Max is shocked. His dentist told him that he has a tooth that needs to come out. The 63-year-old had been sure he would keep his teeth forever. Max is going to work with his dentist on taking better care of his remaining teeth.
Healthy teeth and gums make it easy for you to eat well  and enjoy good food. There are a number of problems that can affect the health of your mouth, but good care should keep your teeth and gums strong.
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 begin to harm enamel. Over time, the acids can cause a hole in the enamel. This hole is called a cavity. Brushing and flossing your teeth can protect you from decay, but once a cavity happens, a dentist has to fix it.
You can protect your teeth from decay by using fluoride toothpaste. If you are at a higher risk for tooth decay (for example, if you have a dry mouth because of medicines  you take), you might need more fluoride. Your dentist or dental hygienist may give you a fluoride treatment during an office visit. Or, the dentist may tell you to use a fluoride gel or mouth rinse at home.
Gum disease begins when plaque builds up along and under the gum line. This plaque causes infections that hurt the gum and bone that hold teeth in place. Sometimes gum disease makes your gums tender and more likely to bleed. This problem, called gingivitis, can often be fixed by daily brushing and flossing.
A more severe form of gum disease, called periodontitis, needs to be treated by a dentist. If not treated, this infection can ruin the bones, gums, and other tissues that support your teeth. Over time, your teeth may have to be removed.
To prevent gum disease:
- Brush your teeth twice a day with fluoride toothpaste.
- Floss once a day.
- Visit your dentist regularly for a checkup and cleaning.
- Eat a well-balanced diet .
- Quit smoking . Smoking increases your risk for gum disease.
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.
- Use small circular motions and short back-and-forth strokes.
- Take the time to brush carefully and gently along the gum line.
- Lightly brush your tongue to help keep your mouth clean.
People with arthritis  or other conditions that limit hand motion may find it hard to hold and use a toothbrush. Some helpful ideas are:
- Use an electric or battery-operated toothbrush.
- Slide a bicycle grip or foam tube over the handle of the toothbrush.
- Buy a toothbrush with a larger handle.
- Attach the toothbrush handle to your hand with a wide elastic band.
You also need to clean around your teeth with dental floss every day. Careful flossing will take off plaque and leftover food that a toothbrush can’t reach. Be sure to rinse after you floss.
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.
Hold floss as shown.
Use floss between upper teeth.
Use floss between lower teeth.
Sometimes, false teeth (dentures) are needed to replace badly damaged teeth. 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.
When you are 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.
Be careful when wearing dentures because it may be harder for you to feel hot foods and drinks or notice bones in your mouth from your food.
Keep your dentures clean and free from food that can cause stains, bad breath, or swollen gums. Brush them every day with a denture care product. Take your dentures out of your mouth at night, and put them in water or a denture-cleansing liquid.
Dry mouth happens when you don’t have enough saliva, or spit, to keep your mouth wet. Many common medicines can cause dry mouth. That can make it hard to eat, swallow, taste , and even speak. Dry mouth can cause tooth decay and other infections of the mouth.
There are some things you can try that may help with dry mouth. Try sipping water or sugarless drinks. Don’t smoke and avoid alcohol  and caffeine. Sugarless hard candy or sugarless gum may help. Your dentist or doctor might suggest that you use artificial saliva to keep your mouth wet. Or they may have other ideas on how to cope with dry mouth.
Cancer  of the mouth can grow in any part of the mouth or throat. 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—cigarettes, chewing tobacco, snuff, pipes, or cigars.
- If you drink alcohol, do so only in moderation.
- Use lip balm with sunscreen .
Sometimes dental care can be costly. Medicare does not cover routine dental care. Very few states offer dental coverage under Medicaid. You may want to check out private dental insurance for older people. Make sure you are aware of the cost and what services are covered. The following resources may help you find low-cost dental care:
- Some dental schools have clinics where students get experience treating patients at a reduced cost. Qualified dentists supervise the students. Visit www.ada.org  for a list of U.S. dental schools.
- Dental hygiene schools may offer supervised, low-cost care as part of the training experience for dental hygienists. See schools listed by State at www.adha.org .
- Call your county or State health department to find dental clinics near you that charge based on your income.
- Call 1-888-275-4772 (toll-free) to locate a community health center near you that offers dental services, or visit www.hrsa.gov  (scroll down to “Find a Health Center”).
- United Way chapters may be able to direct you to free or reduced-cost dental services in your community. Call “211” to reach a local United Way chapter.
Here are some helpful resources:
American Dental Association
211 East Chicago Avenue
Chicago, IL 60611-2678
American Dental Hygienists' Association
444 North Michigan Avenue
Chicago, Il 60611
Health Resources and Services Administration Information Center
P.O. Box 2910
Merrifield, VA 22116
National Institute of Dental and Craniofacial Research
National Oral Health Information Clearinghouse
For more information on health and aging, contact:
National Institute on Aging
P.O. Box 8057
Gaithersburg, MD 20898-8057
To sign up for regular email alerts about new publications and other information from the NIA, go to www.nia.nih.gov/health .
Visit www.nihseniorhealth.gov , a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health and wellness information for older adults. Special features make it simple to use. For example, you can click on a button to make the type larger.
National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services