Tooth Loss In Older Adults
Tooth loss in aging adults is of concern for nutritional status, bone health, the structure of remaining teeth, and psychological health.
Although the causes of tooth loss in older adults remain varied and somewhat contested, it is generally agreed upon that tooth loss is by and largely preventable.
Research indicates that older adults are at an increased risk for tooth loss largely thanks to a combination of gum recession and the subsequent exposure of root surfaces, dental caries, gingivitis, periodontitis, and medications.
The progressive nature of tooth loss is such that when one tooth is affected, the remaining teeth and jaw structure are compromised, inviting infection and poor function of the craniofacial unit.
Approximately 50% of persons aged >75 years live with at least one untreated dental carie, and 25% have lost supporting gum structure as a result of an advanced periodontal disease.
Additionally, a staggering 27% of American adults over age 65 have no remaining teeth.
Given this statistic, the prevalence of full and partial tooth loss should be of great concern to both consumers and dental professionals.
Certain groups are more severely affected by full or partial tooth loss than others: black seniors, women, smokers, lower-income individuals, and individuals with less education are more likely to have few or no remaining teeth.
While consumers focus primarily on the cosmetic implications of tooth loss, the physiological repercussions of full or partial tooth loss can be severe and may lead to significant disability.
Even when adjusting for other factors, studies have shown that adults with fewer than 20 teeth remaining at age 70 are significantly more likely to face imminent mobility problems, disability, and morbidity.
In certain instances, tooth loss may be related to trauma or dental caries. However, this is more common for younger adults.
In adults older than age 45, periodontal disease is the leading cause of tooth loss. 17% of adults over age 65 have diagnosed periodontal disease, which may manifest as gingivitis and/or periodontitis.
Additionally, 18% of adults have untreated decay that compromises existing teeth and bone structure, while 50% live with untreated dental caries, either as a consequence of neglect or lack of diagnosis.
Nutrition and Tooth Loss
Impaired nutritional status is of specific concern for older adults with missing teeth.
Nutrition status plays a significant impact on the retention of natural teeth as well as disability, morbidity, and general health and function.
Nutritional status of older adults suffers as teeth are lost and existing teeth are compromised. Studies have shown that Calorie-adjusted nutritional status decreases progressively with tooth loss. Fiber, vitamin, protein, and mineral consumption tend to decrease as teeth are lost. In older adults with missing teeth, prosthetic replacements are likely the most suitable means to spare existing teeth and supporting tissues, restore masticatory function, and improve nutritional intake.
Intake of vitamins, minerals, fiber, and protein are of significant concern with regards to the total and oral health of older adults, as these tend to decline with age, thanks to a variety of social and physiological factors. Unfortunately, these nutrients are the first to decline with tooth loss, further increasing the risk of loss of remaining teeth.
Studies have shown that supplementation of Calcium and Vitamin D help prevent tooth loss in older adults, as the consumption of both nutrients is strong correlates of whole-body bone loss. Sarcopenia also increases the risk for bone loss, which may be prevented through increased protein consumption. In order to reduce the loss of muscle and bone tissue that may lead to increase tooth loss, dental professionals should discuss diet and potential supplementation with older patients.
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