It’s Not Just About a Nice Smile

Some common health conditions, such as diabetes and acid reflux, change the oral environment in ways that promote increased tooth decay and gum disease. It can be harder to brush and floss effectively if we have dementia, arthritis, Parkinson’s disease, stroke or another condition that causes a loss of muscle control. And some medications older adults commonly take, such as diuretics, antidepressants, pain medications, and drugs to treat high blood pressure have the side effect of decreasing salivary flow. The resulting dry mouth (xerostomia) can lead to extensive tooth decay.

Medical science is learning more about the connection between oral health and overall health. Unfortunately, the health care system hasn’t kept up. Today policy experts are issuing calls to include dental care in Medicare other insurance coverage, and to better integrate dental care with other healthcare. Yes, the price tag would be high, but the price of not taking care of our oral health is probably even higher! For example, the Centers for Disease Control and Prevention (CDC) reports that the U.S. loses $6 billion in productivity each year because people miss work for oral health issues. And poor oral health has been linked to:

Malnutrition. Tooth loss, painful teeth and gum problems make it harder to eat a nutritious diet. Many of the most nutritious foods—vegetables, fruits, nuts and meat—are hard to chew, so a senior might turn to processed foods that are high in salt and sugar. This makes it hard to get the nutrients they need.

Social isolation. Oral health problems can tempt seniors to withdraw from social interactions. Missing teeth may cause embarrassment and make it hard to speak clearly. Gum disease may lead to odor. This can be the first step to a cycle of decline, and we now know that loneliness is as hard on our health as smoking and obesity.

Hypertension. An October 2018 study published by the American Heart Association showed that people who have gum disease do not respond as well to medications designed to keep their blood pressure at a safe level. Said study author Dr. Davide Pietropaoli, “Physicians should pay close attention to patients’ oral health, particularly those receiving treatment for hypertension, and urge those with signs of periodontal disease to seek dental care.”

Heart disease. Columbia University researchers reported that brushing, flossing and regular dental visits slow the progression of atherosclerosis (narrowing of the arteries) to a significant degree. An earlier study from the American Heart Association found that people who have their teeth cleaned regularly have a 24 percent lower risk of heart attack and 13 percent lower risk of stroke. Keeping the teeth and gums clean reduces the growth of bacteria that can lead to systemic inflammation.

Dementia. Tooth loss and gum disease have also been linked to an increased risk of dementia. New York University researchers found that gum disease may contribute to brain inflammation and Alzheimer’s disease. University of Florida researchers showed that oral bacteria from poor mouth hygiene is linked to brain tissue degeneration. And a March 2019 study published by the American Geriatric Society found that even taking into account other lifestyle factors, such as smoking, drinking too much alcohol and inactivity, people with gum disease have a higher risk of dementia.

Modern dentistry has come a long way in helping seniors retain a healthy smile. Restorations, implants and periodontal care yield great results, and for patients who have lost most or all of their teeth, modern dentures can be quite comfortable.

But until our healthcare system catches up with this new understanding of the relationship between oral health and overall health, it’s largely up to us to plan for oral health care in our later years. Keep the cost of dental care in mind during retirement planning and be aware of payment strategies and resources that could help. Learn which dental care services are covered by your Medicare plan. Check with your financial planner and your local senior services agency to learn more. If you’re a family caregiver, talk to your loved one’s dentist about how you can help.