Brushing, flossing critical for a healthy mouth

Q. As I age, what can I do to keep my mouth healthy?

A. Your mouth is not exempt from the effects of aging. Older people suffer higher rates of gum disease, dental decay, mouth infections and tooth loss. Fortunately, you can keep your mouth looking and feeling younger than its years by practicing good oral hygiene.

Let's consider what happens in your mouth as you age. Your teeth are amazingly strong, but a lifetime of crunching, gnawing and grinding wears away the outer layer of enamel, as does exposure to acidic foods. Weakened enamel can set the stage for cavities. Cavities can lead to infections of the root of a tooth, requiring a root canal procedure. They also can weaken teeth, causing them to crack.

Along with our teeth, our gums get older too. Gum tissue naturally recedes with age. The gums pull away from the base of the teeth. This leaves a gap between the gum and the tooth that can become a prime target for tooth decay.

Plaque, a mass of bacteria all embedded in a gel-like substance, often forms in and near the gap between the gum and tooth. The bacteria secrete substances that damage the teeth and gums. Plaque is constantly forming, and if you don't remove it by regular brushing and flossing, it will build up and start to attract minerals such as calcium. That's called tartar, and it's hard to fully remove with a toothbrush.

Plaque can cause inflammation of your gums, a condition called gingivitis. When plaque and tartar start damaging the tooth, the soft tissue around the tooth and the jaw bone, you have periodontal disease.

Periodontal disease is the primary culprit in tooth loss among older adults. Fortunately, your dentist can treat periodontal disease with a combination of scaling to remove the hardened plaque and infected gum tissue, antibiotics, and — in advanced cases — surgery.

Medications can affect your oral health. Hundreds of medications cause dry mouth as a side effect. Lack of saliva can lead to irritation and infection in your mouth. It also raises your risk for gum disease and tooth decay. You can moisten a dry mouth by drinking more water and chewing sugarless gums or sucking on sugarless candies. Over-the-counter artificial saliva products may help as well.

So how do you keep your mouth healthy? You know the answer. The pillars of cavity and plaque prevention — brushing and flossing (at least twice a day), and regular cleanings at the dentist's office — remain as important as ever.

If you have trouble brushing and flossing by hand because of arthritis or other conditions, switch to an electric toothbrush. Use toothpaste and mouth rinses that contain fluoride. Fluoride helps rebuild the mineral crystals that make up tooth enamel. It may also inhibit bacteria-laden plaque from sticking to your teeth. With just a few minutes every day, you can protect your mouth and your health.

Ÿ Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com.