Why am I getting more cavities with age?

pillsQ. I’m 63 years old and I’ve always taken good care of my teeth… and I’ve never been prone to cavities. Why am I getting so many cavities all of a sudden?

A.  For most people, for most of their lives, proper diet and proper oral hygiene are enough to keep decay at bay.  With age, however, many of the things that used to help keep the decay rate low can change.

Manual dexterity

With age, manual dexterity often decreases.  This makes complete plaque removal difficult, if not impossible.  Undisturbed plaque leads to disease.  On exposed root surfaces that can result from recession over the years, this is even more important since the covering of tooth root surfaces is less resistant to decay than tooth enamel.

Dry mouth

Many people will have a decrease in the flow of saliva as they age.  This often goes unnoticed, however, since one often has to experience more than a 50% decrease in salivary flow before a feeling of dryness is noticed. Dry mouth is also a side effect of more than 500 medications, including those for allergies or asthma, high blood pressure, high cholesterol, pain, anxiety or depression, Parkinson’s and Alzheimer’s diseases.  Saliva plays an important role in buffering the acid that cavity-causing bacteria produce.  Less saliva tilts the balance towards more decay.

Diet Changes

Increases in the amount and frequency of exposure to simple sugars and acidic foods and beverages in the diet can increase the rate of decay.

Compromised Tooth Structure

Changes in the integrity of the tooth surface can affect how prone one is to decay. Cracked teeth can create microscopic plaque traps that can allow bacteria to penetrate the protective enamel layer and initiate decay. Decades of tooth wear or toothbrush abrasion can expose the softer layer of dentin under the enamel that is more prone to decay.  Fractured and chipped teeth can also create food traps that are difficult to keep plaque free and, therefore, decay free.

Any one of these biological or environmental factors can be enough to significantly increase one’s rate of decay.  When more than one factor is at play, it can create cavity-causing forces that are difficult to neutralize.  Your dentist will be able to help you formulate a plan to maintain and protect your teeth and keep you smiling.

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