We used to expect that as we got older, we lost our teeth. People were comfortable with the idea of false teeth kept in a glass next to their bed. But that is no longer the case. We are all keeping our teeth for much longer. And people don’t want false teeth. We want to keep our teeth for the whole of our lives.

Is this possible? Yes. Dental products and dental care have come on such a long way that we can expect to keep our natural teeth. But there are certain challenges that we will face as our bodies and our teeth age. In this article, we will run through the issues facing older patients and the ways to overcome them.

Dental challenges facing the older patient


Over time, are teeth are going to wear. This is inevitable. Our teeth are there to help us eat and there’s no point having them if we are not going to use them. So we have to accept that our teeth are going to wear. There are two main causes of the biting surfaces of our teeth wearing. The first would be chewing and grinding. The second would be damage caused by acid.

Old metal fillings

Old metal fillings made out of amalgam can last for years and years. And if they are working, there is no need to do anything about them. Amalgam fillings do contain mercury but in a solid state. This is safe and there is no evidence that these amalgam fillings have a negative effect on your health.

If you would like to know more about the safety of amalgam fillings, please read our article.

People now in their 50’s and 60’s did not grow up with the benefit of the fluoride toothpastes that we take for granted today. This generation often have very large metal fillings that were placed when they were teenagers and have been replaced and extended over the years. In this situation, the remaining tooth around the filling can chip or fracture away. Often what’s left is a lot of metal but not much tooth.

Large Metal Amalgam Filling

Large Metal Amalgam Filling

Gum shrinkage (recession)

The expression ‘long in the tooth’ comes from the way that your gums can recede as you get older. When your gums shrink back, they expose the root surface of your teeth. This can lead to sensitivity. It can also lead to damage to the soft root surface from eating and brushing.

Dry mouth

As we age, we face challenges to our health as well as our teeth. Some of us can end up on a whole cocktail of drugs to control things like blood pressure, glaucoma and diabetes to name just a few.

Medicine Tablets

All of these medications have side effects. One of the most common side effects is a dry mouth. Many medications reduce the saliva that flows around your mouth. Saliva flows around our mouth to cleanse and protect it. If the saliva isn’t there, it cannot perform its function. If you suffer with a dry mouth, you are much more at risk of tooth decay. And if your gums have receded, this may well start on the exposed root surface.

The solutions

Okay, all I’ve done so far is give you a list of possible problems. Not particularly helpful and you may have been aware of them anyway. Now what we need are solutions. We need ways to future proof our mouths and make sure we keep our teeth. Let’s start with how to combat tooth wear.

Tooth wear fixes

There’s two elements to this. Firstly, you need to try and minimise the amount of wear that affects your teeth. If you grind your teeth, you may benefit from something like a night guard. Avoiding acidic foods like fizzy drinks are the best way to prevent acid damage. For more diet advice, read the article.

If your teeth have been damaged by wear, it may be possible to rebuild them. There are different ways of doing this. You can use filling materials or you can use porcelain. For more information of treatment of worn teeth, read our article.

Fractured teeth around large fillings

This can be very tricky to prevent if not impossible. Teeth with huge metal fillings can remain sound indefinitely. However, they can fracture. Sometimes teeth require extraction if they fracture below the gum line. However, often fractured teeth can be saved. There are a couple of ways that you can rebuild a tooth in this situation. You can just refill it. But a filling doesn’t tend to add any strength to a tooth so the tooth could fracture again. The second option is to consider something like a crown.  The idea of a crown is that it covers the remaining tooth, protecting it and keeping the tooth strong in the bite.

Preventing and treating gum recession

Again, there are a couple of key issues here; preventing recession and treating recession.

Gums will shrink back naturally with time. But this can be made worse by overzealous brushing. Scrubbing away at your teeth will get them clean but overdoing it will cause recession. An electric toothbrush is a great way to avoid overbrushing. Electric toothbrushes do the work for you and most will tell you when you are pressing too hard.

Often, gum recession doesn’t need any treatment. But sometimes the exposed root surface of the teeth can start to wear away. The root of a tooth is made of dentine. This is much softer than the enamel that covers the top of the tooth. So with eating and brushing, the root can wear and a cavity can form. If this happens, it may be beneficial to repair the root surface with a tooth coloured layer which protects and insulates the tooth.

Worn Teeth Before Treatment

Worn Teeth Before Treatment

Worn Teeth After Treatment

Worn Teeth After Treatment

It is also sometimes possible to graft gum back onto the root. This is not always possible and requires a minor surgical procedure. For more information on treatment of gum shrinkage, read the article.

Dealing with a dry mouth

Having a dry mouth can be uncomfortable. Some people find that sipping water through the day helps with the lack of saliva. Carry a bottle with you and take regular mouthfuls. The other thing you can try is sugar free gum. Chewing gum can help to get your salivary glands going, making more saliva.

If you’re on medications that cause a dry mouth, you are more at risk of tooth decay. So caring for your teeth is even more important than normal. For everything you need to know about taking control of your dental health, read the article.

If you are at high risk of tooth decay, it may be worth asking your dentist for a prescription toothpaste. Prescription toothpastes have more fluoride in them than what you can buy in the shops. Fluoride adds itself to the surface of your teeth. This strengthens the teeth and protects them against decay.

Keeping your teeth forever

Challenges facing older patients

That’s what we all want to do, right? We want to keep as many teeth as possible. As time passes, your mouth and teeth will change. There is a lot that you can do to protect them but you are going to need help from your dentist too.

Of course, there is the possibility that teeth will be lost. This can be despite everything you and your dentist do to protect them. If this is you, don’t worry. There are solutions for missing teeth.

But if you understand how to care for your mouth, you are in control of your dental health. And if you’re in control, you will prevent problems and protect your teeth.

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