How to keep your teeth healthy | members only

A healthy smile knows no age. At least, not in theory. In practice, however, aging comes with an increased likelihood of cavities, gum disease, tooth loss and oral cancer, according to the

U.S. Centers for Disease Control and Prevention (CDC), which attributes older adults’ oral risks to reduced saliva production, receding gums, and difficulties flossing and brushing due to

poor vision, cognitive decline, chronic disease and physical limitations. In fact, one in every five adults age 65 or older has untreated tooth decay; nearly as many have lost all their

permanent teeth due to oral health challenges; and approximately two in three have gum disease, the American Dental Association (ADA) reports. The good news: Proper oral hygiene can help

people of any age attain and maintain a healthy mouth, says general dentist Heidi Aaronson, owner of New Generation Dental Center in Wellesley, Massachusetts. A fellow of the American

College of Dentists, one of _Boston _magazine’s top dentists in Boston for seven years running, and founder of “Tooth Day at Fenway Park” — an annual event that brings oral cancer awareness

to fans of the Boston Red Sox, whose players are among her patients — Aaronson recently shared with us her best tips for fending off cavities, tooth loss, gum disease and other age-sensitive

oral maladies. BRUSH AT A 45-DEGREE ANGLE You already know you should be brushing your teeth at least twice a day, for two minutes each time. But the angle at which you hold your toothbrush

also matters. Don’t hold it straight on — you want to hold the bristles at a 45-degree angle so they get under the gumline. Use thorough, gentle back-and-forth motions. If you’re too

aggressive, you’ll harm your gums. The protective enamel that’s on your teeth ends right above where the gums stop. So if you’re brushing your gums away, you’re exposing the root surface,

which is much more prone to tooth decay since there’s no protective hard shell there. PAY SPECIAL ATTENTION TO SPOTS THAT ARE COMMONLY MISSED Often I find that’s the inside of the lower

teeth, right by the tongue. There are salivary glands right under your tongue, and they’re constantly squirting saliva onto the back of your lower front teeth. The minerals in that saliva

can interact with the plaque on your teeth to form tartar. So that’s where everything tends to build up. WORK TO PREVENT GUM DISEASE Periodontal disease, or gum disease, is caused by

bacteria around the teeth and under the gums. And as periodontal disease worsens, you get bone loss, which can lead to tooth loss. Bacteria under the gums can also cause clots to form in

blood vessels, which can break off and lead to a stroke. And studies have found links between the bacteria in our gums and Alzheimer’s disease, vascular dementia, heart disease, diabetes and

even erectile dysfunction. Flossing is one of the best things you can do to reduce your risk of gum disease. Brushing is not enough. FIND THE FLOSS THAT WORKS FOR YOU The problem for a lot

of older adults is that they have dexterity issues, which makes flossing more difficult. There are pre-threaded flossers with handles that make it a lot easier for some people to floss, but

I’m not a big fan of those because they cost a lot and you have to buy refills. A good alternative is floss picks. Or there are interproximal brushes that look like little pipe cleaners. I’m

a huge fan of those. HATE FLOSSING? TRY A WATER FLOSSER Water flossers have been a huge game-changer for a lot of my patients. It’s not exactly the same thing as flossing — a water flosser

gets under the gums really, really well, but it doesn’t get in between the teeth — but it’s a very good alternative for people who can’t or won’t floss. Hold it at 90 degrees at the gum

level and trace the scalloping of each tooth. You should spend about 30 seconds on each quadrant of your mouth. I’ve seen people with periodontal disease who start using a water flosser, and

within six months their periodontal disease is almost resolved. You can buy one for around $30 — and make sure to clean it regularly.​ ADDRESS DRY MOUTH Saliva re-mineralizes your enamel

to help resist cavities. And it inhibits the growth of harmful bacteria that cause bad breath and tooth decay. But one of the biggest problems for older adults is dry mouth. There are more

than 1,000 medications that cause it, including antidepressants, blood pressure and pain medications, tranquilizers and antihistamines. Changes in your body due to menopause and diabetes can

also cause dry mouth. So treating it is really important.