Best practices for dental care as I age?
July 14, 2016 9:39 AM Subscribe
My parents both had dentures. I am middle-aged (ouch!). Please talk to me about best practices for dental care, so that I can keep my own teeth for the duration of my life.
I would very much like to keep my own teeth, please. I am 45 years old, female. Not yet menopausal, not on any hormones, no other prescription meds, generally in good health.
I see my dentist for cleanings three times a year, and in fact just saw him for a cleaning this past week. I *did* pose this question to my dentist, and his answer was sort of flimsy (he went off on a rant about eating organic foods and avoiding GMO's). His suggestion for preemptively avoiding bone loss was "eat broccoli and other things that naturally contain calcium".
So, while I like him as a practitioner, and while I've been happy with his service overall, in the end he is a businessman, and I'm a little leary that maybe he isn't giving me *all* of the advice he could about maintaining my dental health.
Assume that I brush regularly (with a Sonicare!) and floss too. Limit sugar, avoid gummy things and sodas, etc.
My main concerns are advanced issues like avoiding bone loss, avoiding excessive gum loss, and avoiding other things that I may not even be aware of.
I would very much like to keep my own teeth, please. I am 45 years old, female. Not yet menopausal, not on any hormones, no other prescription meds, generally in good health.
I see my dentist for cleanings three times a year, and in fact just saw him for a cleaning this past week. I *did* pose this question to my dentist, and his answer was sort of flimsy (he went off on a rant about eating organic foods and avoiding GMO's). His suggestion for preemptively avoiding bone loss was "eat broccoli and other things that naturally contain calcium".
So, while I like him as a practitioner, and while I've been happy with his service overall, in the end he is a businessman, and I'm a little leary that maybe he isn't giving me *all* of the advice he could about maintaining my dental health.
Assume that I brush regularly (with a Sonicare!) and floss too. Limit sugar, avoid gummy things and sodas, etc.
My main concerns are advanced issues like avoiding bone loss, avoiding excessive gum loss, and avoiding other things that I may not even be aware of.
I like unwaxed floss. (on preview, I see that you already floss.)
I'm grateful to my dude for encouraging me to floss ever since we started living together, years ago. In fact, I gave him a special edition floss dispenser (inexpensive!) as a birthday present this year, and we enjoyed the heck out of it.
Most floss is thick enough that it's almost impossible to get between my teeth, so I use POH unwaxed (which I think also cleans better). POH has refillable regular floss containers, and their regular floss units are around in stores (the non-gold-plated kind). I think I've seen it at Rite Aid and Whole Foods. Refills are available on their site.
Looks like they're out of those special anniversary-edition gold-top floss dispensers, though.
posted by amtho at 9:51 AM on July 14, 2016 [1 favorite]
I'm grateful to my dude for encouraging me to floss ever since we started living together, years ago. In fact, I gave him a special edition floss dispenser (inexpensive!) as a birthday present this year, and we enjoyed the heck out of it.
Most floss is thick enough that it's almost impossible to get between my teeth, so I use POH unwaxed (which I think also cleans better). POH has refillable regular floss containers, and their regular floss units are around in stores (the non-gold-plated kind). I think I've seen it at Rite Aid and Whole Foods. Refills are available on their site.
Looks like they're out of those special anniversary-edition gold-top floss dispensers, though.
posted by amtho at 9:51 AM on July 14, 2016 [1 favorite]
Also: most dentists will tell you to avoid too-firm toothbrushes. I've heard they will wear away the outer layers of your teeth below the natural (original) gumline, where the teeth are least hard.
posted by amtho at 9:53 AM on July 14, 2016 [4 favorites]
posted by amtho at 9:53 AM on July 14, 2016 [4 favorites]
My primary care physician asked me some years ago to take a calcium supplement. For a variety of reasons, that has been to my advantage. If your dentist is encouraging you to increase your calcium intake, you might, as I do, take a supplement. Decrease in bone density becomes an issue as we get older so it's never too early to start.
posted by janey47 at 10:02 AM on July 14, 2016
posted by janey47 at 10:02 AM on July 14, 2016
I am a person who has older relatives who lost their teeth, and I am also a person who has had a lot of dental work over the years. I am 50.
What I can tell you as a person whose teeth decay at an alarming rate, and who has, therefore, more crowns than I can count, at least three root canals, and one dental implant:
1. One of the most important factors in bone loss in your jaw etc, according to my dentist, my peridontist, my oral surgeon, and my endodontist, is tooth retention.
2. The good news is that current dental practices allow for tooth retention in all sorts of circumstances that used to lead to tooth loss. The state of the art in cavity treatment and prevention, crowns, root canals, and treatment with implants is excellent. Implants especially are useful for this, as the implant itself helps stabilize bone retention in the mandibles, but also because non-implant tooth replacement options (like dentures and bridges) often require damaging the nearby teeth. For instance, if I hadn't gotten an implant but had chosen a bridge when I lost my tooth, the two teeth on either side would have been modifed to hold the bridge, weakening them, and the site of the lost tooth would have undergone bone loss in the jaw.
3. Despite my extensive molar remodeling over the years, the only tooth I've ever lost was the result of a fall in the bathtub where I hit that side of my face on the tub's edge. The impact damaged the root, which eventually caused me pain, and the tooth had to be pulled.
4. I sometimes joke with my dentist about losing my teeth, and despite the terror my dental x-rays would inspire in you, he tells me that I am unlikely to lose my teeth, barring some sort of bizarre scenario where I am the first human to live to 200.
Your regular checkups should be enough to let you if you're having early signs of exposed roots, gum disease, and so on. Receding gums that expose the root can be bad, because there is no protective enamel, and "deep pockets" where your gum meets your tooth can be a sign as well. At my dental checkups, the hygienist measures my pockets with a little...thing...to see if any are in bad shape. Slight gum recession or a few "deep" pockets can generally be reversed with better flossing, or by brushing less often with a softer brush (I have had to do this because I was actually causing gum recession, but switching to the super-soft bristle brush a few years ago fixed the problem).
If your dentist's office isn't monitoring this, you can ask them to, or find a dentist who does. But primarily I came in to reassure you that if my crack team of dentists, all of them extremely well-off thanks to people like me who are on a first-name basis with the staff at the office of the dentist that only does root canals, do not think I'm going to lose my teeth, then I can't imagine that you have a lot to worry about.
posted by not that girl at 10:07 AM on July 14, 2016 [1 favorite]
What I can tell you as a person whose teeth decay at an alarming rate, and who has, therefore, more crowns than I can count, at least three root canals, and one dental implant:
1. One of the most important factors in bone loss in your jaw etc, according to my dentist, my peridontist, my oral surgeon, and my endodontist, is tooth retention.
2. The good news is that current dental practices allow for tooth retention in all sorts of circumstances that used to lead to tooth loss. The state of the art in cavity treatment and prevention, crowns, root canals, and treatment with implants is excellent. Implants especially are useful for this, as the implant itself helps stabilize bone retention in the mandibles, but also because non-implant tooth replacement options (like dentures and bridges) often require damaging the nearby teeth. For instance, if I hadn't gotten an implant but had chosen a bridge when I lost my tooth, the two teeth on either side would have been modifed to hold the bridge, weakening them, and the site of the lost tooth would have undergone bone loss in the jaw.
3. Despite my extensive molar remodeling over the years, the only tooth I've ever lost was the result of a fall in the bathtub where I hit that side of my face on the tub's edge. The impact damaged the root, which eventually caused me pain, and the tooth had to be pulled.
4. I sometimes joke with my dentist about losing my teeth, and despite the terror my dental x-rays would inspire in you, he tells me that I am unlikely to lose my teeth, barring some sort of bizarre scenario where I am the first human to live to 200.
Your regular checkups should be enough to let you if you're having early signs of exposed roots, gum disease, and so on. Receding gums that expose the root can be bad, because there is no protective enamel, and "deep pockets" where your gum meets your tooth can be a sign as well. At my dental checkups, the hygienist measures my pockets with a little...thing...to see if any are in bad shape. Slight gum recession or a few "deep" pockets can generally be reversed with better flossing, or by brushing less often with a softer brush (I have had to do this because I was actually causing gum recession, but switching to the super-soft bristle brush a few years ago fixed the problem).
If your dentist's office isn't monitoring this, you can ask them to, or find a dentist who does. But primarily I came in to reassure you that if my crack team of dentists, all of them extremely well-off thanks to people like me who are on a first-name basis with the staff at the office of the dentist that only does root canals, do not think I'm going to lose my teeth, then I can't imagine that you have a lot to worry about.
posted by not that girl at 10:07 AM on July 14, 2016 [1 favorite]
I'm only two years younger than you and both of my parents had partials. My parents were both extremely poor growing up. My dad was born during the great depression and my mom was the 7th child in her family, yet only the second to start school knowing any English. My adult teeth are fine except for some damage from an overly enthusiastic dentist when I was a child. My gums are perfect. While it is true that genetics play a role in gum and teeth health, so does childhood poverty. If you aren't currently having any problems then you may want to blame their childhood on their issues and feel blessed.
Three times a year is excessive unless you are being treated for something serious. Once a year is fine for healthy adults. Get a second opinion before you hand over any more money.
Drink plenty of water, brush with soft bristles two or more times a day, floss when you can, and don't drink sodas.
posted by myselfasme at 10:33 AM on July 14, 2016 [1 favorite]
Three times a year is excessive unless you are being treated for something serious. Once a year is fine for healthy adults. Get a second opinion before you hand over any more money.
Drink plenty of water, brush with soft bristles two or more times a day, floss when you can, and don't drink sodas.
posted by myselfasme at 10:33 AM on July 14, 2016 [1 favorite]
IANAD but I think a lot (most?) of tooth loss is due to gum disease (and the bone loss that goes along with it) rather than tooth decay. Flossing is crucial, but you can also use those little interdental brushes to gently clean in between teeth/at the gumline. Some people use WaterPik-type machines for the same purpose. For me, grinding and clenching my teeth during sleep is probably the number one contributor to dental issues--right now my dental health is pretty good, but I do have some gum recession. So if you grind/clench, you should get fitted for a night guard. Even though they won't necessarily stop the grinding/clenching, they will help protect your teeth somewhat.
Also, there's probably some controversy about this, but I have no problem using toothpaste and mouthwash that contain antibacterial products (mainly because of my risk factors).
Finally, I find that I'm sometimes lazy about brushing my teeth after lunch, but if I bring some raw carrots to work as a snack, this is pretty effective in and of itself.
posted by bennett being thrown at 10:42 AM on July 14, 2016
Also, there's probably some controversy about this, but I have no problem using toothpaste and mouthwash that contain antibacterial products (mainly because of my risk factors).
Finally, I find that I'm sometimes lazy about brushing my teeth after lunch, but if I bring some raw carrots to work as a snack, this is pretty effective in and of itself.
posted by bennett being thrown at 10:42 AM on July 14, 2016
Be aware that too much brushing & cleaning can be bad as too little. My mother was almost obsessive in her teeth cleaning ways scrubbing her teeth three times a day. She used medium to firm toothbrush & by the age of 60 had pretty much scrubbed away huge patches of enamel.
posted by wwax at 11:31 AM on July 14, 2016 [1 favorite]
posted by wwax at 11:31 AM on July 14, 2016 [1 favorite]
To address something not yet discussed -avoiding bone loss to help keep your teeth- being active with weight bearing exercise and eating calcium rich foods. Get your vitamin D3 level checked and if it's low take a supplement (most of us need it in the winter at least in the midwest). If you smoke quit. Healthy bones don't guarantee healthy teeth but they sure help and osteoporosis definitely can lead to unpleasant dental stuff.
posted by leslies at 2:48 PM on July 14, 2016
posted by leslies at 2:48 PM on July 14, 2016
Mouthwash with fluoride paired with a calcium source in your diet I believe can maintain and strengthen enamel.
posted by mortaddams at 4:07 PM on July 14, 2016
posted by mortaddams at 4:07 PM on July 14, 2016
Sonicare is at the top of my list of reasons why, at 70, my teeth are my own. I grew up in a soft water environment and enjoined a lot of cavities as a youngster so there are a lot of patches in there. But the sonic toothbrush has done wonders for keeping my gums firm.
posted by ptm at 5:55 PM on July 14, 2016
posted by ptm at 5:55 PM on July 14, 2016
My dentist recommended Nimbus toothbrushes to me (expensive; you order them online). Also, she says not to use Glide floss, or that type, because it slips between the teeth TOO easily.
posted by bookworm4125 at 6:34 PM on July 14, 2016
posted by bookworm4125 at 6:34 PM on July 14, 2016
If you are 45, healthy, have all of your teeth and see a dentist regularly, your teeth have survived in conditions that your parents probably never benefited from. Dentistry changed remarkably in the 70's, when the causes for periodontal (gum) disease were finally identified, categorized and addressed. Add fluoridation, and a crazy effective campaign by the ADA (american dental association had the acronym first!) to get you to go regularly and you've arrived at where you are. there is almost no reason, if you remain in good general health, that your oral condition will fall off a cliff.
Dry mouth secondary to medications is the leading cause of decay in an aging population, so be wary of that, but you don't have to obsess over it.
Lastly, if your relationship with your dentist really has you believing he is making recommendations to pad his wallet rather than with your best health interests in mind, find another dentist.
posted by OHenryPacey at 8:36 PM on July 14, 2016 [1 favorite]
Dry mouth secondary to medications is the leading cause of decay in an aging population, so be wary of that, but you don't have to obsess over it.
Lastly, if your relationship with your dentist really has you believing he is making recommendations to pad his wallet rather than with your best health interests in mind, find another dentist.
posted by OHenryPacey at 8:36 PM on July 14, 2016 [1 favorite]
Response by poster: All great answers, thank you everyone!
posted by vignettist at 7:53 AM on July 15, 2016
posted by vignettist at 7:53 AM on July 15, 2016
Get one of those rotating toothbrushes that stimulates your gums.
Go see the dentist twice a year and follow their instructions to the letter.
posted by ostranenie at 9:33 PM on July 15, 2016
Go see the dentist twice a year and follow their instructions to the letter.
posted by ostranenie at 9:33 PM on July 15, 2016
I had resisted buying Plackers as it seemed to cater to the lazy and was bad for the environment. I finally accepted that the convenience of Plackers is what I needed to actually floss after every meal, as opposed to intending to very soon. I had my first dental checkup ~3 months after regular Placker use, and my Dentist was blown away by how healthy my teeth and gums were. Plackin' 3X a day comes out to $30/yr, and it's worth that just to experience what it's like for a dentist to not shame me when I go in for a cleaning.
posted by yorick at 7:23 AM on December 6, 2016
posted by yorick at 7:23 AM on December 6, 2016
This thread is closed to new comments.
We all die anyway, but daily flossing (at least 1x/day) will do more to save your gums and improve your overall dental heath. If you don't like putting your hands in your mouth, there are a number floss holders and sticks with floss that do the same thing. Twice-yearly cleanings are also something I've done since my 20's (no root canals, one crown, a few cavities).
posted by dbmcd at 9:49 AM on July 14, 2016 [1 favorite]