Oral health after 60: keeping your teeth and dentures in good shape

What changes in the mouth after 60

Well-kept teeth can last a lifetime: getting older does not make teeth fall out. After 60, however, the risks shift. Decay appears more often on the roots, saliva frequently decreases because of medicines, gums recede, and fillings or dentures made years ago sometimes reach the end of their working life.

The main things to watch:

• root decay, at the gumline or under the edge of a crown;
• dry mouth linked to medication;
• gum disease, which can progress without pain;
• wear and fractures of heavily filled teeth;
• the fit and hygiene of dentures;
• the soft tissues of the mouth, which should be examined regularly.

The good news is that most of these problems can be prevented or treated simply when they are caught early. That is the whole point of follow-up tailored to your age, your treatments and the way you live.

Root decay: the risk people do not expect

When the gum recedes, it exposes the root of the tooth. The root is not protected by enamel but by cementum, a softer tissue that loses minerals more easily. Decay often settles there silently, as a brown or yellowish area at the neck of the tooth, sometimes between teeth or under the edge of an old crown.

Several factors make it worse after 60: less saliva, more frequent sugary snacks (sweet tea, biscuits, lozenges), brushing that has become harder, and sensitivity that sometimes leads people to avoid brushing the area.

Prevention relies on specific measures:

• fluoride toothpaste twice a day, without rinsing heavily afterwards;
• on your dentist's advice, a higher-fluoride toothpaste or a fluoride varnish applied at the practice;
• cutting down on sugary snacks between meals;
• check-ups that include examining the necks of the teeth and, if needed, an X-ray.

Root decay caught early is treated with a filling; left to progress, it can weaken the tooth until it breaks off at the gumline.

Medicines, dry mouth and general health

After 60, it is common to take several medicines every day. Many of them reduce saliva, and their effects add up: the mouth becomes dry, decay and thrush progress, and dentures hold less well. Causes and solutions are covered in our article on dry mouth.

Your dentist also needs to know about your treatments in order to treat you safely:

• anticoagulants and antiplatelet drugs, never to be stopped on your own before an extraction: what to do is decided with the prescribing doctor;
• osteoporosis treatments (bisphosphonates, some injections), which call for precautions before surgery;
• diabetes, whose control directly affects gum health;
• heart and blood pressure medicines and some painkillers.

The simple habit: bring your list of medicines or your prescriptions to every appointment, and mention any change since your last visit. This information counts as much as the X-ray when choosing the right treatment.

Gums, worn teeth and sensitivity

Gum disease (periodontitis) is common with age, not because we are getting older, but because it progresses slowly over many years. It is often painless: gums that bleed a little, teeth that look longer, gaps that open up, a bad taste. Without treatment, it can lead to loose teeth. A gum examination is part of every check-up after 60.

Teeth also wear down: repeated friction, night-time clenching, acidic foods, overzealous brushing. The result is chipped edges, shorter teeth, and sensitivity to cold or heat. A heavily filled tooth with large old restorations can crack when you bite on something hard.

What your dentist may suggest, depending on the situation:

• gum treatment and a suitable maintenance schedule;
• a desensitising varnish or toothpaste;
• protecting exposed necks of teeth with a small restoration;
• a night guard if you clench;
• replacing failing old restorations before they break.

Brushing well when your hands are less nimble

Arthritis, poorer eyesight, a tremor or the after-effects of a stroke can make brushing harder. Hygiene does not have to suffer, as long as the tools are adapted:

• an electric toothbrush, which needs less precise wrist movement;
• a thicker handle (available ready-made, or you can bulk up the handle with foam) for a better grip;
• long-handled interdental brushes rather than floss, as they are easier to manage;
• a magnifying mirror and good lighting;
• sitting down to brush if your balance is unsteady.

When a person depends on a relative or carer, that person can take over: stand behind or beside them, gently brush each surface and clean the denture every day. In frail older people, good oral hygiene is associated with a lower risk of chest infections caused by inhaling bacteria, so this daily routine protects much more than the teeth. The dentist can show the carer the technique during the appointment.

Removable dentures: care and warning signs

A partial or full denture needs cleaning every day, just like teeth:

• take it out and brush it over a basin filled with water (so it does not break if dropped), with a dedicated brush and mild soap rather than abrasive toothpaste;
• rinse it after meals;
• take it out at night, unless your dentist advises otherwise, to rest the gums and reduce thrush;
• store it in a case, following the instructions for its material;
• never use boiling water or bleach, which warp or damage the acrylic;
• also brush your gums, tongue and any remaining teeth.

Over time, the bone and gum under the denture change and the fit deteriorates. See your dentist if the denture moves, rubs or clicks when you speak, if a sore does not heal within two weeks, or if the gum under the palate turns red. A reline is sometimes enough. When retention remains poor, more stable solutions exist, such as a telescopic denture on the remaining teeth or a denture stabilised by dental implants. Age in itself is not an obstacle: our article on implant contraindications explains what really matters.

Follow-up suited to you after 60, in Agdal

There is no single rhythm: how often you come is set according to your risk of decay, the state of your gums, your medicines and your dentures. For many patients over 60, regular visits at least once a year, sometimes more often, make it possible to deal with problems while they are still small.

At German Dental Clinic in Agdal, an assessment after 60 includes a review of your treatments, examination of the teeth, their necks, the gums and the soft tissues, a check of your dentures and, if needed, a digital X-ray. Treatment is then organised by priority, with your comfort and general health in mind. A relative is welcome to come with you to follow the explanations.

Think about diet too: teeth or dentures that make chewing difficult push people towards soft food and away from fruit, vegetables and protein. Regaining comfortable chewing is part of overall health. If you live in Rabat and would like a review, for yourself or for a parent, you can book an appointment.