June 26, 2009
For the nation’s 36 million seniors, humor often is the perfect antidote to the daily challenges of aging, especially when it comes to teeth. But denture jokes have much less of a bite these days than they did a generation or two ago. According to the latest national oral health survey published in 2004, roughly two out of every 10 older Americans are edentulous, or toothless. In the mid 1980s, that number was four out of every 10 older Americans. As a greater proportion of Americans enter their retirement years, dentists will treat more largely dentate seniors. The problem is not enough is now known about the scope of their oral health needs.
In the June issue of the journal Gerodontology, NIDCR grantees and colleagues provide some interesting new data on the periodontal health of older men. The data are from the MrOS dental study, a component of the Osteoporotic Fractures in Men (MrOS) study that is under way at research sites in Portland, Oregon and Birmingham, Alabama. In the reported study, dentists and hygienists offered half-mouth periodontal examinations to 1,347 study participants. The men were mostly Caucasian, averaged 75 years of age, and nine out of 10 retained their natural teeth. But, as the authors noted, they formed an especially unique research cohort. The men were highly educated, largely in good to excellent health, most visited the dentist annually, and 37 percent had never smoked. The latter being a key point because smoking is a strong risk factor for chronic periodontitis, suggesting the incidence of the disease might be fairly low in this group. But the researchers found a surprisingly ‘high proportion’ of these men had evidence of gum disease. Specifically, 38 percent had calculus below the gum line, 53 percent had gingival bleeding, 82 percent had at least one site with clinical attachment loss of gum tissue that was five millimeters or more, and 34 percent had at least one site with a pocket depth between tooth and gum of six millimeters or more. The researchers also reported that 38 percent had severe periodontitis.
“Despite annual dental visits by the majority of these well-educated, non-smoking men, the extent of severe periodontitis suggests that the goals of the dental visit may need to be redirected as men age,” the researchers noted. “While there is a prevailing clinical impression that adults who maintain the vast majority of their dentition past 65 years of age are relatively resistant to chronic periodontitis, worsening oral hygiene status and the higher risk of periodontal pockets in the oldest-old suggests that some older adults may need to be moved from a routine disease prevention regimen to a more intense disease management programme. It is possible that dentists may be assuming that moderate disease is coincident with age rather than active bacterial infection, thereby systematically undertreating older adults, leading to the severity of disease seen in this report.”
- Phipps KR, Benjamin KS, Chan S, Jenning-Holt M, Geurs NC, Reddy MS, Lewis CE, and Orwoll ES. Periodontal health of older men: the MrOS dental study, Gerodontology 2009; 26: 122-129.