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Aging and Oral Health

Forestall a heart attack with a toothbrush, or a stroke with some floss.

Photograph by Nathan Sparks
Researchers are finding that the risks of stroke and heart attack are closely tied to our oral health. Plaque around the teeth, cavities, and gum disease may be uncomfortable and risky to our dental health no matter how old we are, but they can also be predictors of how just long we’ll live.
The Link between Heart, Mouth, and Brain

“Medical science is backing up the critical link between your oral health and your systemic health,” says Steven Brock, DDS, at Dental Images, 1715 Downtown West Blvd. “The whole tie-in of how to keep from having a heart attack or having a stroke is finding out that your oral condition is front row and center in that equation.”

He says the risk is not only the bacteria in the mouth, but the immune system’s aggressive response that makes clots in blood vessels more likely to occur.

“If the blocked vessel is located near the heart or brain, then it can be life-changing and end in a call to 911,” he says.

But beyond keeping our heart and brain healthy, Brock says recent longevity research shows that having sound teeth or dental implant-supported replacements allow us the ability to eat fresh fruit and vegetables and high-quality protein that can extend our lives by 5 卦-7 years.

Brock says the link between the mouth and the heart and brain has changed his practice.

Brock relates that during a two-day presentation on the subject, expert Dr. Bradley Bell told cardiologists and primary care physicians, “Doctors, you’re not going to be able to properly manage the cardiovascular risks your patients have unless you have an effective working relationship with an informed and aware dentist who understands his roles and responsibilities in helping protect your patient.

“He turned around to the dentists in the room and he said, ‘Let me tell you, your primary mission is not to help save your people’s teeth. Your primary mission should be to help protect the quality of their lives, the integrity of their heart, and their ability to maintain a lifestyle of self-care by protecting their brain.’”

The Importance of Dental Care As We Age

And as we get older, the care of our teeth should be high on our to-do list, but often , before they reach old age, people think of oral health as cavities, something they left behind in childhood.

Not so. “Most of the residents here at NHC Farragut have dentures or partials,” says Harriet AmmonetteAssisted Living Admissions Coordinator. “Very few still have their own teeth.”

She says NHC residents continue to see their own dentists.

“The biggest problems seem to be ill-fitting dentures due to weight loss, gradual changes in the mouth attributed to old age, and even some medications. Keep in mind too, that this is a generation that didn’t have half of the dental procedures, preventive cleanings, x-rays, dental products, etc., at their disposal. I am sure that is the main contributing factor as to why most do not have their own teeth.”

Symptoms To Watch out for as We Get Older

“There is generalized recession of the bone around the roots of the teeth, and when your bones recede a little bit, your gums recede with them . . . and the root surfaces begin to show,” says longtime Knoxville dentist, Reuben Pelot, who practices in Farragut at 11514 Kingston Pike. “You don’t know at what age exactly these things will happen,” he says, adding that people may see more root surface in their late 50s.

“You add 20 years to your life—you’re going to see more of that. But are you going to be 78 or 98 before it’s ever a problem? Nobody really knows.”

“Because of wear, old fillings and crowns can make teeth more prone to crack or break,” Pelot says. “Say for instance, they bite down on a popcorn kernel that hasn’t popped. There’s a lot of breakage in the older generation.”

Jack Gotcher, oral and maxillofacial surgeon at the University of Tennessee Medical Center, agrees. “As areas of tooth roots begin to be exposed to the oral environment,” he says, “decay may begin to proceed underneath fillings or crowns. This type of decay is often hard to detect until significant tooth destruction has already happened. The first sign that something is wrong may be when a crown breaks or falls off.”

Good News about New Treatments

“I often treat older patients for receding gums, and a dry mouth—both bad news for dental health,” says Jody Griffin, DDS, one of four practitioners at Cornerstone Dental Arts on Peters Road.

According to the American Dental Association, saliva is the mouth’s primary defense against tooth decay since it washes away food and other debris, neutralizes acids and provides disease-fighting substances. Dry mouth can be caused by poor health or can be the side effect of medications.

Griffin says home care, including dental probiotics, can help. He can also treat gum inflammation and disease with laser therapy at the Cornerstone office, and offers dental implants to replace missing teeth or to secure ill-fitting partials.

Newest Technology from Europe

Now, high in the alps of Italy, not far from the German border, a special milling machine is being manufactured for Brock’s practice. Zirkonzahn is leading the way in zirconium dental technology. The company produces equipment that uses zircon and other new dental materials to create on-site fabrications of crowns, veneers and natural esthetic dental restoration.

“It’s a European integrated dental design and milling system that works not just for single tooth repair,” Brock says, “but allows us to perform full mouth dental planning for bone-based foundation implant placement and allows us to create custom orthopedically beautiful smiles for people that need a second chance who have lost their teeth.

“Our new CAD/CAM mill is being fabricated in Italy right now. It will be shipped here and be on site by the end November. We’re working to combine 3D facial recognition and 3D dental imaging. We’re going to make a full 3D avatar of each patient where we can see their face, we can see their teeth, we can see their bone, we can see everything related to decision-making—to create not only a surgical plan, but also the design of the final beautiful zirconium tooth replacement for the patient.

We are able to share visually in 3D the proposed outcome of treatment before we start. That creates a lot of peace of mind for the patient and our team before we begin the makeover journey.”

Particular problems of the Elderly Dental Patient

“As we age,” Gotcher says, we are more likely to have additional medical problems which can affect dental care. For example, heart problems, such as heart failure, angina, or history of myocardial infarction, may directly affect the ability to have safe dental care in a typical office setting. Other common heart rhythm problems such as atrial fibrillation can negatively influence cardiac function. If patients experience anxiety or elevations in blood pressure and heart rate, it may put significant strain on their weakened heart. Careful monitoring of heart rate, blood pressure, or EKG may be needed in some cases. Many common medications, such as anticoagulants (blood thinners) have to be monitored and regulated prior to surgical procedures.”

A Great Smile at Any Age

“Cosmetic dentistry has really come a long way,” Pelot says. “Now with the advent of implants, if there’s enough bone support the dentist can put in an implant to replace the root of the tooth. The implant itself is surgically implanted in the jaw and covered over … You come back for a second stage and attach a device to it called an abutment that sticks out of the gum. You make a crown and cement that to the abutment.

“There is always the opportunity to make a difference in one’s dental health no matter the age or past situation,” Brock says. “The art and science of dentistry today presents a gateway for anyone to embrace a better-preferred direction if challenges with dental inflammation or tooth loss exist. It all starts with a thorough assessment and a plan. Your heart and sound mind may very well depend on it.”

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