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Oral health is an important and often overlooked component of an older person’s general health and well-being. Dr. Mark Goedecke and our team know that for many of our older patients, oral health can become an issue when arthritis or other neurological problems render them unable to brush or floss their teeth as effectively as they once did. Today, we thought we would discuss four common oral health issues our older patients face and how they can avoid them:

Cavities: It’s not just children who get tooth decay—oral decay is a common disease in people 65 and older. Ninety-two percent of seniors 65 and older have had dental caries in their permanent teeth, according to the National Institute of Dental and Craniofacial Research. The risk for tooth decay increases because many older adults don’t go to the dentist as often as they used to, thus cavities go undetected and untreated for longer than they should. Keeping regular appointments with Dr. Mark Goedecke is the key to getting cavities treated in a timely manner.

Difficulty eating: Oral health problems, whether from missing teeth, cavities, dentures that don’t fit, gum disease, or infection, can cause difficulty eating and can force people to adjust the quality, consistency, and balance of their diet.

Dry mouth: Also called xerostomia, dry mouth is a common issue for a lot of seniors. Our friends at the Oral Cancer Foundation estimate that 20 percent of elderly people suffer from dry mouth, which means the reduced flow of saliva (saliva plays a crucial role in preventing tooth decay). Many seniors are on multiple medications for a variety of chronic illnesses or conditions. Common medications taken that may cause dry mouth are decongestants, antihistamines, blood pressure medications, pain pills, incontinence medications, antidepressants, diuretics, muscle relaxers, and Parkinson’s disease medications. To help counter this, we suggest drinking lots of fluids and limiting your intake of caffeine and alcohol. We also encourage you to check with Dr. Mark Goedecke during your next visit if you think your medications are causing your mouth to feel dry.

Gum Disease: Gum (periodontal) disease is an infection of the gums and surrounding tissues that hold teeth in place. While gum disease affects people of all ages, it typically becomes worse as people age. In its early stages, gum disease is painless, and most people have no idea that they have it. In more advanced cases, however, gum disease can cause sore gums and pain when chewing.

Gum disease, which can range from simple gum inflammation to serious disease, is usually caused by poor brushing and flossing habits that allow dental plaque to build up on the teeth. Plaque that is not removed can harden and form tartar that brushing simply does not clean. Only a professional cleaning at our office can remove tartar. The two forms of gum disease are gingivitis and periodontitis. In gingivitis, the gums become red, swollen, and can bleed easily; in periodontitis, gums pull away from the teeth and form spaces that become infected.

Proper brushing, flossing, and visiting our office regularly can prevent gum disease. Seniors with limited dexterity who have trouble gripping a toothbrush should ask Dr. Mark Goedecke about modifying a handle for easier use or switching to a battery-powered toothbrush.

Time to brush! So, you make sure you gently brush the plaque off the outside surfaces of your teeth. You want to present a gleaming smile to the world, after all. And you make sure to brush the inside surfaces as well, because who wants to feel a fuzzy patch of plaque every time their tongue hits their teeth? And, naturally, you remember to clean the tops of your molars, because those crevices make them more cavity-prone than any other surface.

Done? Not quite!

You might be surprised to learn that no matter how well you’ve brushed all the visible surfaces of your teeth, you’ve left quite a bit of enamel untouched—the adjoining, or touching, surfaces of the teeth which sit next to each other.

You’ve probably noticed that your bristles can’t . . . quite . . . reach all the enamel between your teeth (especially between your molars!) when you’re brushing. This means that food particles and plaque have an easier time sticking around. And when the bacteria in plaque are left undisturbed, especially with a banquet of food particles available, they produce acids which gradually eat away at the enamel covering our teeth, creating a cavity.

Here’s where we work in some specific dental vocabulary. “Interproximal” means between the adjoining, or touching, surfaces of the teeth. And an interproximal cavity is a cavity which develops on one of those side surfaces of your teeth.

• Discovering Interproximal Cavities

Clearly, a cavity between the teeth won’t be as obvious as other cavities. How will you know if a dental appointment is in order?

There are typical symptoms which can show up when you have a cavity. Chewing might be painful. You might feel pain or sensitivity when you eat or drink something which is hot, or cold, or sweet. But pain and/or sensitivity aren’t always present, especially when a cavity is just beginning to develop.

Regular exams are important so you can catch small cavities before they become more serious. That’s why, at your regular dental exams, Dr. Mark Goedecke will always check for any signs of decay on every surface of each tooth, including those places which aren’t easily visible. And that’s why X-rays can be an important tool for locating these tricky cavities.

• Treating Interproximal Cavities

If Dr. Mark Goedecke and our team finds a cavity between your teeth, there are different treatment options available depending on the size of the cavity:

• A typical cavity will require a filling. The decay will be removed, and then the area will be cleaned and filled. You’ll probably choose a filling material which can be matched to your enamel color if the restoration will be noticeable.
• If decay has spread to the pulp chamber inside the tooth, a root canal is often the best treatment option, with a crown applied afterward to protect the tooth.
• A tooth so decayed or infected that it cannot be saved might require extraction.

Dealing with any weakness in a tooth as quickly as possible is always better than waiting until a more complicated treatment option is needed. Of course, the best treatment is prevention, and, luckily for us, it’s not a complicated process at all.

• Preventing Interproximal Cavities

In fact, it’s about as basic as it can be—brush and floss effectively. We recommend brushing for two minutes at least twice a day and flossing once each day. While most of us are good about keeping up with brushing, sometimes that daily flossing is more a goal than a reality.

But it’s flossing which really does the trick when it comes to interproximal cleaning. If you floss correctly, food particles and plaque are removed from between the teeth and around the gumline—places where bristles just can’t reach. The next time you get your teeth cleaned at our Mt. Pleasant office, ask for tips on how to perfect your technique. And, if you have difficulty flossing, ask about alternatives such as water flossers and interproximal brushes.

Preventing cavities on the exterior surfaces of your teeth is probably pretty much automatic by now, but don’t forget the potential for stealth decay! If Dr. Mark Goedecke and our team find signs of erosion on the sides of your teeth, or if your hygienist lets you know that you’ve got a lot of interproximal plaque buildup, work with us to make sure “interproximal cavity” doesn’t become a working part of your dental vocabulary.

You’re biting into something delicious, and, Ouch! You bite into something you didn’t mean to—the inside of your tender cheek.

Painful moments like this happen every now and again. But if you find that more frequent cheek biting means that you’re extra-cautious when eating or speaking, if you wake up with sore cheeks in the morning, or if you catch yourself habitually chewing on your cheeks during the day, it’s time to visit our Mt. Pleasant office.

Causes of Cheek Biting

Many of us experience the occasional cheek chomp when we’re eating or talking. No fun! Besides the pain, a bite can cause broken skin, inflammation, a canker sore, or a mucous cyst. Luckily, the discomfort from these accidental bites generally resolves after a few days.

Sometimes, though, biting becomes a more frequent annoyance. Regular bites can be caused by several conditions, including:

• Sleep Bruxism

Bruxism is the medical term for tooth grinding. When sleepers unconsciously clench or grind their teeth as they slumber, it’s known as sleep bruxism. Sleep bruxism not only causes tooth damage, jaw problems, and facial pain—that nightly gnashing can mean bites to delicate cheek tissue.

• Problems with Dental Restorations

The placement of a crown, bridge, or implant can cause biting to occur more often if the alignment of your restoration with your other teeth isn’t ideal or has shifted, or if the restoration needs replacement.

• Wisdom Teeth

Most of us don’t have the room to welcome four new—and large—teeth. When wisdom teeth come in, they can lead to cheek bites, especially if they erupt leaning outward toward your cheeks.

• Orthodontic Misalignment

If you notice that you seem to be biting your cheek a lot when eating or speaking, it could be an orthodontic problem.  When your teeth or jaws don’t align properly, if your mouth is small, or if your teeth have shifted over time, your cheeks might feel the consequences.

Treatment Options

Why see Dr. Mark Goedecke? A one-time bite can be extremely uncomfortable, and might lead to inflammation or even a sore spot inside your mouth. Usually, both pain and sore spot fade in a short while, and saltwater rinses or oral gels can soothe your injured cheek tissue. Your dentist’s office can give you advice on treating minor bites.

But what about continuous biting? Regular biting injuries can lead to bigger problems. Tissue in the cheeks can thicken or erode. Scar tissue can build up inside the mouth. Ulcers and other sores can become larger and more painful.

If you’ve been biting your cheeks more often, Dr. Mark Goedecke can diagnose the cause and offer you treatment options depending on the reason for this frequent biting:

• Sleep Bruxism?

Dr. Mark Goedecke might suggest a nightguard to provide protection from the damaging effects of bruxism. Nightguards not only prevent further biting, they give your cheeks the chance to heal. We can custom fabricate a guard for the most comfortable and effective fit.

• Restoration Problems?

If regular cheek biting occurs after you’ve gotten a crown, a bridge, or an implant, visit our Mt. Pleasant office. This might be a problem that can be resolved with a bit of reshaping, whether removing a bit of the restoration or building up a spot. If a crown or other restoration has shifted or is failing, replacement might be in order.

• No Room for Wisdom Teeth?

Most of us don’t have room in our mouth to accommodate wisdom teeth, and extracting them is a common dental procedure. Wisdom teeth can be the source of many dental problems, including impaction, shifting teeth, and even damage to surrounding teeth. If you see signs that your wisdom teeth are starting to come in, talk to your dentist about your options.

• Orthodontic Problems?

Orthodontic treatment can improve tooth and bite alignment—and can eliminate those painful cheek bites if misalignment is what’s causing them. Modern orthodontic treatment offers patients of all ages more options than ever before, including traditional and lingual braces, clear aligners, and functional appliances.

Whatever the reason for painful cheek biting, you deserve to eat and speak and enjoy your day without constant “Ouch!” moments affecting your comfort and health. If these moments are happening all too often, visit Goedecke Family Dentistry for the answers to your biting problems.

Your dashboard lights up when you need an oil change. Your smoke detector beeps when you need to switch out the batteries. But when it’s time to replace your toothbrush, you’re on your own. Luckily, there are several not-too-subtle clues that you should be shopping for a new model.

• Fraying

Is your toothbrush looking a bit scruffy? Do those once orderly bristles look like they have the toothbrush equivalent of bed head? Have some bristles vanished altogether? Time to retire that toothbrush. Once the bristles are frayed, you just can’t reach plaque as effectively, especially where it likes to hide between the teeth.

Are you prematurely fraying? You could be brushing too hard. Overbrushing can damage delicate gum tissue and cause wear and tear to tooth enamel. If you find your brush fraying after only a few weeks of use, you might be using too much force. Remember, plaque is a sticky film, but it’s a soft sticky film. Ask us for advice on just how hard you need—or don’t need—to brush.

• Odor

This one really goes without saying—no one wants an aromatic toothbrush! How to make sure your toothbrush is fresh and clean?

Always rinse carefully after you brush. This will get rid of any toothpaste, bits of food, or other particles left on your brush.

Let your toothbrush air dry. It might seem more hygienic to keep your brush covered in a bathroom setting, but a closed, moist container is a perfect breeding ground for germs. Don’t let them make a home in your bristles!

• Illness

A cold or a bacterial infection (like strep throat) is no fun. But now that you’re feeling better, it might be time to throw out your toothbrush. The chances of re-infection are very low, unless your immune system is compromised, but this is a perfect opportunity to replace your brush with a fresh, germ-free model.

And if you share your toothbrush, or if you store it right next to a loved one’s or family member’s (which you really shouldn’t do, for this very reason), germs get shared, too. Quarantine your brush while you’re ill, and replace it once you’re out and about.

• Discomfort

Bigger isn’t necessarily better. A brush with a head that’s too big won’t allow you to get into those small spaces in your mouth where plaque likes to collect.

And harder doesn’t mean more effective. A brush with hard bristles can cause damage to your gums and enamel. We almost always recommend soft-bristled brushes for this very reason.

There are so many styles of brush out there, you’re bound to find the perfect fit with a little trial and error. Or ask Dr. Mark Goedecke for suggestions the next time you’re at our Mt. Pleasant office for a cleaning!

• The “Best By” Date Has Passed

Because of its durable construction, your toothbrush can last a long, long time. But no matter how comfortable and effective your toothbrush is right now, it was never meant to go through life with you. Bristles break down over a period of months, and just don’t clean as effectively. Your brush should be changed every three months, and this includes changing the head on your electric toothbrush.

Unfortunately, you don’t have a flashing light or annoying beep to remind you when it’s time to change brushes, so you’ll have to devise your own reminders. Reminder apps, calendar notes, the first day of a new season—use whatever works best for you. 

Don’t ignore the clues your toothbrush is leaving you. Replacing your brush whenever it’s necessary helps guarantee that the time you spend cleaning your teeth and gums will lead to confident, healthy smiles. Case closed!