Adult Oral Health Conditions

It is a known fact that we all get only one set of permanent teeth. Therefore, it is essential to take proper care of the teeth and gums for our entire life. The threat to oral infections, tooth decay, and tooth loss continuous throughout life. The risk of losing teeth increases with age due to reduced saliva production.

Often many people face difficulties in accessing dental treatments. Moreover, they dread the cost of dental procedures and try to fix dental problems by using pain medications. As we grow older, some of our health concerns earn full attention, and we start to neglect our oral health.

However, many people don’t know that oral health is directly linked to overall health and well-being — for example, immune disorders, diabetes, and bone disorders like osteoporosis. Today’s article will highlight the importance of adult oral health care and common oral health problems faced by adults.

What is the effect of poor oral hygiene on adult oral health?

Poor oral hygiene is not limited to young children and adolescents. It can happen to anyone as long as you have natural teeth in your mouth. The prime cause of poor oral hygiene is excessive plaque and bacterial growth in the mouth. (1)

Dental plaque is a biofilm of bacteria that usually build on the surface of the tooth. Plaque also forms a host for bacterial growth. With increased consumption of food rich in sugar and carbohydrate, the plaque and bacteria together produce acids that eat away the tooth enamel over time.

Moreover, they can attack an existing tooth filling and form carious lesions around it. Other consequences of poor oral hygiene include gum infection, periodontal breakdown, bone, and tooth loss. Additionally, oral bacteria may enter the bloodstream and spread the disease to the vital organs of the body, such as the heart. (2)

Another common issue faced by adults is dry mouth. Dry mouth is an oral condition which is caused by reduced salivary flow and production in the mouth. It makes chewing, swallowing, and speaking difficult. Moreover, it increases the risk of tooth decay and gum infections. Regular dental check-ups are crucial for every adult to keep a check on their oral health status.

What are the common adult oral health problems and treatments?

Gum disease

Gingivitis or gum disease is a reversible disease which affects the health of the gums. However, failure to treat gingivitis may lead to a more severe and destructive form of disease progression. Around 25% of the population in the United States suffer from severe gum disease.

The first sign of gum disease is usually bleeding from the gums, followed by redness and swelling around the gums. As the disease progresses, it involves the deeper periodontal tissues which form the anchoring units of the tooth.

Periodontal disease causes detachment of the gums from the tooth surface. Furthermore, it can cause bone and tooth loss in advanced stages. Treatment of gum disease often depends upon the type and extent of the disease progression. It can range from simple scaling and root planning to gum graft surgeries. (3)

Good oral hygiene practice is crucial to revert the health of the gums and prevent severe complications of periodontal disease. Brush your teeth at least two times a day, followed by flossing. Regular dental check-ups are essential for periodontal examinations.

Dental conditions that involve the tooth

Tooth decay and cavity

Studies have shown that an average adult between the ages of 20 and 64 has three or more decayed teeth in the mouth. Moreover, one in every four adults in the United States have untreated tooth decay. That sums up to around 27% of the total population in the United States. Several causes lead to tooth decay and the formation of tooth cavities

  • Poor oral hygiene
  • Dry mouth
  • Consumption of food rich in sugars and carbohydrates
  • Drinking acidic and sugary drinks

All of these reasons encourage plaque and bacterial accumulation in the mouth. These two components produce acids that cause enamel demineralization. Further progression of this process leads to tooth decay and cavity formation. (4)

Treatment of tooth decay also depends on the extent of the cavity. Small lesions can be treated with a tooth filling. However, deeper decay that has involved the pulp tissue may require a root canal treatment. In adults, poor oral hygiene often causes tooth decay around existing tooth fillings. Therefore, it is crucial to maintain good oral health even after treating your teeth.

Tooth sensitivity

Tooth sensitivity is also a consequence of enamel demineralization. As the enamel layer gets depleted, it exposes the underlying dentin to the oral environment. Dentin consists of multiple tubules that are highly sensitive to air, pressure, and temperature. Usually, hot and cold foods aggravate tooth sensitivity and make the person wince. Some of the causes of tooth sensitivity may include –

  • Tooth decay
  • Acid erosion
  • Fractured tooth
  • Fractured filling
  • Gum disease
  • Exposed tooth root

Extensive dental conditions like tooth decay and fracture can be treated professionally using tooth filling or crown placement procedures. Preventative measures to address tooth sensitivity include the use of desensitizing toothpaste. However, proper oral health care is the key to the prevention of tooth sensitivity.

Tooth staining and discoloration

In today’s world, people are more conscious about the color of their teeth and the look of their smile. Tooth discoloration often takes a toll on the self-esteem and confidence of a person. Multiple reasons can cause tooth staining and discoloration. Such factors can be characterized as follows –

  • Poor oral hygiene – inadequate tooth brushing and flossing allows plaque accumulation that forms a yellowish sticky layer on the tooth surface. Plaque also attracts tooth staining food substances and further degrades the natural color of the teeth.
  • Oral habits – smoking or tobacco chewing are one of the prime causes of tooth staining. Such practices can eventually cause permanent tooth discoloration.
  • Foods or drinks – many foods and beverages like tea, coffee, wine, and citrus fruit cause evident tooth staining.
  • Oral disease – tooth decay, head and neck radiation therapy, chemotherapy, and oral infections are some of the common oral conditions that cause tooth discoloration. Additionally, specific dental treatments, like amalgam restorations, can cause tooth staining.
  • Medications – antibiotics like tetracycline and doxycycline are well known to cause tooth discoloration. Additionally, mouth rinses that contain chlorhexidine and cetylpyridinium chloride also cause tooth staining. Other medications include antihistamines, antipsychotic drugs, and antihypertensive medications.
  • Genetic and environmental factors – excessive fluoride levels and genetically thinner enamel are prime sources of tooth staining.
  • Aging – is the age advances, the enamel layer wears down, exposing the underlying dentin. Such events cause a decrease in tooth transparency, which gives a darker appearance.
  • Traumatic injury – traumatic injury in young adults can sometimes disturb the enamel formation of developing permanent teeth. Such events cause permanent tooth discoloration of the adult tooth.

Superficial stains on the tooth surface can often be treated with simple oral health practices and professional tooth cleaning procedures. However, extensive tooth discolorations may require tooth whitening treatment or enamel microabrasion, which provides a shiny and smooth appearance to the enamel.

Permanent tooth discolorations often cannot be treated by chemical treatments. These cases may require placement of veneer or crown to cover the damage and improve the aesthetics of the smile.

Missing teeth

Missing teeth is one of the most common dental findings in an adult’s mouth. Loss of teeth can have a significant impact on the functions of the mouth; for example; it interferes in proper chewing and speaking. Moreover, missing teeth can cause loss of bone in that particular area. (5) Several reasons cause tooth loss at an early age –

  • Systemic conditions like diabetes
  • Genetic disorders like ectodermal dysplasia
  • Congenitally missing teeth
  • Tooth decay
  • Progressive gum disease

It is essential to replace the missing tooth and fill the space between the teeth. Failure to do so can further increase the damage; for example, it causes a shift in the positioning of adjacent teeth, difficulty in chewing food, and affects the look of your smile. Often the treatment for replacement of missing teeth includes the following –

  • Bridge – usually a three-unit bridge is suitable for single tooth replacement. These fixed unit rakes support from the adjacent teeth to anchor the replaced tooth.
  • Dentures – These are removable dental appliances which are commonly preferred by older adults above the age of 60 years. A denture is mainly used for multiple tooth replacement. (6)
  • Implants – Dental implants are an excellent way of tooth replacement. It consists of a titanium screw that acts as the tooth root and supports the dental crown in the arch. Implants provide closest aesthetic results to a natural tooth.

Fluorosis

Fluorosis is a dental condition which causes gives a mottled appearance of the teeth. This condition is formed due to excessive intake of fluoride, especially during the developmental stages of permanent teeth.

Clinically, fluorosis is seen as an intrinsic discoloration on the tooth surface. Moreover, it damages the enamel structure giving it a rough chalky or pitting on the tooth texture. Often patients with fluorosis have a low risk of caries development.

Typically, fluorosis has a high chance of occurrence from the time a child is born to eight years of age. However, the permanent effects of fluorosis persist in adulthood. A person with dental fluorosis is advised not to use fluoridated toothpaste or any fluoride supplements. Acidic drinks are strictly avoided to prevent enamel erosion. Treatment of fluorosis may vary depending on the severity of the condition.

  • Mild stages are treated by bleaching agents to improve the discoloration.
  • Moderate fluorosis often requires micro-abrasion of the tooth.
  • Severe fluorosis may require veneers, crowns, and tooth-colored fillings to cover the defects and discoloration of the teeth.

Dry mouth

Dry mouth is an oral condition which reduces the salivary flow and production in the mouth. Often this condition is influenced by –

  • Certain medications like diuretics, decongestants, antidepressants, and antihistamines.
  • Health conditions like rheumatoid arthritis and Sjogren syndrome.
  • Other causes of dry mouth include radiotherapy, neurological problems, and a dysfunctional immune system.

Symptoms of dry mouth usually include a constant discomfort and dry feeling in the mouth, burning mouth, difficulty in chewing, swallowing, and speaking. Moreover, dry mouth is one of the most significant contributors to tooth decay and gum disease. Dry mouth is usually treated by a preventative measure such as –

  • Increased consumption of water
  • Proper oral health care practice
  • Use of sugarless chewing gum to increase the salivary flow
  • Avoidance of spicy food, tobacco, alcohol, and acidic food items

Oral cancer

Oro-pharyngeal cancer has become an increasing oral health problem among older adults, especially in people between the age of 45-55 who are heavy smokers and drinkers. The commonly affected sites include the lips, tongue, gums, lining of the cheek, jaw bone, roof of the mouth, and throat. (7)

Often these lesions start as pre-malignant tiny white or red spots. Sometimes these lesions may be accompanied by swelling or soreness in the mouth and throat. Typical symptoms of oropharyngeal cancer include –

  • Red or white wounds in the mouth that bleed easily
  • Non-healing oral ulcers
  • Sore mouth
  • Presence of thick and hard lumps in the mouth
  • Numbness, pain or tenderness in the affected area
  • A shift in the positioning of the teeth

Regular dental visits are crucial to detect the signs and symptoms of oral cancer at an early stage to allow proper treatment of the lesion. This includes a thorough dental examination followed by an x-ray study. A biopsy may be required to confirm the diagnosis and identify the type of oral cancer. Treatment of oropharyngeal cancer often includes radiotherapy, chemotherapy, and surgical intervention to altogether remove the lesion.

Effect of Chronic diseases

Our health and well-being have a direct link with oral hygiene and conditions. Often diseases like diabetes, heart disease, weak immune system, and use of multiple medications can increase the risk of tooth loss and poor oral health. It is essential to treat the underlying health condition to control oral symptoms and improve oral health. Some of the common chronic health diseases and its effect on oral health are listed as follows –

Hormonal changes

Pregnancy and menopause are the two main types of changes that affect the oral health of a woman. Some of the causes of oral lesions during pregnancy may include –

  • Increased hormone levels in the body tissues
  • Change in eating habits
  • Vomiting or morning sickness
  • Medications

Usually, hormonal changes in the oral tissues can lead to increased risk of gum disease and bone loss. It is essential to discuss your current situation with the dentist to come up with effective treatment plans and dental routines. Moreover, the dentist will take precautions while taking dental x-rays, especially during pregnancy.

Menopause is characterized by physiological changes in the body due to reduced estrogen production. This condition often affects the oral health in the following ways –

  • Increased risk of periodontal disease
  • Dry mouth and burning mouth sensation
  • A drop in calcium level that causes fragile bones and often leads to osteoporosis of the jawbones
  • Increased risk of tooth decay and cavity formation

Usually, symptomatic treatment is followed to control the dental conditions. Moreover, diet modification and supplements are advised to maintain calcium levels in the body.

Systemic disease

Diabetes is one of the leading health conditions that affect the majority of the American population. Moreover, it has a substantial negative impact on oral health which includes –

  • A decreased salivary flow that causes dry mouth
  • Increased risk of tooth decay and gums disease
  • Increased sugar levels slow down the healing of cold sores, ulcers or cuts in the mouth (8)
  • Oral infections

Rheumatoid arthritis

Rheumatoid arthritis is a chronic autoimmune disease that affects multiple joints in the body. Most of the times, it causes swollen joints, followed by stiffness and inflammation of the affected area. Oral effects of rheumatoid arthritis include –

  • Gum disease and periodontal breakdown
  • Bone loss
  • Tooth loss
  • Poor oral hygiene
  • Change in the fit of dentures
  • Bad breath and taste alteration
  • Pain and tenderness around the temporomandibular joint

Treatment usually includes symptomatic approach. Regular dental visits are required for professional tooth cleaning, followed by diet counseling. Patients are educated on proper oral health care regime to avoid further progression of the oral disease.

Patients with stiff joints of hands or jaw may be advised to use alternative dental care products to ease the process of tooth brushing.

Retroviral disease

HIV/AIDS is well known to cause a weak immune system. (9) Moreover, it increases the risk of oral infections like –

  • Oral thrush – yeast infection in the mouth that may develop on the soft tissues.
  • Dry mouth
  • Painful sores
  • Fungal infections like candidiasis
  • Viral infections like herpes and HPV

Usually, oral signs and symptoms are the prime indicators that help the dentist to detect the underlying immune disorder.

Bone disorders

Osteoporosis is a condition that can cause weak bones and teeth. Moreover, it can rapidly progress the process of bone loss in the jaws. Medications used for osteoporosis also have adverse effects on the jaw bone. It can cause the formation of tumors or lumps that may affect the functionality of the mouth. Other oral effects of osteoporosis include –

  • Gum infections
  • Painful swelling of the jaw
  • Loosening of teeth
  • Numbness in the jaw bone
  • Bone exposure in the mouth

Preventative measures to maintain good oral hygiene and reverse gum infections are used. Usually, the patient is advised to continue their medications for osteoporosis to avoid weakening of the bone during dental procedures. Continuous communication between the dentist and physician helps to plan an effective treatment for the patient.

A note on dental insurance

Dental health insurance plays a significant role in providing beneficial healthcare plans for the betterment of oral health among the population. Typically, dental health insurance plans can be characterized as follows –

  • Direct reimbursement programs – these programs reimburse a predetermined percentage of the total cost of dental care regardless of the type of treatment. It allows full freedom to choose the type of dentist and provides incentives to the patient to work with the dentist towards a healthy and economical dental plan.
  • Usual, customary and reasonable plan – this plan affiliates a group of dentists in the area and allows the patient to choose among the selected dental professionals. Moreover, it pays a set percentage of the dentist’s fee or plan administrator’s reasonable and customary fee limit, whichever is less. (10)
  • Table or schedule of allowance program – this plan determines a list of covered services with an assigned amount of money. The dollar amount pays for the services regardless of the fee charged by the dentist. The patient pays the difference between the allowance charge and the dentist’s fee.
  • Capitation program – this plan pays contracted dentist a fixed amount per enrolled patient. In return, the dentist provides a few free services specified by the dental office.

Overview of adult oral health conditions and characteristics

Adults are usually at increased risk of dental problems because of their lifestyle and food habits. Moreover, certain health conditions can make a person more susceptible to oral infections. Some of the common dental problems faced by adults are tooth decay, gum disease, dry mouth, oral cancer, oral infections, and loss of bone and teeth.

Although several treatments can help to replace the teeth or fix the dental issue, it is essential to maintain excellent oral health. Good understanding of oral health care can help to prevent some of the problematic dental issues that occur with advancing age. Moreover, it helps to retain the natural teeth and keep them healthy for a long time.