Midlife Prevention for a Healthy Mouth and Dentition

  • Frauke MüllerEmail author
Part of the Practical Issues in Geriatrics book series (PIG)


This chapter highlights that too often the mouth is not considered as part of the body and forgotten during any clinical assessment, whatever the age of the patient. Ageing affects considerably the multiple components of the orofacial system such as teeth, mucosa, saliva, jaw-closing muscles, temporo-mandibular joint and the alveolar bone. The most prevalent oral conditions in old age remain coronal and root caries as well as periodontal disease, all fostering tooth loss when left to progress without treatment. Most oral diseases and tooth loss can be avoided by managing the related risk factors, notably by adopting a healthy diet, daily meticulous oral hygiene with topical application of fluoride, moderate alcohol intake and smoking cessation. Dental restorations should be state of the art to avoid biological and technical complications. The regular use of dental services along with an individual oral health care plan, ideally established in midlife between the patient and his dentist, help to maintain a healthy mouth and dentition for life.


Oral health Oral diseases Coronal and root caries Tooth loss Peridontal disease Oral mucosa Salivary glands Temporo-mandibular joint 


  1. 1.
    WHO (2003) The world health report 2003—shaping the future. World Health Organization, GenevaGoogle Scholar
  2. 2.
    Petersen PE, Bourgeois D, Ogawa H et al (2005) The global burden of oral disease and risks to oral health. WHO, GenevaGoogle Scholar
  3. 3.
    Li X, Kolltveit KM, Tronstad L, Olsen I (2016) Systemic diseases caused by oral infection. Clin Microbiol Rev 13:547–558CrossRefGoogle Scholar
  4. 4.
    Hayes M, Da Mata C, Cole M et al (2016) Risk indicators associated with root caries in independently living older adults. J Dent 51:8–14. CrossRefPubMedGoogle Scholar
  5. 5.
    Ryan Camilon P, Stokes WA, Nguyen SA, Lentsch EJ (2014) The prognostic significance of age in oropharyngeal squamous cell carcinoma. Oral Oncol 50:431–436. CrossRefPubMedGoogle Scholar
  6. 6.
    Jin LJ, Lamster IB, Greenspan JS, Pitts NB et al (2016) Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis 22:609–619. CrossRefPubMedGoogle Scholar
  7. 7.
    Newton JP, Abel EW, Robertson EM, Yemm R (1987) Changes in human masseter and medial pterygoid muscles with age: a study by computed tomography. Gerodontics 3:151–154PubMedGoogle Scholar
  8. 8.
    Liu B, Dion MR, Jurasic MM, Gibson G, Jones JA (2012) Xerostomia and salivary hypofunction in vulnerable elders: prevalence and etiology. Oral Surg Oral Med Oral Pathol Oral Radiol 114:52–60.; [pii]: S2212-4403(12)00035-1CrossRefPubMedGoogle Scholar
  9. 9.
    Luraschi J, Korgaonkar MS, Whittle T et al (2013) Neuroplasticity in the adaptation to prosthodontic treatment. J Orofac Pain 27:206–216. CrossRefPubMedGoogle Scholar
  10. 10.
    Hartmann R, Müller F (2004) Clinical studies on the appearance of natural anterior teeth in young and old adults. Gerodontology 21:10–16CrossRefGoogle Scholar
  11. 11.
    Sheiham A, Steele JG, Marcenes W et al (2001) The relationship among dental status, nutrient intake, and nutritional status in older people. J Dent Res 80:408–413CrossRefGoogle Scholar
  12. 12.
    Millwood J, Heath MR (2000) Food choice by older people: the use of semi-structured interviews with open and closed questions. Gerodontology 17:25–32CrossRefGoogle Scholar
  13. 13.
    Papas AS, Joshi A, Giunta JL, Palmer CA (1998) Relationships among education, dentate status, and diet in adults. Spec Care Dentist 18:26–32CrossRefGoogle Scholar
  14. 14.
    Weiss A, Beloosesky Y, Boaz M et al (2008) Body mass index is inversely related to mortality in elderly subjects. J Gen Intern Med 23:19–24. CrossRefPubMedGoogle Scholar
  15. 15.
    Moynihan P (2005) The interrelationship between diet and oral health. Proc Nutr Soc 64:571–580CrossRefGoogle Scholar
  16. 16.
    Moynihan PJ, Butler TJ, Thomason JM et al (2000) Nutrient intake in partially dentate patients: the effect of prosthetic rehabilitation. J Dent 28:557–563CrossRefGoogle Scholar
  17. 17.
    World Health Organization (2015) World report on ageing and health. WHO Press, GenevaGoogle Scholar
  18. 18.
    Peltola P, Vehkalahti MM, Wuolijoki-Saaristo K (2004) Oral health and treatment needs of the long-term hospitalised elderly. Gerodontology 21:93–99CrossRefGoogle Scholar
  19. 19.
    Bergstrom J (1989) Cigarette smoking as risk factor in chronic periodontal disease. Community Dent Oral Epidemiol 17:245–247CrossRefGoogle Scholar
  20. 20.
    Pretty IA, Ellwood RP, Lo EC et al (2014) The Seattle Care Pathway for securing oral health in older patients. Gerodontology 31(Suppl 1):77–87. CrossRefPubMedGoogle Scholar
  21. 21.
    Krall EA, Wehler C, Garcia RI et al (2001) Calcium and vitamin D supplements reduce tooth loss in the elderly. Am J Med 111:452–456CrossRefGoogle Scholar
  22. 22.
    Jenson L, Budenz AW, Featherstone JD et al (2007) Clinical protocols for caries management by risk assessment. J Calif Dent Assoc 35:714–723PubMedGoogle Scholar
  23. 23.
    Walls AW, Meurman JH (2012) Approaches to caries prevention and therapy in the elderly. Adv Dent Res 24:36–40. CrossRefPubMedGoogle Scholar
  24. 24.
    Gunsolley JC (2010) Clinical efficacy of antimicrobial mouthrinses. J Dent 38(Suppl 1):S6–S10. CrossRefPubMedGoogle Scholar
  25. 25.
    Sjögren P, Nilsson E, Forsell M et al (2008) A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc 56:2124–2130. CrossRefPubMedGoogle Scholar
  26. 26.
    Sjögren P, Wardh I, Zimmerman M et al (2016) Oral care and mortality in older adults with pneumonia in hospitals or nursing homes: systematic review and meta-analysis. J Am Geriatr Soc 64:2109–2115. CrossRefPubMedGoogle Scholar
  27. 27.
    Iinuma T, Arai Y, Abe Y et al (2015) Denture wearing during sleep doubles the risk of pneumonia in the very elderly. J Dent Res 94:28S–36S. CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Stafford GD, Arendorf T, Huggett R (1986) The effect of overnight drying and water immersion on candidal colonization and properties of complete dentures. J Dent 14:52–56CrossRefGoogle Scholar
  29. 29.
    Maupome G, Peters D, Rush WA et al (2006) The relationship between cardiovascular xerogenic medication intake and the incidence of crown/root restorations. J Public Health Dent 66:49–56CrossRefGoogle Scholar
  30. 30.
    Weeks JC, Dutt A, Robinson PG (2003) Promoting sugar-free medicines: evaluation of a multi-faceted intervention. Community Dent Health 20:246–250PubMedGoogle Scholar
  31. 31.
    Makinen KK, Pemberton D, Cole J et al (1995) Saliva stimulants and the oral health of geriatric patients. Adv Dent Res 9:125–126. CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal Medicine, Rehabilitation and Geriatrics, Service of GeriatricsUniversity Hospitals of GenevaGenevaSwitzerland
  2. 2.Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental Medicine, University of GenevaGenevaSwitzerland

Personalised recommendations