Understanding Dental Changes with Age: Insights from a Dentist

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A vibrant and healthy smile is essential for a long, well, and joyful life. However, similar to our bodies, our teeth undergo changes associated with aging.

Curious about what happens to your teeth as you age? Discover the natural aging process of teeth and learn how to ensure your smile stands the test of time.

First, what are teeth made of?

The tooth crown boasts a resilient enamel coat that encases the softer, brown dentine, safeguarding the centrally located pulp.

Enamel constitutes an intricate network of brittle, honeycomb-clustered strands that interact with light, creating an opalescent appearance, characterized by a pearly, milky iridescence.

Dentine beneath the enamel forms the majority of the tooth crown and root, comprising collagen, mineral, water, and proteins. The woven collagen strands contribute to flexibility, enabling them to stretch and spring back, effectively preventing teeth from cracking or breaking during grinding and chewing.

The pulp, situated centrally, contains blood vessels and nerves, establishing communication with the rest of the body.

Within the mineral and collagen matrix of dentine, small, interconnected tubules are formed by specialized cells known as odontoblasts, which settle around the pulp once our teeth fully develop.

Each tooth possesses a finite number of odontoblasts, a departure from the constantly replenished specialized bone cells that undergo renewal.

How do our teeth change as we age?

As dentine loses its spring and becomes brittle, our teeth encounter challenges in renewing and are more susceptible to fractures.

This vulnerability is particularly common in teeth with existing crack lines, large fillings, or root canal treatments.

Over time, the outer surface of enamel thins, revealing the relatively opaque dentine, which darkens as we age.

The darkening of dentine results from the collagen weave stiffening and shrinking, and the fluid in the tubules filling with minerals.

Odontoblasts continue forming dentine inside the tooth to reduce the translucent pulp space. The increased dentine makes our teeth appear opaque and insulates them from hot and cold sensations. This is why X-rays are useful for detecting cavities that may not be felt.

Micro-gaps and age-related fine crack lines in enamel accumulate food and drink particles, leading to discoloration and staining. These stains can be easily managed with tooth whitening.

For an enduring smile and dental health, consider these seven tips to prevent dental decline:

1. Avoid unnecessary forces

Refrain from using your teeth to hold objects like tools or open packaging.

Take precautions to mitigate forces such as grinding or clenching by wearing a night guard.

If you possess large fillings or root canal-treated teeth, consult your dentist about specific filling materials or crowns that can safeguard your teeth from cracking or breaking.

2. Share the load

If you lack molars or premolars, evenly distribute chewing forces to prevent overloading your remaining teeth.

Replace missing teeth with bridges, implants, or well-fitted dentures to support your bite. Regularly check your dentures to ensure they fit and support adequately, and replace them at least every ten years.

3. Preserve your enamel

Minimize further enamel and dentine loss by opting for soft-bristled toothbrushes and non-abrasive toothpaste.

Be cautious of certain whitening toothpastes that can be abrasive, potentially causing roughening and wear on tooth surfaces. If in doubt, opt for toothpaste labeled “sensitive”.

Limit your exposure to acidic foods (such as lemons or apple cider vinegar) and try to manage conditions like reflux or vomiting to preserve enamel and prevent erosion.

4. Enhance your saliva

Saliva serves as a protective barrier against acid attacks, rinses our teeth, and possesses antibacterial properties to minimize erosion and decay (hole formation).

Additionally, saliva plays a crucial role in facilitating chewing, swallowing, and speech.

However, age-related changes to our salivary glands and certain medications prescribed to address chronic illnesses such as depression and high blood pressure can lead to a reduction in both the quality and quantity of saliva.

Consult your doctor to explore alternative medication options that may improve your saliva production or address reflux disease and prevent erosion.

5. Treat gum disease

From an aesthetic standpoint, addressing gum disease (periodontitis) helps minimize gum shrinkage (recession), which commonly reveals the relatively darker tooth roots that are more susceptible to developing cavities.

6. Manage and prevent senescence

Cellular senescence is the process that alters DNA in our cells, diminishing our ability to withstand physical, chemical, or biological damage.

Cellular senescence contributes to the increased risk of new cancer formation, the spread of existing cancers, and the onset of chronic illnesses such as Alzheimer’s disease, diabetes, osteoporosis, and heart disease.

You can mitigate cell damage by addressing lifestyle factors like smoking, uncontrolled diabetes, and chronic infections such as gum disease.

7. Adapt and ask for help

Ageing can impact our cognition, hand dexterity, and eyesight, making it challenging to clean our teeth and gums as effectively as before.

If this resonates with you, consult your dental care team. They can assist in cleaning your teeth and recommend products and tools tailored to your situation and abilities.

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