Dental and periodontal changes are normal phenomena that occur in the aging process. While some elderly patients may show only physiological wear of the teeth, others may develop more severe destruction, thus affecting oral health.

This article examines specific periodontal changes in elderly patients and the importance of regular dental care in this age group.

Dental wear

Tooth wear is a common phenomenon seen in elderly patients. It is influenced by several factors, including genetics, the thickness of the remaining enamel layer, diet and type of chewing.

Hard foods, which contain folates or silicates, can accelerate the process of tooth wear.

There are several types of tooth wear, such as erosion, which is the result of contact with chemicals, and abscesses, which are caused by occlusal trauma.

Dental alignment changes

Elderly patients may experience dental alignment changes following the loss of several teeth.

Edentations, whether missing several dental units or just one, can lead to the migration of bordering teeth towards the edentulous spaces. These changes can affect dental functionality and aesthetics and may require appropriate treatment such as dentures or implants.

Changes in enamel and interdental papillae

As patients age, tooth enamel can become thinner and lose its shine.

Enamel, which is made of hydroxyapatite, undergoes physiological wear processes and surfaces become smooth over time

advancing age, leaving gaps between teeth. These spaces can be unsightly and can pose a risk for the development of caries, particularly in the case of poor oral hygiene.

Dental contacts

The contacts between teeth are essential for the even dispersion of masticatory forces.

In young patients, the contacts are punctiform, but in older patients, they can become extended surfaces with shortening of the arches. These changes can affect masticatory function and may require occlusal adjustments to restore proper occlusion.

Dental pulp changes

At the level of the dental pulp, there is a continuous apposition of secondary dentin, leading to a shrinkage of the pulp chamber size. This process of thickening of the pulp walls reduces tooth sensitivity and patients may not feel the pain associated with carious lesions in the early stages.

It is therefore crucial that elderly patients have regular dental check-ups at approximately six-month intervals. These regular visits allow early identification and treatment of carious lesions and help to keep teeth on the arch for as long as possible.

The importance of regular dental care in elderly patients

Regular and proper dental care plays a crucial role in maintaining oral health in elderly patients. Understanding the specific changes that occur in the periodontium of elderly patients allows the dentist to provide an individualized treatment plan and offer appropriate oral care recommendations.

In addition, patients need to be aware of the importance of oral hygiene and a healthy diet in maintaining dental health.

Adopting correct brushing technique, flossing and using oral hygiene solutions can help prevent dental disease. Also, avoiding excessive consumption of acidic or sugary foods and drinks can help maintain healthy tooth enamel.

Teeth are multi-functional structures of the body that are involved in maintaining balance and health.

Like any other organ, dental units also deteriorate over time.

Genetics, the thickness of the remaining enamel layer, the food the patient eats and the type of chewing contribute to this wear and tear.

The patient can grind food in the following ways:

  • Vertical chewing, which involves large, vertical movements that maintain the sharp, abrupt relief of the occlusal surfaces.

  • Horizontal mastication – these are the scrubber type patients, who possess horizontal mastication. These patients produce lateral movements, rubbing the dental units together, with an increased risk of wear.

  • Combined vertical and horizontal chewing exhibits both lateral and vertical movements.

The teeth of elderly patients may be physiologically worn, correlating with the patient’s age, or may show much greater than normal destruction for this segment.

Specific aspects of healthy teeth of the elderly:

– worn dental crowns – due to chewing, phonation and swallowing, teeth wear down. Hard foods, which contain folates or silicates, also contribute to the acceleration of this process. Tooth wear can be of several types such as erosion, which is characteristic of contact with chemicals, and abscesses, which are the result of occlusal trauma.

– darker tooth color (brownish grey) – this color is caused by loss of thickness of the enamel layer. Thus, the underlying, darker-colored dentin shows through giving the tooth a yellowish color.

  • changes in tooth alignment due to the loss of several teeth – edentulousness is characteristic of elderly patients. Whether several dental units are missing or just one, the teeth that border the gaps will undergo changes, migrating towards the edentulous gaps.

Appearance of teeth in elderly patients:

  • The enamel has a smooth appearance and loses its shine- normally, in young people, the enamel is of appreciable thickness and the hydroxyapatite prisms of which it is composed have a varied arrangement, which gives it its glossy appearance. As enamel ages, however, it undergoes a physiological process of wear, whereby the surfaces become smooth.

  • Interdental papilla recedes – the spaces between the teeth in young people are occupied by dental papilla. As we age, the dental papillae recede with the rest of the gums and unsightly gaps remain between the teeth, which can be a risk factor for caries if hygiene is poor.

  • Dental contacts – teeth have contacts with each other, which play a role in the even dispersion of masticatory forces. In young people, the contacts are punctiform, whereas in the elderly, these points turn into surfaces, with shortening of the arches.

At the level of the dental pulp there is a continuous apposition of secondary dentin, which leads to a shrinkage of the pulp chamber size.

Thus, in case of aggression, the tooth will have a reduced sensitivity, therefore carious lesions can develop deeper without the patient feeling pain.

This is why it is important for the patient to have dental check-ups every six months, so that carious lesions can be detected early and the teeth can be kept on the arch for as long as possible.


Periodontal changes in elderly patients are normal phenomena that can affect oral health. Tooth wear, alignment changes, changes in enamel and interdental papillae, and pulpal changes are specific issues found in this age group. By understanding and monitoring these changes, along with proper oral care and regular visits to the dentist, elderly patients can maintain oral health and keep their teeth on their arches for a longer period of time.

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