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Expected Dental Challenges - 40-50 Years Old

This period is marked with the more noticeable darkening of the colour of the teeth and small cracks (called craze lines) beginning to become much more visible.

I already wrote in an earlier article in this series about options for bleaching the teeth, and bleaching is very effective in this period of life as well if a person is bothered by the gradual darkening of the teeth. Home bleach options either with custom trays or without them work effectively. In office bleaching also works, but has some cost and longevity disadvantages. Your dentist can help you decide if bleaching is right for you and what method would be best in your case.

At least some root structure is visible on most people in this period. Root exposure although not actually caused by aging is usually associated with middle age and beyond. Your dentist or dental hygienist can help you develop brushing habits that minimize root exposure. Usually exposed root is not sensitive permanently, but may be for a while. There are many agents that can be quite effective for root sensitivity. There are microscopic fibers that connect the roots of the teeth to the bone. When too aggressive brushing or the long term effects of calculus (tarter) on the teeth succeed in making the gums recede, root surface is exposed and the fibers that used to connect the exposed portion of root and the bone fall off the tooth leaving microscopic holes in the surface of the root. The small holes are called tubules and are connected to a nerve inside the root.

Usually, the body will stop root sensitivity on its own by plugging the tubules from the inside through the formation of new tooth structure where the nerve of the tooth is located. On some people, the sensitivity is not controlled by the body alone and must be relieved in another way. The only way to stop root sensitivity is to plug the tubules. Whether the body plugs the tubules from the inside or we plug the tubules from the outside, the effect is similar. Of course, a filling could be done, but often the root is exposed all the way around the tooth and a filling would significantly weaken the tooth if it was placed. Sensodyne toothpaste and other similar products put into the mouth large amounts of particles that are just the right size to plug the holes. The effect is temporary since the particles fall off the surface of the root in a few hours. The tubules can be plugged using other more high tech materials that can be applied by your hygienist or dentist. There is also a fairly new home use product called MI Paste that is reported to fill the tubules permanently with calcium. That mechanism of action is not proven, but regardless of how MI Paste is actually doing it, the product is exceptionally effective at reducing root sensitivity. It is one of several Japanese products that have similar chemistry, but is the only one that is currently available in Canada.

If floss has still not been adopted into the daily routine in the 40-50 year old period, bone has usually disintegrated enough to require specialist (periodontist) intervention in order to assure long term survivability of the teeth. As I have said in this column before, daily floss is mandatory if a person is expecting to keep a full complement of teeth throughout life.

What is termed cuspal fracture is common in this period. This is when a tooth (usually one that has a moderate or large filling in it) breaks off one of its mountain tops (cusps). It is usually not a painful fracture because the crack has been spreading for many years little by little until it spreads right through part of the tooth and a piece falls off. Cracks spread because of hot and cold cycling. This is when we eat or drink things like ice cream and coffee. The teeth expand, then contract many times every day. This constant expansion and contraction causes micro cracks to form and expand over time. This kind of fracture is why many people need crowns to replace the fractured tooth structure during this period. Occlusal (biting) force is still very high during this decade and the teeth are starting to show signs of stress which lead to fractures.

- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)

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