Your dental health, examined

Want to spend less time in that reclining chair? Open wide for this guide to healthy teeth and gums at every age.

In Your 20s & 30s
The State of Your Smile
Your teeth and gums are healthy—especially if you’ve been heeding the well-known advice: Brush at least twice and floss once daily; see your dentist twice a year.

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Keep an Eye On
Sensitivity: As you age, your gums naturally recede, which exposes the roots of the teeth; also, enamel starts to soften. Both can trigger that zingy feeling when you eat something cold. Proper brushing is key to avoiding receding gums, says Dr. Robert E. Roesch, a Fremont, Neb.–based spokesperson for the Academy of General Dentistry.

Use a soft-bristled brush (manual or electric), and “hold it at a 45- to 60-degree angle toward your gums,” he says. Gently brush up and down, not side to side; the latter can be hard on gums. To strengthen enamel, choose a toothpaste and a mouth rinse (to use after brushing) with fluoride, says Dr. Emanuel Layliev, a dentist and the director of the New York Center for Cosmetic Dentistry, in New York City.

Strees: Stress can make you gnash your teeth—literally. Gnashing, a.k.a. tooth grinding, “often occurs while you’re asleep, so you’re not even aware of it,” says Dr. Jacqueline Fulop-Goodling, an orthodontist in New York City. Grinding wears down the tops of teeth and increases the risk of cavities. See your dentist if you frequently wake up with headaches or a sore jaw; he can fit you with a protective mouth guard to wear at night.

Your daily soda: “The acid content in soda erodes enamel,” says Dr. Anthony Iacopino, a Winnipeg, Manitoba–based spokesperson for the American Dental Association. Use a straw to limit the liquid’s contact with teeth, and rinse your mouth with water after you drink. And, odd as it seems, don’t brush right after you have acidic drinks (or acidic foods, such as citrus fruits)—this can actually exacerbate erosion.

Cosmetic Considerations
Braces work at any age, so it’s not too late to fix a crooked smile. The traditional wire variety and Invisalign, clear braces that you can remove, work equally well. And today the costs are comparable—on average, about $5,000 for a 10- to 12-month course of treatment. So the choice is mainly a cosmetic one.

In Your 40s
The State of Your Smile
Structurally, it hasn’t changed much since your teens. “When I see an X-ray of a healthy mouth, it’s hard to tell whether the person is 85 or 25,” says Fulop-Goodling. (See? All that flossing was worth it.)

Keep an Eye On
Older fillings: “White resin fillings last for about eight to 10 years, and silver fillings last for up to twice as long,” says Iacopino. Beyond that, fillings start to wear down, become loose, or crack, allowing bacteria to seep in, which causes decay. Your dentist can identify fillings that need to be replaced. The same rule applies to bridges and crowns.

Your gums: There’s a link between periodontitis, or gum disease, and an increased risk of cardiovascular disease, not to mention diabetes and rheumatoid arthritis. A recent study in the Journal of Periodontology reported that at least 23 percent of women aged 30 to 54 have periodontitis. If your gums are sore or red, or if they bleed when you floss, talk to your dentist. She may refer you to a periodontist, who can properly diagnose the condition and discuss treatment options, from more in-depth cleanings to, in rare cases, gum surgery.

Your exercise level: Believe it or not, your fitness level may determine the health of your smile. In a 2010 study in the Journal of Periodontology that looked at 1,160 healthy people, those who had the lowest body mass indexes (BMI) and the highest fitness levels were at the lowest risk for periodontal disease. Although researchers aren’t sure of the reason for this, people who take care of their bodies seem to take better care of their teeth. “The healthiest mouths I see are usually in the fittest patients,” says Donald Clem, a periodontist in Fullerton, Calif.

Cosmetic Considerations
Decades of coffee and red wine may have dimmed your pearly whites. An easy fix that works at any age: whitening, whether at home or done professionally. Just be sure you don’t overdo it. “Overuse can remove enamel, the hard white surface of the tooth,” says Iacopino, and leave you worse off than when you started. Also, the ingredients in whitening products can cause sensitivity; a prebleach fluoride rinse may help, as can using a toothpaste for sensitive teeth afterward.

In Your 50s & Beyond
The State of Your Smile
The good news is that your teeth should be less sensitive now, since over time the nerves shrink slightly, says Layliev. The not-so-good news: You might be prone to more plaque buildup than in your earlier years.

Keep an Eye On
A dry mouth: Hundreds of medicines, from antihistamines to antidepressants, can cause a dry mouth. Because saliva flushes away decay-causing bacteria, it’s important to keep your mouth moist by drinking lots of water, chewing sugarless gum, and sucking on sugarless candies.

Your bones: Your jaw, which holds your teeth in place, is obviously a bone. And as you age, your risk of osteoporosis, or weakening of the bones, increases significantly. According to the National Institutes of Health, older women with osteoporosis may be more likely to lose teeth. A dental X-ray can help identify osteoporosis, as can symptoms such as loose teeth. To keep bones strong, the National Institute of Medicine recommends that women over the age of 50 get 1,200 milligrams of calcium and at least 600 international units (IU) of vitamin D daily.

Suspicious sores: A sore that doesn’t go away in two weeks could be a sign of oral-cavity cancer. More than 30,000 Americans are diagnosed annually with the disease. Most of those diagnosed are smokers, but one in four is a nonsmoker.

Burning sensations: When you hit menopause, your mouth can get as hot as your flashes. Called burning-mouth syndrome, this condition can be caused by a drop in estrogen. Your lips, palate, gums, and tongue feel as if you’ve burned them on hot coffee—except the sensation doesn’t subside. “Hormone therapy may help,” says Pamela McClain, a periodontist in Aurora, Colo. See your dentist to discuss your options.