Why Your Oral Health Declines as You Age, and What You Can Do About It

Back in the day, losing your teeth was an unfortunate part of aging for most people, and it started early. Even George Washington began losing teeth in his 20s and wore dentures made of ivory and metal (ouch) when he was president.

Luckily, times have changed. With advances in dental technology, education and public health, people can now live out their lives with a full set of natural teeth.

Still, aging can be tough on teeth and gums, as it's linked to an increased risk of certain oral conditions. But there's a lot you can do to prevent that.

Here, we spoke to Leena Palomo, DDS, MSD, professor and chair of the Ashman Department of Periodontology and Implant Dentistry at New York University, to better understand what happens to your mouth as you get older and how to combat the effects of aging on your teeth and gums.

Older adults are vulnerable to certain oral health issues. Here are a few problems that become more prevalent with age:

Pearly whites looking a little less bright? Unfortunately, tooth discoloration tends to occur with age. Here's why: Over time, the enamel's outer layer wears down, uncovering the dentin (the hard yellow tissue beneath the enamel), according to the Cleveland Clinic. What's more, your dentin also grows as you age, giving your teeth a darker appearance.

Other factors, including eating foods that stain your teeth, tobacco use, trauma to your teeth, poor dental hygiene and certain diseases and medications can also contribute to darkened enamel, per the Cleveland Clinic.

"A lot of these things are additive in nature, so as time goes on, they tend to have a cumulative effect," Dr. Palomo says.

Almost one-third of adults older than 65 deal with dry mouth (also known as xerostomia), a condition that occurs when you don't produce enough saliva, according to the American Dental Association (ADA). And the number rises to 40 percent of people in their 80s.

Dry mouth increases with age for several reasons, Dr. Palomo says. The most common reason is that your salivary glands deteriorate naturally as you age.

Another common culprit is medication. As we get older, we're more likely to be taking a medicine to treat a chronic health issue, and certain medications — including antidepressants, heart drugs and decongestants — can worsen dry mouth, she says.

And the more meds in your pillbox, the greater the problem. "Several medications together have a huge synergistic effect on dry mouth," Dr. Palomo says. Indeed, older adults who take four or more daily prescription medications are more likely to experience xerostomia, per the ADA.

Certain health conditions themselves — such as diabetes, Alzheimer's or Parkinson's disease — are also linked to an increased risk of dry mouth, according to the ADA.

Dry mouth and tooth decay go hand and hand, especially as we age, Dr. Palomo says. Our saliva — which has antibacterial and cleansing properties — protects the root surfaces from tooth decay, she explains. So, if your mouth is dry as a desert, it's more vulnerable to bad bacteria that can cause cavities.

Older folks also have a greater risk for root decay due to increased gum recession, which exposes root surfaces, and nearly half of adults over 75 have at least one root cavity, per the ADA.

More than two-thirds of people 65 and older are affected by gum (periodontal) disease, according to the Centers for Disease Control and Prevention (CDC).

Gum disease, like most other oral issues, is a cumulative condition, Dr. Palomo says. Think of it like this: If you lost one millimeter of gum tissue when you were a kid, and your gums continued to recede a little more over the years, you're likely to look "long in the tooth" later in life, Dr. Palomo says.

Periodontal disease is also more likely to develop in people with chronic, age-related medical problems such as arthritis, diabetes, heart diseases and COPD, per the CDC.

That's because your heart, your kidneys and the supporting structures of your teeth are all made up of the same blood supply, the same bone and the same connective tissue, Dr. Palomo explains. So, while we tend to think about oral health as a separate issue, the mouth is actually the mirror for the rest of the body, she says.

In other words, when you experience problems in other organs or systems, your mouth will reflect that.

Almost one-fifth of adults 65 and older and a quarter of people above 75 have lost all their teeth, per the CDC.

Tooth loss is the most obvious sign of a snowballing dental issue that has deteriorated with age and time, Dr. Palomo says. For example, if gum disease is left untreated, the bone structures that support the teeth can weaken and wane, causing teeth to become loose, according to the CDC.

Mouth cancers are more common in older adults, with the average age of diagnosis at 62, according to the CDC. Certain high-risk habits like smoking, especially if it's a long-term behavior, increase your odds of oral cancer.

"As we look at tips to protect your teeth and gums as you age, lifelong prevention is the key," Dr. Palomo says. That means you should start making your mouth a priority now — the earlier, the better.

While you probably already know the fundamentals — brush twice daily (two minutes each time) and floss every day — there are a lot of other things you can do for your dental health to prevent oral problems and ensure your teeth stay in tip-top shape as you get older.

"Soft bristles are kind to the soft tissue of your mouth," Dr. Palomo says. On the other hand, hard, sturdy bristles are too abrasive and may damage tooth surfaces.

Just make sure to replace your toothbrush or brush head every three months. When bristles become old and frayed with use, they can wear away both the hard and soft tissue of your teeth and gums, so you're more likely to see periodontal recession, Dr. Palomo adds.

While it's possible to brush your teeth successfully with a regular toothbrush, investing in an electric toothbrush (we know, it can be costly) might be worth it in the long run. That's because people who use an electric toothbrush tend to have healthier gums, fewer cavities and less tooth loss, according to the Oral Health Foundation.

This may be in part because electric toothbrushes tout some terrific bells and whistles with big benefits for your mouth. For example, many electric toothbrushes come with an app that connects to your device, which alerts you if you've missed an area of your mouth, Dr. Palomo says.

Overlooking an area is a common mistake. Often, our minds wander when we brush, so we can easily neglect to cover every tooth surface, Dr. Palomo says. But when we repetitively miss the same area of the mouth, we increase our risk for disease.

Another fantastic feature of electric toothbrushes is the automatic shut-down function. If you're pushing too hard or using too much pressure, the brush will beep or turn off, Dr. Palomo says. "Pushing too hard amounts to the same damage as using a hard-bristled or old, frayed toothbrush," she explains.

Regular dental care is crucial at every age but especially as we get older, Dr. Palomo says. That's because a routine dental visit can catch a problem early on and nip it in the bud.

But when you delay your dental care, a small issue can snowball into something more complicated, like a root canal or tooth extraction. Put another way: Seeing your dentist now — and often — can prevent bigger problems down the line.

So, how often do you need a dental check-up and professional cleaning? People who have relatively healthy teeth and gums and are at low risk for oral conditions can see their dentist every six months,Dr. Palomo says.

But for someone with a higher risk — including people who smoke and those who have diabetes, inflammatory conditions like arthritis or a history of gum disease — twice a year isn't enough, Dr. Palomo says. For these folks, quarterly maintenance is recommended (so, every three months).

Eating nutrient-rich foods and exercising regularly are just as important for your teeth as they are for your overall health. Healthy habits can help you reduce your risk for chronic medical conditions — like heart disease and diabetes — which are risk factors for oral disease, Dr. Palomo says.

To counteract dry mouth and a shortage of saliva, it's important to stay hydrated, Dr. Palomo says.

So, how much water should you sip per day? Because people come in such different shapes and sizes, the general recommendation of eight cups (64 ounces) per day may be a little too broad and unrealistic, she says.

A better benchmark might be to aim for about half your body weight in ounces, Dr. Palomo says. So, for instance, a person who weighs 120 pounds would shoot for about 60 ounces, while someone who weighs 200 pounds would aspire to 100 ounces.

If staying hydrated helps keep your mouth healthy, it stands to reason that avoiding (or decreasing) dehydrating drinks is another smart strategy.

To that end, try to limit caffeinated and alcoholic beverages, which can dehydrate you, per the ADA.

Nicotine is cytotoxic (meaning it kills important cells) and makes the capillaries, the vessels that carry healing factors to places in our mouths (and all over our body), smaller and more restricted, Dr. Palomo says. "So not only are we killing off healing cells, but we're also cutting off the superhighways by which those healing cells reach their destination," she adds.

Heat is also cytotoxic, so other forms of puffing, such as cigar or pipe smoking, are also destructive to the dental environment, Dr. Palomo says.

While quitting smoking is something to celebrate, your best bet for brilliant oral health — and preventing problems like gum disease and mouth cancer — is not starting in the first place. "It takes 10 to 11 years to return to the oral health of a never-smoker," Dr. Palomo says.