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Senior Correspondent

Q: I seem to be getting more cavities in my teeth as I get older. Is this another part of the aging process? 

A: Tooth decay — and gum disease — are caused by plaque, a layer of bacteria. This plaque can build up quickly on the teeth of older people. In addition, seniors have a greater tendency to get decay around older fillings. And we have more fillings than younger people because we didn’t all grow up with fluoride. 

Cavities in the roots of teeth are also more common among older adults, because the roots are exposed when our gums recede and we become “long in the tooth.” The root surfaces are softer than tooth enamel and decay more easily. 

Dry mouth, which is a lack of saliva, promotes tooth decay. Saliva is needed to neutralize the cavity-causing acids produced by plaque. 

Most dry mouth — a condition also known as xerostomia — is related to the medications taken by older adults rather than to the effects of aging. More than 400 medicines can affect the salivary glands. These include drugs for urinary incontinence, allergies, high blood pressure, depression, diarrhea and Parkinson's disease. Also, some over-the-counter medications often cause dry mouth. 

Dry mouth can also be caused by cancer treatments such as chemotherapy and radiation, nerve damage in the head or neck, the autoimmune disease Sjogren's syndrome, endocrine disorders, Alzheimer's disease, stroke, anxiety disorders and depression. 

Despite all of the dental problems related to age, seniors are holding onto their teeth longer than they used to. One reputable survey showed that the rate that seniors lose their teeth has dropped by 60 percent since 1960. This improvement has been attributed to advancements in treatment and better oral hygiene. 

Cleaning your teeth is especially important as you age. Dentists advise that you brush your teeth twice a day with a fluoride toothpaste and clean between your teeth with floss or other interdental cleaner. 

Gum disease is common among seniors because it develops painlessly over a long period of time. It is caused by plaque, but it can be aggravated by smoking, ill-fitting dentures and poor diet. Symptoms include bleeding, swollen or receding gums, loose teeth, a change in your bite, and persistent bad breath or taste. 

Another change as you grow older is difficulty keeping your teeth white. Again, plaque is to blame. Because plaque can build up faster and in greater amounts as we age, older people have a hard time maintaining a bright smile. Changes in dentin, the bone-like tissue that is under your enamel, may also cause your teeth to appear slightly darker. 

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