Unfortunately, dental cavities are something that most of us have experienced at some point in our lives. When we first went to the dentist as children, one of the first questions our parent’s asked was: does my child have any cavities? As a profession, dentistry has done a number of things to help prevent tooth decay. One of the very effective methods was to put fluoride in drinking water. I have been practicing dentistry in Alberta for nearly 30 years, 27 of those years in Calgary. When Calgary
removed the fluoride from the drinking water in 2011, one of the best initiatives for reducing dental cavities in our society at large was lost. Since then, I have seen a significant change in the caries index of my patients, though some groups have been more affected than others.
I first saw an increase in caries in my younger patients from lower socioeconomic backgrounds. Then, I saw an increase in cavities in my middle to higher socioeconomic status patients, followed closely by seniors and individuals that were at a higher risk to begin with. When I let my senior patients know that they are at risk for dental cavities, the question of why that may be and what they can do invariably comes up. In this article, I will focus on seniors, as their situation can encompass the broader society.
The following are some of the more common reasons seniors are at higher risk for cavities:
- The type of bacteria that lives in our mouth: only certain types of bacteria cause cavities.
- Dental anatomy: some of us just have teeth that are harder to clean (for example very deep grooves).
- As we get older, roots can become more exposed: roots not covered by the hard enamel surface are more susceptible to cavities.
- With age, amount of saliva generally decreases: saliva acts as a buffer and constantly washes the inside of the mouth to prevent cavities.
- As we get older, we generally see an increase in the number of medications we take. Side effects of these common medications often reduce the amount of saliva being generated.
- Foods we eat or gastric reflux can increase risk of cavities.
- Specific diet: foods with a high glycemic index, carbonated drinks, or low pH can increase the risk of caries.
- Dexterity: Brushing and flossing can simply be hard to do for a lot of us, especially as we get older.
What can our seniors, or anyone else that is at higher risk for cavities, do to reduce their risk? Here are some of the more common possibilities I discuss with my patients:
- Regular dental hygiene appointments with a fluoride varnish application
- Prevident or equivalent toothpaste: these toothpastes have 10x the amount of fluoride in it than regular toothpaste, which will make the tooth more resistant to acid.
- MI paste: this is a natural product that has recaldent in it, which helps remineralize teeth.
- Electric toothbrush: helps with manual dexterity.
- Chlorohexidine rinse: this is a prescription mouth rinse that reduces the number of cavity-causing bacteria in the mouth.
- Xylitol mint or gum: xylitol is a natural sweetener that affects the metabolism of the bacteria.
- Saliva supplements: offset some of the problems associated with dry mouth
- Monitor the diet (or possibly a diet analysis): be careful of foods that have a highglycemic index or are sticky by nature.
- Pit and fissure sealants
- If you have gastric reflux, speak to your physician.
- Fluoride trays
- Bleaching trays (I personally have not used this option often, but it is still viable)
Here at Braeside Dental Centre, we will assess our patients’ risk of dental cavities and discuss some of the above possibilities to help reduce the incidence of tooth decay. If you would like to speak with a dental specialist here at Braeside Dental Centre Call 587-316-1582