health and wellness. Tooth loss is linked to a higher incidence of cardiovascular disease and stroke. Functional teeth are vital to a healthy lifestyle. The elderly can take proactive steps to guard their natural teeth and pursue multiple options to correct missing teeth.

Why Do Older Adults Lose Their Teeth?

Why Do Older Adults Lose Their Teeth?

Teeth experience physical stress from chewing, undergo attacks from plaque and germs, and face exposure to harmful foods daily. Unlike other body parts, teeth cannot repair themselves. A tooth’s inner layer consists of soft tissue and nerves called pulp. Dentin is the middle layer surrounding the pulp. It gives the tooth its shape and structure. The entire tooth is coated in enamel, which protects it. Over time, each part of the tooth breaks down or decays. Certain factors expedite breakdown and lead to tooth loss.

  • Poor oral hygiene: Some older adults may have not practiced proper oral hygiene in their youth, weakening the teeth. Other seniors neglect daily brushing and flossing as they age due to cognitive changes, lack of daily routines, and simple oversight. Twice-daily brushing removes germs and plaque, protecting the teeth and gums from deterioration.
  • Ignoring Dental Care: Older adults often forego routine dental exams that detect minor problems before they worsen. A recent poll found that less than half of Americans over 65 had visited a dentist within the previous year. Seniors sometimes lose health insurance upon retirement or have trouble attending appointments, leading them to skip treatment until their dental problem causes severe pain, infection, or tooth loss.
  • Poor-fitting Bridges and Dentures: Artificial teeth replace missing teeth to help seniors chew and speak as they did with their natural teeth. Ill-fitting dentures, which may be poorly fashioned or no longer fit due to changes in the jaw, are harmful to natural teeth. Poor-fitting bridges and dentures place excessive stress on the other teeth, leading to misaligned bites that can crack and break them.
  • Poor Diets: Sugary foods, acidic beverages like juice, coffee, tea, alcohol, and carbonated drinks all harm teeth. A poor diet can also create a breeding ground for the harmful bacteria that attack teeth and gums. Seniors with poor diets are likely to have weaker immune systems and poorer overall health, further compromising tooth and gum integrity.
  • Tobacco Products: Smoking cigarettes and cigars or using smokeless tobacco harms the teeth and gums. Older adults who use tobacco products expose their teeth and gums to harmful pollutants, which diminish tooth health, elevate cancer risk, and damage oral soft tissue.
  • Gum Disease: Teeth have roots made of soft tissue and nerves, which attach to the gums. Many seniors experience gum disease, which causes the gum tissue to recede and expose the roots to germs and food particles. Recessed gums can result from chronic health conditions, poor overall health, and inconsistent hygiene.
  • Chronic Dry Mouth: Saliva is a tooth’s defense mechanism. It washes away food particles, keeps germs from propagating, and neutralizes acids. Natural saliva production slows with age, exposing the teeth. In addition, many medications used to manage seniors’ health cause dry mouth as a side effect.
  • Cancer: Oral cancers, which are most common in the elderly, can compromise the gums and salivary glands, weaken the teeth, and eventually cause them to fall out. For many seniors, tooth decay and gum disease, which lead to tooth loss, are side effects of chemotherapy or radiation, especially when used to treat head and neck cancers.
  • Diabetes: Diabetes, a metabolic disorder that impacts the cardiac and immune systems, is more common in older adults. It also increases the likelihood of a person developing gum disease, the leading risk factor for tooth loss. Those with diabetes are 1.5 times more likely to experience total tooth loss than their peers.

How Do Missing Teeth Impact Seniors’ Health and Wellness?

How Do Missing Teeth Impact Seniors' Health and Wellness?

Missing teeth have overt impacts on seniors and many overlooked consequences. Dental problems and oral health impact an individual’s physical and emotional well-being.

Direct Effects of Tooth Loss

  • Malnutrition: Missing teeth cause older adults to avoid firmer foods, including fresh fruits and vegetables, meats, and whole grains. These foods are high in nutritional value and fiber. Seniors with missing teeth may eat soft foods like soups, boiled vegetables, or high-sugar processed foods that lack vitamins.
  • Teeth Shift: The gaps created by missing teeth allow the remaining teeth to move, filling in the open spaces in the gums. As the remaining teeth move, they weaken the underlying roots and compromise the soft tissue of the gums. Many seniors experience additional bone loss in the jaw due to missing teeth.
  • Abnormal Bite Patterns: Missing teeth change how the upper and lower jaws articulate during chewing. This misalignment creates abnormal stress on the teeth, increasing the likelihood of cracking or breaking. Altered bites can cause damage to the cheeks and tongue, increasing a senior’s risk of oral infections.
  • Stress on the Jaw: Without all 32 teeth, the jaw rests in an abnormal position because the upper and lower teeth don’t create the same tension when the mouth is closed. As a result, the jaw joints function irregularly, causing excessive pressure or pain in the jaw. This can exacerbate the loss of bone density and cause tooth grinding for the elderly.

Indirect Effects of Tooth Loss

  • Gum Disease: Missing teeth lead to gum disease and open a pathway for harmful bacteria to enter the bloodstream. Gaps lead to inflamed gum tissue, which causes pain and compromises the integrity of the nearby teeth.
  • Bone Loss: Gaps from missing teeth create openings in the jawbone. Without the structure of the tooth, the jawbone can collapse into the opening. This leads to a loss of bone density and weakens the surrounding teeth.
  • Dementia Risk: Investigations are ongoing, but researchers now believe there is a link between oral bacteria and cognitive degeneration, like dementia and Alzheimer’s. The proximity of the mouth and brain creates an easy pathway for infection, especially when seniors are missing teeth. One study found a 48% higher risk of cognitive impairment in participants with more missing teeth than their peers.
  • Altered Appearance: The teeth help hold the jaw in place, add to the underlying structure for facial muscle, and add definition to a person’s appearance. Missing teeth adjust jaw alignment, allow soft tissue to sag, and alter facial symmetry.

How Do Missing Teeth Impact Daily Life for Seniors?

How Do Missing Teeth Impact Daily Life for Seniors

Tooth loss causes major disruptions to a senior’s day-to-day life. Coping with missing teeth creates high levels of stress and anxiety, which can elevate blood pressure and create hopeless feelings in older adults.

  • Food Choice: Seniors may favor pureed foods, soft snack foods, and liquids if they are missing teeth. This diet deprives them of necessary vitamins and fiber, vital dietary components of healthy aging and immune function. Over-reliance on soft foods is also harmful to the remaining teeth.
  • Diminished Self-esteem: Many seniors may feel embarrassed and insecure about gaps in their teeth. The loss of confidence can compromise their quality of life as they disengage from others and become more passive in social situations.
  • Isolation: For some older adults, they may wholly avoid social interactions due to tooth loss. This isolation is detrimental and fuels depression and anxiety, which have harmful physical effects beyond the emotional impact.
  • Speech: Missing teeth may alter the sound of an adult’s voice. This change can lead to self-doubt and reservation, causing seniors to withdraw from family and friends. Reluctance to speak discourages them from maintaining their doctor’s appointments and other obligations related to their health.

What are the Options for Replacing Missing Teeth?

What are the Options for Replacing Missing Teeth

Advances in dentistry allow providers to replace lost teeth with dental prostheses. Today’s tooth replacement techniques are well-established procedures with more predictable results than previous interventions. Today, dentists can implant artificial teeth or craft an effective dental prosthesis that has a natural appearance in a relatively short period.

These treatments transform the patient’s appearance and simulate natural teeth, allowing the person to eat and speak as they did before tooth loss.

There are many options for tooth replacement. Determining the proper intervention requires consultation with a qualified dentist. Seniors should consider their options and discuss the best treatment with their caregivers.

  • Dental Bridges: A dental bridge fills in a gap created by one or more missing teeth. Dentists craft a false tooth that affixes to the two natural teeth or crowns on either side of the space. Bridges are cemented in place but will need replacement if the anchor teeth decay or the false tooth is damaged.
  • Dentures: Dentures are removable artificial teeth used to replace multiple missing teeth. Dentists can create partial dentures to replace a few teeth or complete dentures to replace the 16 upper or 16 lower teeth. The appliance fits snuggly around the gums. Dentures must be removed nightly and cleansed.
  • Dental Implants: Dental implants are artificial teeth that dentists anchor to a patient’s jaw using metal rods that simulate roots. Implants are a permanent solution and are the closest replacement to natural teeth. They require that the patient is healthy enough to undergo oral surgery.
  • Dental crowns: Crowns are used to preserve damaged or decayed teeth that remain viable. The dentist shaves the natural tooth down to a nub, removes the decayed portions of the tooth, and often performs a root canal. They then affix a metal or composite cap over the remaining portion of the tooth that simulates a natural tooth.
  • Veneer: Veneers are a ceramic façade that dentists affix to the front of natural teeth. They are a cosmetic option that masks underlying chipped and discolored teeth. Veneers require that the underlying teeth are sturdy and healthy enough to support the appliance.

What are the Pros and Cons of Dentures vs. Implants?

What are the Pros and Cons of Dentures?

What are the Pros and Cons of Dentures?

Pros:

  • Minimally Invasive: Dentists make dentures by taking a mold of a patient’s mouth and gums using a thick paste. They then send the mold to a lab to have artificial teeth crafted and set into a plate that conforms to the patient’s mouth.
  • Low Risk: Placing dentures is non-invasive. They are a low-risk solution because there is no infection risk. In addition, the failure rate of dentures is low because there is no cutting of the gums.

Cons:

  • Con, Up Keep: Dentures must be removed nightly, cleaned, and reinserted the following morning. Seniors with memory loss or cognitive challenges may misplace or forget to insert the appliance. Older adults need to rinse dentures after eating, clean their mouth and gums every time they remove the dentures, and brush them at least once a day.
  • Con, Slippage: Some older adults experience ineffective bonding and slippage with dentures. They may come loose while speaking or unbind when eating. Older adults may have to avoid certain problem foods.

What are the Pros and Cons of Implants?

What are the Pros and Cons of Implants

Pros:

  • Permanent Solution: Implants are permanently anchored to the jaw. They do not slip or adjust, providing predictable day-to-day behavior.
  • Simulate Natural Teeth: Patients treat implants like natural teeth. Older adults only need to brush and floss regularly. Seniors can eat an unrestricted diet and will speak normally in all situations.

Cons:

  • Invasive: Placing implants requires longer dental visits in which the provider cuts into the gums and bone to place the anchors for the implants. The invasiveness increases the risk of infection and failure if the rods shift. Seniors should consult with their doctors before considering implants.
  • Time Consuming: Getting implants requires multiple office visits to place the anchors, mold the teeth, and insert the implants. The patient’s jaw must heal after the anchors are placed before the implants can be affixed.

How to Choose between Dentures and Implants?

How to Choose between Dentures and Implants

Seniors should consult their dentists and discuss their options with loved ones before deciding between dentures and implants. Only an individual can know the factors that impact their situation, but considerations include:

  • Cost: The final cost of dentures and implants varies by region and the extent of the work. Dentures are significantly less expensive than implants. In many cases, a full set of dentures costs almost as much as one implanted tooth. Patients with extensive tooth loss may be best served with dentures.
  • Age: Seniors should factor their life expectancy into their decision. Implants last for many years but are costlier and more invasive. Dentures are less expensive, but changes in the jaw could require replacement dentures to prevent exacerbation of altered bite patterns and gum ulcers from irritation.
  • Compliance: Implants are lower maintenance and should be cared for similarly to natural teeth. Dentures are removable and can be easily lost, particularly if a senior has cognitive or memory challenges. In addition, poor denture hygiene can cause infection and illness.
  • Bone Health: Seniors need healthy jaw bones with enough density to accept the rod for implants. The older adult must also be healthy enough that the jaw bone will heal around the rod. In some cases, bone grafts are needed to add volume to the jaw for implants. Anyone can safely wear dentures.

Senior Tooth Loss FAQs

Senior Tooth Loss FAQs

At what age do adults start losing teeth?

With proper daily hygiene and preventative dental care, teeth should last a person’s lifetime. Tooth loss is not an inevitable part of aging. The extent of unmanaged tooth decay, lifestyle, and a person’s underlying health dictate if and when they lose teeth.

Older adults are more likely than younger adults to experience tooth loss.

What may cause sudden tooth loss in the elderly?

While tooth loss may seem sudden, it is a gradual process. The nerves in older adults’ teeth deteriorate over time, leading to desensitization. As a result, they may not experience pain related to tooth decay.

Older adults with significant untreated gum disease may experience seemingly rapid tooth loss as the pulp and root of the tooth break down quicker than in other adults.

Is it normal for older adults to lose their teeth?

No. With twice daily brushing, flossing, and routine dental checkups, natural teeth can remain for a person’s entire life. Older adults should focus on proper hygiene, quit using tobacco products, reduce alcohol intake, and visit their dentist for bi-annual cleanings to extend the life of their natural teeth.

How do elderly individuals hold their dentures in place?

Advances in dental science allow providers to craft snug-fitting dentures that closely adhere to an individual’s gum line. Well-designed dentures can be held in place with the natural layer of saliva between the device and the underlying bone.

Depending on the case, dentists may recommend adhesive dental pastes or bonds, which help dentures stay in place. Older adults with dentures need to continue routine dental visits. The doctor will check the integrity of the denture, confirm proper adherence, and monitor the gumline and jaw for anatomical changes that could affect denture use.