What every older adult needs to know about gum disease


Even after years of regular cleanings and good dental hygiene, it’s common for people over age 65 to experience periodontal disease, also known as gum disease. In fact, nearly 60% of people in this age group have gum disease.1

“Gum disease refers to inflammation and infection around the tissues that support your teeth and gums,” says David Hershkowitz, D.D.S., division chief of restorative dentistry at Penn Dental Medicine at the University of Pennsylvania. If left untreated, infection can spread to the bone. This can cause pain while you chew and may eventually lead to tooth loss.

Here’s a look at why periodontal disease is more common in older adults — plus how to prevent and treat it.

Why older adults are at higher risk of gum disease

Anyone can develop gum disease, at any age. But there are a few reasons why people over 65 may be at higher risk, says Dr. Hershkowitz. These include:

  • Dry mouth. This condition occurs when the salivary glands don’t produce enough saliva. About 30% of people over age 65 have dry mouth, as do 40% of those over the age of 80, according to the American Dental Association.2 One reason may be that older adults are more likely to be taking medications that can contribute to dry mouth, such as blood pressure medications, notes Dr. Hershkowitz.
  • Type 2 diabetes. If your blood sugar isn’t well controlled, it can lead to irregular immune responses, inflammation, decreased salivary flow and damage to vessels that bring blood supply and oxygen to the tissues, Dr. Hershkowitz explains.
  • Mobility issues. If you have a condition such as hand or wrist arthritis, it may be harder to floss and brush your teeth, says Dr. Hershkowitz.

How to keep your gums healthy

Gum disease can often occur with aging, but it’s not inevitable. Here are some things you can do to help prevent or keep it from getting worse.

Brush twice a day

The American Dental Association, recommends brushing twice a day for 2 minutes with a toothpaste containing fluoride. No matter if your toothbrush is manual or electric, both are effective at removing plaque.3

Electric toothbrushes are more expensive than manual ones, but they come at a variety of price points. And the more expensive ones are not necessarily better, notes Dr. Hershkowitz. “Whether you have a $50 electric toothbrush or a $500 one, they do the same things, with proper use,” he says.

Floss daily

Older adults who floss every day have a much lower risk of developing gum disease, according to a study.4 “Flossing helps remove bacteria and food that are caught between the teeth, which can cause gum inflammation,” says Dr. Hershkowitz.

If flossing is hard for you because of an issue such as wrist arthritis, you can use a water flosser. This is a device that aims a stream of water between your teeth to help remove food particles.

See the dentist regularly

Dr. Hershkowitz recommends that you see the dentist twice a year. You should also make an appointment to visit the dentist if you notice any signs of gum disease, including:5

  • Red, swollen, tender or bleeding gums
  • Loose or sensitive teeth
  • Pain while you chew
  • Persistent bad breath

UnitedHealthcare Medicare Advantage plans offer preventive and comprehensive dental benefits that can help protect your teeth and gums and can provide coverage for dental care not included with Original Medicare.6 This may include routine cleanings, fluoride, fillings, crowns, root canals, extractions and dentures. Specific dental benefits offered will vary by plan. If finances are a concern, other low-cost options include community health centers and dental schools. Learn more at the Bureau of Primary Health Care.

If you're under 65, there are also a variety of dental plan options to consider.

Don’t smoke or use tobacco

Smoking weakens your immune system, making it harder for the body to fight off gum infections. People who smoke have twice the risk of gum disease as that of nonsmokers, according to the Centers for Disease Control and Prevention.7  Tobacco in any form — cigarettes, pipes or spit tobacco — increases the risk. And if you do need to be treated for gum disease, the treatments may not work as well for smokers.7

Get treatment as soon as possible

Mild periodontal disease can be treated with scaling and root planing, says Dr. Hershkowitz. Your dentist will remove all the plaque above and below the gumline, cleaning all the way down to the bottom of your gum pocket. Then they will smooth out the teeth roots, to help your gums reattach. This generally takes more than one visit, and it often requires local anesthesia.8

If you have more extensive gum disease, it may require surgery. Your dentist will fold back gum tissue to remove disease-causing bacteria, then smooth over diseased bone before putting the tissue back into place.9

It’s best to see your dentist as soon as you notice any gum issues — and to keep up with regular dental checkups. That way, you can keep your teeth and gums as healthy as possible as you age.

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