By 2060, according to the US Census, the number of US adults aged 65 years or older is expected to reach 98 million, 24% of the overall population. Older Americans with the poorest oral health tend to be those who are economically disadvantaged, lack insurance, and are members of racial and ethnic minorities. Being disabled, homebound, or institutionalized (e.g., seniors who live in nursing homes) also increases the risk of poor oral health. Adults 50 years and older who smoke are also less likely to get dental care than people who do not smoke. Many older Americans do not have dental insurance because they lost their benefits upon retirement and the federal Medicare program does not cover routine dental care.

Oral health problems in older adults include the following:

• Untreated tooth decay. Nearly all adults (96%) aged 65 years or older have had a cavity; 1 in 5 have untreated tooth decay.
• Gum disease. A high percentage of older adults have gum disease. About 2 in 3 (68%) adults aged 65 years or older have gum disease.
• Tooth loss. Nearly 1 in 5 of adults aged 65 or older have lost all of their teeth. Complete tooth loss is twice as prevalent among adults aged 75 and older (26%) compared with adults aged 65-74 (13%).Having missing teeth or wearing dentures can affect nutrition, because people without teeth or with dentures often prefer soft, easily chewed foods instead of foods such as fresh fruits and vegetables.
• Oral cancer. Cancers of the mouth (oral and pharyngeal cancers) are primarily diagnosed in older adults; median age at diagnosis is 62 years.
• Chronic disease. People with chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) may be more likely to develop gum (periodontal) disease, but they are less likely to get dental care than adults without these chronic conditions. Also, most older Americans take both prescription and over-the-counter drugs; many of these medications can cause dry mouth. Reduced saliva flow increases the risk of cavities.

Oral cancer can start in any part of the mouth or throat, including the tongue. It is more likely to happen in people over age 40. A dental checkup is a good time for your dentist to look for signs of oral cancer. Pain is not usually an early symptom of the disease. Treatment works best before the disease spreads. Even if you have lost all your natural teeth, you should still see your dentist for regular oral cancer exams.

You can lower your risk of getting oral cancer in a few ways:

• Do not use tobacco products, such as cigarettes, chewing tobacco, snuff, pipes, or cigars.
• If you drink alcohol, do so only in moderation.
• Use lip balm with sunscreen.
• Electronic cigarettes (e-cigarettes) are relatively new, and scientists are still learning about their long-term health effects. However, we do know e-cigarette vapor contains cancer-causing chemicals.

Dry mouth happens when you don't have enough saliva, or spit, to keep your mouth wet. It can make it hard to eat, swallow, taste, and even speak. Dry mouth can increase your risk of tooth decay, fungal infections of the mouth, and cavities. Many common medicines can cause this problem. For example, medicines for high blood pressure, depression, and bladder-control issues often cause dry mouth.

There are things you can do that may help. Try sipping water or sugarless drinks. Don't smoke, and avoid alcohol, caffeine, soft drinks, and acidic fruit juices. Avoid spicy or salty foods. Sugarless hard candy or sugarless gum that is a little tart may help. Your dentist or doctor might suggest using artificial saliva to keep your mouth wet.

Sometimes, false teeth (dentures) are needed to replace badly damaged teeth or teeth lost because of gum disease. Partial dentures may be used to fill in one or more missing teeth. Dentures may feel strange at first. In the beginning, your dentist may want to see you often to make sure the dentures fit. Over time, your gums will change shape, and your dentures may need to be adjusted or replaced. Be sure to let your dentist handle these adjustments.

Be careful when wearing dentures because it may be harder for you to feel hot foods and drinks or notice bones in your food. When learning to eat with dentures, it may be easier if you:

• Start with soft, non-sticky food.
• Cut your food into small pieces.
• Chew slowly using both sides of your mouth.

Keep your dentures clean and free from food that can cause stains or bad breath. Avoid small crunchy foods that can get trapped under the dentures and hurt your gums. Brush dentures every day with a denture-care product, and soak them in water or a denture-cleansing liquid at night. Be sure to leave them out of your mouth while you sleep to prevent swollen gums.

Gum disease begins when plaque builds up along and under your gum line. Plaque causes an infection that hurts the gum and bone that hold your teeth in place. A mild form of gum disease may make your gums red, tender, and more likely to bleed. This problem, called gingivitis, can often be fixed by brushing and flossing every day.

A more severe form of gum disease, called periodontitis, must be treated by a dentist. If not treated, this infection can lead to sore, bleeding gums, painful chewing problems, and even tooth loss.

To prevent gum disease:

• Brush your teeth twice a day with fluoride toothpaste.
• Floss regularly.
• Visit your dentist routinely for a checkup and cleaning. Tell the dentist about any medical conditions you have and medications you take.
• Eat a well-balanced diet.
• Quit smoking. Smoking increases your risk for gum disease.

Teeth are covered in a hard, outer coating called enamel. Every day, a thin film of bacteria called dental plaque builds up on your teeth. The bacteria in plaque produce acids that can harm enamel and cause cavities. Brushing and flossing your teeth can prevent decay, but once a cavity forms, to avoid further damage, a dentist must fix it with a filling.

Use fluoride toothpaste to protect your teeth from decay. If you are at a higher risk for tooth decay (for example, if you have a dry mouth because of a condition you have or medicines you take), you might need more fluoride. Your dentist or dental hygienist may give you a fluoride treatment during an office visit or may tell you to use a fluoride gel or mouth rinse at home.

There is a right way to brush and floss your teeth. Every day:

• Gently brush your teeth on all sides with a soft-bristle brush and fluoride toothpaste. Replace your toothbrush every 3 to 4 months.
• Use small circular motions and short back-and-forth strokes.
• Brush carefully and gently along your gum line.
• Lightly brush your tongue or use a tongue scraper to help keep your mouth clean.
• Clean between your teeth with dental floss, prethreaded flossers, a water flosser, or a similar product. This removes plaque and leftover food that a toothbrush can't reach.
• Rinse after you floss.

People with arthritis or other conditions that limit hand motion may find it hard to hold and use a toothbrush. Some helpful tips are:

• Use an electric or battery-operated toothbrush.
• Buy a toothbrush with a larger handle.
• Attach the toothbrush handle to your hand with a wide elastic band.

See your dentist if brushing or flossing causes your gums to bleed or hurts your mouth. If you have trouble flossing, a floss holder may help. Ask your dentist to show you the right way to floss.

Taking care of your teeth and gums as you get older can prevent problems like toothaches, tooth decay (cavities), and tooth loss. A healthy mouth also makes it easier for you to eat well and enjoy food.

It's especially important to take care of your teeth and gums if you have a health condition like diabetes or heart disease — or if you're taking medicines that can cause oral health problems.

Follow the steps below to keep your teeth and gums healthy as you get older.

Brush and floss your teeth every day.

Brushing and flossing helps remove dental plaque, a sticky film of bacteria (germs). If plaque builds up on your teeth, it can cause tooth decay or gum disease.

• Brush your teeth with fluoride toothpaste twice a day — brush after breakfast and before bed
• Floss between your teeth every day — if you have trouble flossing, ask your dentist about using a special brush or pick instead

Watch for changes in your mouth.

Your risk of getting oral cancer increases as you get older. If you see any changes in your mouth, it’s important to get them checked out.

See a doctor or dentist if you have any of these symptoms for more than 2 weeks:

• A spot in your mouth, lip, or throat that feels uncomfortable or sore
• A lump or thick area in your mouth, lip, or throat
• A white or red patch in your mouth
• Difficulty chewing, swallowing, or moving your jaw or tongue
• Numbness in your tongue or mouth
• Swelling in your jaw
• Pain in one ear without hearing loss

See your dentist regularly for a checkup and cleaning.

There’s no single rule for how often people need to see the dentist – it varies from person to person. The next time you get a checkup and cleaning, ask your dentist how often you need to come in.

Keep in mind that Medicare doesn’t pay for routine dental care. You may want to get private dental insurance. Get help finding low-cost dental care.

Talk to your doctor about dry mouth.

Dry mouth means not having enough saliva (spit) to keep your mouth wet. Dry mouth can make it hard to eat, swallow, or talk. It can also lead to tooth decay or infection.

Dry mouth is a side effect of some medicines. It can also happen if you have certain health problems (like diabetes) or if you're getting chemotherapy or radiation (treatments for cancer).

If you have dry mouth, talk with your doctor or dentist and ask what you can do.

Practice healthy habits.

• Eat healthy and cut down on sugary foods and drinks. This can help prevent tooth decay – and it’s good for your overall health.
• Don't smoke or use other tobacco products. Smoking cigarettes, chewing tobacco, or using snuff puts you at higher risk for oral cancer. Smoking also increases your risk for gum disease.
• If you smoke, call 1-800-QUIT-NOW (1-800-784-8669) for free help quitting.
• If you drink alcohol, drink only in moderation. This means no more than 1 drink a day for women or 2 drinks a day for men. Heavy drinking increases your risk of oral cancer.

Do you take care of an elderly parent or other older adult? If so, remember that a healthy mouth can help them enjoy food, chew better, eat well, and avoid pain and tooth loss.

Plaque puts a healthy mouth at risk. It can collect on teeth that aren’t brushed well. The buildup can cause bad breath, tooth decay, and gum disease.

Some older adults need to be reminded to brush and floss teeth. Others may need help actually getting it done.

You can take steps to help make brushing easier. For example, try a power or multiple-sided toothbrush. You can also modify the toothbrush handle to make it easier to hold.

If older adults need help, remember to wash your hands and wear disposable gloves before you begin. Use the “tell-show-do” approach. Tell them what you are going to do, show them, and then do what you’ve described.

Regular dental visits are important too. At a dental visit, you can ask for ways to help the person you care for.