Dentitions of Senior Citizens

We ran our year-end reports and one statistic in particular set me to thinking.  Woolgathering and mulling, actually.  Taking a snapshot at 2010's twilight we see that 8% of our patients are age 80 and over.

And nearly all of these excellent folks have most or all of their teeth.

Oh, sure, they may have crowns to restore teeth that must have got hit with decay when they were younger.  (That's the thing about teeth- being hard, mostly mineral objects that don't have the healing capacity of tissues made up of living cells, they really show the wear and tear that we subject them to, whether from decay or excessive grinding.  They don't "heal" in the traditional sense of the word.)  Our older patients may also have bridges or implants to replace a number of missing teeth.  Some even have partial dentures because they find it economically challenging to replace a number of missing teeth with "fixed" restorations, bridges or implants that stay in place.  Still, modern partials can be made very stable and esthetic.

Few of our patients, however, have full dentures, especially without implant support.  A denture with implant support is an oral Rock of Gibraltar, an immovable object that is locked and loaded and ready to face that irresistable force of "Lobster Thermidor a Crevette with a mornay sauce served in a Provencale manner with..."  Oh, you know the rest...

When I first started in practice here, though, in (gasp!) 1988, the vast majority of our patients who were 80 and older had removable dental prostheses- full or partial dentures.  They also tended to have breakdown of their bites, crowding, high decay rates, uncontrolled plaque and gum disease... Their dental health was much poorer than the population group who is 20 years younger and is now "coming up" into the eldest age range that human beings commonly attain.  80 to 100!  How fortunate we are that so many of us can live that long these days.

In any event, I remarked on this to Dr. Sukoneck last night and he replied that, although we now make only a few dentures each year, mostly replacements, not new ones- years ago, he made a dozen or more dentures a month!  I cannot even conceive of such a thing happening now.

The reasons for these incredible positive changes in the dental health of American seniors are complex.  One major factor is that in the early part of the 20th century dentistry was often painful and the technology was primitive, even by the overall medical standards of the day.  Sugar was also readily available and awareness of its role in causing cavities was minimal.  Fluoridation of water was still decades away, and in many communities it never happened.  Thus it is documented that from the 1910's to the 1940's, 95% plus of Americans' back teeth had decay or fillings.

Thus the oldest patients that we saw 20 years ago did not, generally speaking, benefit as much from preventive dental care nor from the improved treatments that became available later.  Much progress has been made, and this progress has benefitted the oldest patients that we see now.

In looking for a picture for this post, this one came to mind- my Dad (quite natural-toothed himself) on the wing of a P-47 Thunderbolt.  Just two weeks after his 90th birthday...

 
Casual Insouciance at 90!

Comments

[Jesse Hake]

Hmmm...I think the reason for it is simple: dental care is very important to them. Now, despite the advancements in dental care, people still tend to forget the basics. Great picture! Did your dad fly Thunderbolts during the war? My dad flew Hellcats, hehe.

[Rick Wilson DMD]

Thanks for commenting, Jesse. No, Dad was in WWII in France, but not as a pilot. He's always been a fan though! And, man, the F6F has just about the best combat record of any plane in history until the F-15, what? And how did your Dad and all those Navy pilots ever land them on those old flattops...