Aging and Your Dental Health

Keep that Smile Goin'

I'm Dr. Michelle with Jax Beaches Family Dentistry and I'm super blessed to practice with my amazing partner Dr. Elizabeth Alfuente and we have an incredible team of hygienists and front office administrators and dental assistants that make everything come together.

Welcome to our webinar!

September is Healthy Aging Month. So that is why this topic Aging and Your Dental Health is so timely because it goes along with the theme for the month. We still are in the midst of a pandemic and I will tell you for the last four to six months, as we decided what topics to do, it's been really challenging to not continue month after month after month to focus on the pandemic because it has so many issues associated with it. However, several months ago, we decided to move on and continue to discuss Complete Health because the Complete Health of your body as it relates to the health of your mouth is really a focus for Jax Beaches Family Dentistry, which is the name of our practice. So the teeth, gums, and the rest of your oral cavity really take extra care as we age or as I like to say as we have more birthdays. If you want to have a healthy smile, a healthy mouth, and a youthful-looking mouth it requires some more attention, just like a lot of things. Everyone out there that is over a certain age or has had a certain number of birthdays would agree with me on that. I found this little quote and it's actually an article that was awesome about aging and the health of your mouth done by Harvard and it said, "Aging isn't always pretty and your mouth is no exception. Ever consider why you shouldn't look a gift horse in the mouth?" which I thought was funny.

The interesting thing about where we are in our society is that as short a time ago is a century ago, most people just assumed that they were going to lose their teeth and they're going to end up with dentures, and so really the health of your mouth and the care of your mouth after a certain point of time really didn't matter because we were all going to end up with Dentures. So today the awesome news is three-quarters of our population, especially in the United States over the age of 65 still retain at least some of their natural teeth so we want to take care of them. As we age, decay, gum disease, oral cancer, mouth infections, and tooth loss all have a tendency to accelerate.

This is my awesome partner. I forgot that and here's my amazing team. We just did a complete Health Summit on Amelia Island over the weekend. We had a blast and we learned all kinds of exciting and interesting things. If I have time, I'll share some of them with you. It's really exciting. This is our beautiful office in the Jacksonville Beach area. It's actually in Neptune Beach, Florida.

Here's an example of really severe wear, however, this is relatively common in people once they get over the age of 65. Your teeth are amazingly strong. The molars can exert over 200 pounds of pressure, but as you are using your teeth day after day after day over the many years that you're chewing, slowly, over time this is what happens with your teeth, especially if you have a tendency to drink carbonated beverages, eat citrus, and if you have a tendency to grind your teeth. Then as they wear and things get thinner, they have a tendency to crack and break and then you know what? I tell my patients on a daily basis is your teeth are like little gears and they're supposed to fit together a certain way. As those gears break down, especially your big Eye Teeth that protect your pulled bite, your whole bite and the entire system begins to break down. You can see when you look in this person's mouth that a dentist or dentists, most likely, have tried to put in things like gold coverings and porcelain coverings to protect the back teeth, so they don't continue to break. So the other thing that will happen over time and especially with this kind of level, the chance of having tooth damage that is severe enough to require a root canal triples once you're age over the age of 65. A lot of that's just sort of normal wear and tear and, as I mentioned if you have a tendency to grind which right now what we try to do and this is some of what we talked about at our really amazing Summit. We try to find out what the root cause of that grinding is because if that root cause of the grinding is an airway restriction, we're concerned about the airway restriction because of your overall health and then people like this person are also motivated to protect their teeth. They don't want their teeth to look like this. They don't want their front teeth to snap off. So one of the amazing things in dentistry right now is that we can actually take a look at the airway to figure out why the person's grinding, so when we do fix the teeth and make these front teeth prettier, they're not going to continue to break them. That way when we put an appliance in to protect their teeth, we are also opening up their airway and helping them with their overall health, which is one of the more amazing things and new things in dentistry right now.

We have lots of options to help with this problem where before we just fixed up the teeth and put a night guard in and hoped for the best. Now, we can figure out why people are grinding. One of the things that will happen as a result of grinding, can be that teeth will get sensitive. Now the good news about Mother Nature is that as we have more birthdays the canals or the inside of the nerve of the tooth gets smaller and smaller, so sometimes as you're grinding you're not really noticing the sensitivity. The great thing about the design of teeth is that it protects us from that as we have more and more birthdays. So there are multiple reasons why you get sensitive teeth.

GRINDING

Some of it is as you're grinding and the teeth are getting thinner, it's wearing away the enamel which is the protective, white coating, right? That's what makes your teeth white is that there's enamel around the softer part of the tooth. Then as you're grinding it you have a tendency to expose that softer area and you'll notice along the root surfaces, especially where you brush, is kind of twingy and sensitive and you'll notice that certain acidic foods and certain types of drinks will make your teeth kind of mini and that's when we recommend amazing toothpaste like Sensodyne or those products that have that chemical in them that seals up that part of the tooth so that you don't look like this lady on the slide where your tooth is hurting every time you drink. So there's a bunch of different causes for sensitivity. You can have a cavity, right? You can have fractured teeth, worn fillings, gum disease, worn tooth enamel, and exposed roots. There are all kinds of different treatments for sensitivity because there are different reasons for the sensitivity, right? So the desensitizing toothpaste when you have a recession and that root is exposed is really helpful. You can also get fluoride treatments at the dental office, which honestly if you have a recession and you have those exposed roots, I would recommend every time you come in. If you're over the age of 40, we often have people come in every three or four months instead of every six months. You can get fluoride put on by the hygienist and that really soaks in stays with you for quite some time. So I would really recommend that for people as you age and as your gums are receding. The other thing that we can do just like the patient that was in the picture from earlier, right? We can overlay the biting surface with something that's man-made like gold. Gold always will be the best but not everybody wants jewelry in their mouth but gold actually really helps a lot. You can also, as your gums recede sometimes, get gum grafting which brings that gum tissue back over the surface of the tooth.

CRACKED TOOTH SYNDROME

Then we have cracked tooth syndrome, which is one of the most frustrating things I think in dentistry when you have really big fillings and you're grinding your teeth, you'll sometimes get cracks, up underneath those fillings. The sensitivity from that cracking really is hard to get rid of. The primary thing that we do at the beginning of noticing crack tooth syndrome is wrapped a crown around the tooth. What that crown does is it holds together the crack in the tooth and holds together the cracked tooth syndrome. I would say, 70 to 80% of the time that completely gets rid of it. The patient was unable to bite down on that tooth that the crack in the tooth never flexes anymore and it really takes care of it. But, you know, every once in awhile the fracture once it's symptomatic it's already in the nerve and then it sometimes needs a root canal. Root canals have a bad name. Root canals are something I enjoy doing so when someone has a crack in the tooth and it stays painful, generally in our practice, I'm the one that does that. Root canal technology has really come a long way. It's come a long way in that we use lasers to clean out the inside of the tooth that makes the smell, [09:52-09:57] it works out really well more often because the canals are cleaner and it's a much easier procedure now. Sometimes, like I say, when you get a crack, you need all that. It is important to keep as many of your own teeth as you can because especially if you're clenching and grinding the more teeth you have, the better. As we start to lose teeth if we're hard on out teeth then that can that can cause issues. The source, as I said before, of the grinding is sometimes airway issues. If you go to our YouTube channel, you can see some videos and some webinars that I've done on grinding and on airway issues. Our YouTube channel is a great place to go for information.

FLOURIDE

One of the best solutions is always going to be prevention; fluoride is sometimes in your water, but most of the time, especially as we age, we need help from fluoride supplements. Everybody thinks of fluoride and supplements as something that is just important for school-age kids, just important, only important when your teeth are developing and the reality is that it is something that we now know that we need throughout our life. The rate of tooth decay actually in people over 65 drastically outpaces that tooth decay of children. That's important for people to know we have a tendency as we age and our gums are receding and we have changes in our saliva to get something that's called root surface decay, that's a completely different disease than childhood decay. It has to be treated differently. It's treated with different medications and it has to be treated in a pretty significantly different way. We have different fluoride products and obviously, we have traditional dentistry rights important to brush, floss, and come to the dentist. As I mentioned a few minutes ago, most of the time when our patients are over the age of 40, I would say, or they show early signs of things like gum disease or extreme decay, we have people come in every three to four months just so we can keep a closer eye on them. Then when we begin to have dexterity issues, which happens for all different reasons, sometimes just arthritis so it's hard to hold on to a tiny little toothbrush and manipulate it the way it's supposed to, it's a really good idea to switch to an orthric brush. So the fluoride found in toothpaste really helps and then we also have some additional products and it's not just to you know, prevent future decay, it's not something that we are scolding you or are telling you to do but also when we notice that you have some break down certain types of products will actually help those areas heal. If we notice that you're having trouble with decay and the decay is caught soon enough or early on enough then we can actually use these special products to heal that area so that you don't have to have drilling done.

So while teeth are very sturdy, it's very important that those sturdy teeth are supported by healthy gums. When they aren't that's called periodontal disease or gum disease, which most of you listening, I'm sure to have heard of that. The primary culprit of gum disease is to floss, which obviously we're trying to avoid, and it doesn't come from either not going to the dentist or because you are old which I get a lot from my patients. "I'm having these problems because I haven't been to the dentist or I'm having these problems because I'm old." Really it's something that, when it's left undetected and untreated and we haven't talked about it or you haven't been in regularly to get your gum treatments done then it progresses. It's also a bacterial disease which we will talk to talk about because we definitely have a physical treatment where we do deep cleaning and we are debriding or getting rid of the tartar or calculus whatever word you've heard it called, the hardened stuff on your teeth that you can't get off. Then we have the plaque which is the bacterial component of it that we treat. Not only are we doing that, but we're also using the documents to just keep your mouth clean in general and also get your teeth to look more youthful because treating gum disease and flossing, to me is that not that interesting or exciting or fun? Right? It's more fun to talk about things that are going to make your mouth look better to make you more youthful. So one of those products which I'm incredibly passionate about partly because of where my own oral health was heading and the way my teeth were looking as a dentist is this product called Perio Protect. Perio Protect is a custom tray that is beautifully designed in that not only do we send images or Impressions to the laboratory to make the trick custom but we actually send the probing depths and that is the measurement between the top of the gum and the bone and that allows them to put a gasket all around the tray. You put a very low dose of hydrogen peroxide which no one is allergic to and it is not a caustic chemical. We put that in the tray 15 minutes a day and not only as you can see from this picture, does it bleach your teeth make them incredibly useful you can also see the difference in the color of the gum tissue here. This before-and-after is actually me and makes me a little emotional because I'm passionate about the fact that my teeth don't have to look as yellow as they used to no matter what kind of bleaching I did. They actually look beautiful and youthful and then also it's completely gotten rid of the gum disease that I was not able to resolve any other way. So I highly recommend these it's really our secret weapon for our patients. We used to have patients, you know a couple of times a day that we would be yelling at them about flossing, yelling about them about brushing, recommending different brushes, telling him to come in more often, and really no matter what they did, they were just frustrated. Nothing was really helping and it didn't really matter what they did. And so now we have other options. We also learned, over the weekend, about different options too of doing salivary testing so that we can actually identify the bad bacteria that are causing the problem and that will allow us to implement different antibiotic treatments, different types of rinses, and different things that can actually go in the tray that are specific for the specific kind of bacteria. So, you know, other than custom in-office crowns and all the amazing root canal technology, I will say that this particular product and the testing of the saliva to make gum treatment more specific have been some of the most incredible changes and improvements in technology and dentistry. It is really changing people's lives and helping them create amazing overall health that will allow them to age better and in a healthier environment.

The other thing that we do with these trays is we have a product called CTX, it's from the company called Carries Free. There are also other products that have similar makeup. The critical thing with these products is; not only do they have fluoride but they also have a pH neutralizing rinse that goes along with their gel. It comes and kit and it's prescribed by your dentist according to what your different issues are. Some people have problems with decay because they simply drink things like Mountain Dew and I haven't quite yet so obviously I have an acidic mouth. Some people have issues with decay because they have a high bacterial count and some people have problems with decay, just because they have a general high pH and issues because their mouth is dry. We have different kits for all these different issues. We also take that gel that I brush my teeth with, we put it into people's Perio Protect trays just like traditional fluoride trays to help people hold it in their mouth longer. We use all kinds of different things to treat and reverse dental disease and a lot of them are very new. So it's exciting to give people that used to be super frustrated and people that are trying to keep their teeth for a lifetime, to give them different options of treatment.

When talking about the health of our mouth is smoking. Obviously, as you age every time you another year goes by that you're smoking. It has more of a negative impact on your mouth. It dries out your mouth. So if you have salivary issues because you're on multiple medications and you are smoking. I want to get down on my hands and knees except I would disappear from this screen and implore you to stop smoking. It's just another reason not to smoke because when our mouth is dry we really just can't take maintain a healthy mouth. And then the other thing to keep in mind obviously everybody knows this, right if you're smoking you put yourself at risk for oral cancer. The problem with oral cancer really is that we've come a long way in this country with different cancers like breast cancer and cervical cancer and even things like lung cancer with early diagnosis and with different screenings that we do but oral cancer has not had that change. The mortality and morbidity of oral cancer haven't changed at all and that's mostly because we don't have any oral cancer screening techniques that are being done routinely. In our office, you are annually checked for oral cancer with a special light that allows us to see it when it's a stage 1 and 2. The biggest problem with oral cancer is we don't see it till it's a stage 4 and so, you know, if you are if you're seeing a dentist, please ask them about the light screening and if they're not doing it, come see us. No, actually, I'm sure that company that gave us our light source, who sold us our lights can help you find someone that does it. So yeah, that's our secret weapon in our office for oral cancers, doing that screening.

Then as we already mentioned a little bit before, the most important thing with your oral health obviously is to keep your teeth, right? We all want to keep our teeth for a lifetime if we can but we also want to make sure that as we're doing that and as we're preserving the health of our mouths we are keeping in mind our overall health. Beyond a reasonable doubt now, we know that the bacteria in our mouth travel through our bloodstream and it triggers inflammation and causes issues like cardiovascular disease and Alzheimer's, that again is another reason why we're going to start this week. I'm just putting that out there this week we're going to start testing people's bacteria in their mouth by testing their saliva, especially if they have you cardiovascular issues or if cardiovascular issues run in their family, we can test that and make sure they don't have bacteria in their system that's going to negatively impact them. The other thing that is super important, if you're listening to this or if you know anyone that's a diabetic, when you are a diabetic, especially if you're over the age of 40, you must go to the dentist every 3 months. The only hope that you have of controlling your blood sugar is by having super-duper healthy gums, sort of like the picture of my beautiful gums now. It must be kept track of really diligently because the high blood sugar if your blood sugar gets out of control and it's high, it causes an increase in sugar in the oral fluids which feeds the bacteria and then if you have uncontrolled blood sugar, it also damages the blood supply in the gums. Periodontal disease in and of itself causes your sugar to not be able to be controlled. So it becomes this vicious cycle. So super important if you're a diabetic or you know, you know a loved one is a diabetic, the best thing you could do for them and their overall health is to ask them when they had a cleaning last, or when they saw a dentist last. And, it doesn't help to just see a dentist. You need to have seen a dentist and see that dentist on a regular basis.

That's just good for all of you to know.

A really important factor, which we already talked about, was dry mouth. The main reason is, as we have more birthdays, I don't like to say as we age because of my age, but as we have more birthdays we want to keep in mind whether or not we have a dry mouth and dry mouth most often is from medications, especially certain types of medications, like anti-seizure medications and heart medications.

But also as we have multiple medications on this that I read it from it says hundreds of medications list dry mouth as a side effect and then when you end up with four or five medications or for sure gonna end up with a dry mouth because it just kind of files on. I wrote myself a note on here: It is supercritical, the minute you feel like back-to-back days or back-to-back weeks your mouth is dry, you notice yourself drinking more fluids. You notice yourself feeling like you need to suck on a mint or, no matter what it is you're noticing, if you're noticing your mouth is dry, please alert your dentist because I have seen people even in a couple of month period of time end up with severe decay and it is super sad to me because it is something that we can stop at the, you know, we can just hit it in its path if we know about it.

The other really important thing, if you take nothing else away from this entire webinar, is that if you have a dry mouth, please do not suck on a mint, do not put anything in your mouth to alleviate that dryness that has any sugar in it. Between not having saliva and sucking on something that has sugar in it, you will literally destroy your teeth in a short period of time. Please make sure you alert someone and please make sure nothing goes in your mouth that has sugar.

The other thing that you want to do if you end up with dry mouth and if your dentist communicates with your Physicians and the Physicians basically say, sorry, there's really nothing we can do this person has to be on these three medications. There's no way to alter them if we're stuck with a dry mouth and we really have to quit smoking, we also have to seriously limit alcohol and caffeinated beverages.

All kinds of good news, right? Because if we have a dry mouth because we're on multiple medications or we have something like Sjogren's syndrome or you know, just some sort of autoimmune disorder and we are smoking, drinking alcohol, and drinking coffee or caffeinated beverages. We're really going to be in trouble with our oral health.

What are the different signs that you need to see a dentist other than all of those, you know maintenance wonderful product things that we need to do in order to stay youthful but there are there are times in between our every three to four months we know we need to see the dentist and it's important to know why to call because we at Jax Beaches Family Dentistry see same day emergencies and we make sure that all of our patients know that and we pray that we do all we can too to make sure that people in the community know that we see same day emergencies so that people aren't stuck when they have a feeling they need us, but I do often get people who either finally come in on Monday, even though but they've been suffering all weekend because they don't want to bother us or they're even afraid to call me or text me if they're a friend of mine. So here's the thing with that: the reason for 30 years. I've always seen same day emergencies and I'm insistent about it to the point. And if anyone that has something they even think is an emergency. They are to come into the office that day and that is because, as a rule, dental disease and these dental infection dental problems, even severe ones, almost have no symptoms. So even if you have a slight awareness in your teeth, it's probably a problem. So that's just something to keep in mind.

Some of the warning signs that you're having issues are persistent bad breath. Bad breath could be a webinar in and of itself. I will tell you that the other beautiful things about pair of protect rays, which I don't think I mentioned is that it is it knocks out your mouth odor in about three days. It's an amazing side effect of it treating your gum disease other than your beautiful white teeth. If your gums are bleeding and they are inflamed, please get them checked right away. Sometimes it's just write a piece of popcorn kernel or something stuck up under the gum. But sometimes you're having bleeding inflamed gums because you have a really bad infection. So please come in. Mouth sores are also important. It's good for us to see them when they first start so that we can track and make sure that they resolve in seven days. So if you wait too long for you know for us to see it see it, it makes it harder for us to resolve it. We also have an amazing laser at Jax Beaches Family Dentistry that we can use to help with the healing and help it not be so uncomfortable for so long.

Any discolorations or lumps or you know things that are growing that shouldn't be there, super important to let us know, very important to notify us of a dry mouth which we already talked about, obviously jaw pain and tooth pain. Jaw pain, you know, can be a problem in your jaw joint itself. If is stuck open or closed, really important to deal with that early on. A jaw that's actually stuck, if it becomes chronic can be really difficult to manage, so let's not let that happen please.

Hot and cold sensitivity. A lot of people think, "Oh, well, it's just sensitive to cold. It's no big deal," all of your teeth really and sections of your teeth should all feel like all the other ones. So even though it's only a little sensitive if a tooth is standing out, it really is important to share that with your dentist because it's not normal and when things aren't normal, it's good for us to see hem early on. It's also good for a dentist to see them before you start taking antibiotics that were prescribed by someone else or that you have in your medicine cabinet. Like we all know we're not supposed to take somebody else's medicine or is in our medicine cabinet with the problem with taking it and no one's seeing you first is that you sometimes you'll math terms that can lead to long-term issues, which are not good.

So I want to thank you so much for attending the webinar today really appreciate your time and attention. I hope this information is helpful for you and your journey toward health and youthful living as you have more birthdays. If there's anything we can do to help you or if there's any questions that you have, I'm a very sort of an open and available person. I'm very passionate about complete health and I'm passionate about this topic so if you have questions, you can call the main number or you can email me at MD hockey at Jacksonville Beach Dennis.com, and I appreciate your time.