Are you getting "long in the tooth" or long in the tooth?





We have all heard of the phrase: “getting long in the tooth”. We use it when talking about horses and humans. They say you can tell a horse’s age by looking at their teeth. While we could probably say the same about humans, I hope that as people become more educated about their oral health and overall health, they will be able to defy this logic and keep their teeth in great shape well into their old age. In any case, people often say they are “getting long in the tooth”, meaning they are getting old.

DOES GETTING OLD MEAN OUR TEETH ARE DETERIORATING?

What we often find is that in the dental practice, a lot of people will use their age to try to rationalise oral health problems. As if to say, with age, all things in our bodies deteriorate and so do teeth. To some extent, this is true. Our permanent teeth start erupting at the age of six. By twelve years of age, we have all our permanent (adult) teeth (except maybe wisdom teeth). That means, by the time we are sixty two, our teeth have been enduring daily acid, sugar, bacterial, abrasive and traumatic attacks from all different sources, for FIFTY years! And people very rarely nowadays refer to themselves as “getting long in the tooth” at the age of sixty two, do they? So, after fifty or sixty years of use and abuse, teeth do deteriorate. They may wear down, they may crack and chip, some gum recession may occur.

CAN THIS DETERIORATION BE SLOWED DOWN? There are many factors which affect how your teeth will look and feel in old age. The above consequences of ageing don’t have to be aesthetically disastrous and they don’t necessarily need any treatment. However, problems arise when people experience a lifetime of heightened risk of tooth decay and periodontal (gum) disease. As these problems get treated early in life and the underlying causes of the problems don’t, people enter a cycle of ongoing dental treatment which ends only one way: with loss of teeth! Eventually the bacteria run out of teeth to dissolve, the dentist runs out of teeth to restore and the patient runs out of teeth to function with (to eat, to speak, to smile)! To slow this process down, it is important to take oral health seriously early in life. Excellent oral hygiene, high standard of professional care, good dietary habits and management of lifestyle and health risks (including medication) will ensure that risk of tooth decay and periodontal disease remains low. This will avoid the need for early treatment and leave more tooth structure for the old age. OK, I’ll REMEMBER THAT, BUT I AM ONLY 25 AND I LOOK LIKE THIS: “Getting long in the tooth” also has another, more literal meaning! It can be used as a layman’s term to describe gingival (gum) recession. Gingival recession has been shown to increase with age and affects men more often than women.However, there are different potential causes of gingival recession and they are all treated differently. 1. PERIODONTAL DISEASE (PATHOLOGY) There are many reasons why someone may suffer from gum recession. The picture above is an illustration of severe periodontal disease, caused by the presence of bacteria in the plaque deposits around the gums and possibly exaggerated by smoking . This disease affects the gum as well as the underlying bone surrounding the teeth and keeping them firm. As a result of the disease, the bone “drops down” along the root surface and gum soon follows. Here are some other possible causes of gum recession: 2. TRAUMA The picture on the left represents what could have been started by a humble toothbrush! Toothbrush abrasion is a very common cause of gum recession. This traumatic “removal” of, what is usually thin and fragile gum tissue from the necks of the teeth, exposes root surfaces which are unprotected by enamel and leaves them open to acid attacks (acid erosion) or decay. In cases where toothbrush abrasion is obvious, it is usually the left hand side that is more affected (in right-handed individuals). 3. ANATOMICAL FACTORS- crowded teeth, thin fragile gum tissue If the attachment of the lower lip (frenum) to the lower jaw is naturally high up close to the gum margins of the lower front teeth, especially if it is wide at base, it can possibly cause traumatic pulling on the gum margins and induce recession. 4. TOOTH MOVEMENT Exaggerated movement of lower teeth with braces has been reported to cause or worsen gum recession. Careful pre-treatment planning is always necessary before commencing this treatment. CAN GINGIVAL RECESSION BE TREATED? The short answer is: it can, but not always. Gingival recession which is a result of a pathological process is almost impossible to treat and reverse. Gingival recession in thin fragile gum types is more difficult to treat and reverse than in thick and tough gum types. Overall, gingival tissue is very difficult to restore. It usually involves grafting of tissue from other sites in the mouth. It is a type of treatment provided by a specialist periodontal surgeon and requires rigorous follow up and exceptional oral hygiene. Often, gingival recession is minor and can go undetected by most people (they only realise it is there when a dentist mentions it). In this case, no treatment is necessary. Keeping the areas of recession clean and getting regular professional preventative care is usually the only treatment needed. If you are suffering from periodontal disease, a good, close relationship with your dentist and hygienist is very important. Don’t allow yourself to fall off their ‘radar’ and go without care for prolonged periods of time. Ageing is unstoppable, but ageing gracefully is possible and well within your reach. If you have some time, check out this great link: The Lifetime of Teeth in 3D







Tijana Fisher | WELLBEING COMMUNITY BLOGGER Tijana Fisher is a dentist, a wife and a mum (not in order of importance, of course)! She loves her life because she has been blessed with great variety and complete absence of the mundane. Every day, she puts on her different hats and slips into her different roles, all thoroughly enjoyable and challenging. She loves writing and sharing her knowledge (and opinion) with others. She also loves hearing other points of view, even if polar opposites to hers. This makes life rich and interesting and even teaches her a thing or two!