Semidey Dental Podcast

EP #4: A Guide to Oral Longevity

• Alex Semidey • Season 1 • Episode 4

Share episode

Discover the ripple effects of aging on your pearly whites as Dr. Alex joins us to unravel the intricate connection between our advancing years and the well-being of our mouths. Are you aware of the silent adversary lurking in the shadows of middle age, known as dry mouth? It's more than just an inconvenience; it's a gateway to a myriad of dental dilemmas. This episode lays bare the stark realities of xerostomia, the unseen threat induced by everyday medications that staunch the flow of saliva—our natural plaque-fighting champion. With Dr. Alex's expertise, we examine why it's imperative for dental professionals to step up their game in educating and keeping a vigilant eye on the oral changes that come with age.

Brace yourself as we chart a course through the choppy waters of maintaining stellar oral hygiene in the golden years. From the struggles with brushing finesse due to dwindling dexterity, to the harsh truth of hormonal upheavals wreaking havoc on gum health, we leave no stone unturned. Our conversation sails through the importance of tailored dental tools like electric toothbrushes and how regular checkups can be your lighthouse in the storm. As we bid our listeners goodbye, we don't just leave you with a warm farewell, but with actionable advice and a heartfelt recommendation for Jeremy's dental journey—because a vibrant smile doesn't have to fade with time. Join Dr. Alex and me as we share how to safeguard that grin for years to come on Word of Mouth.

Jeremy:

Hello everyone. We are back for another episode of word of mouth. I'm your cohost, jeremy Wolf, joined by your host, dr Alex Semede. Dr Alex, hello, so nice to see you again, my man, always a pleasure. We were just getting into some interesting topics of gum disease and I know you wanted to talk a little bit. As you know, I just turned 44. I think you said you're turning 41. So we're getting there, we're getting up there, so aging health Especially middle-aged brother. How time starts to fly so fast.

Dr. Alex:

It happened, it happened.

Jeremy:

How, I don't know, but it happened. I never thought it would come, but not last. So aging and oral health right. Give us an overview of how the aging process affects oral health.

Dr. Alex:

All right. So everybody knows, as we mature, things change Right I get, better I get better.

Jeremy:

Like a fine wine, I get better. We'll go with that brother.

Dr. Alex:

Yeah, in certain aspects and in others, things start to dip and sag and that hold up as well and the things happen. So the mouth is really no different man and as we're getting older, things like this start coming into our radar. So I just wanted to take a couple minutes today and talk about some of the things that happen with the mouth as we age and as we get older and some of the flags that we can be looking out for to prevent issues and catch them as early as possible. So, yeah, we'll kind of just jump right into it.

Dr. Alex:

One of the top things that we see in our demographic right, like mid to late 30s and beyond, is we start incorporating a lot of medications into our lives. Oh, blood pressure's high Doc, put me on a pill. Cholesterol is a little high, got me on the Crestor Get. Certainly, you know, start start having the rumblings of the potential diabetes, the pre diabetes and things like that. And, of course, like we have medications that are important to control whatever it is that's happening in the body. But have you ever read the side effect list of any medication? It is its insanity.

Jeremy:

Yeah, it's terrifying. It's almost like it's almost comical in a way. The stuff you read on there it's so obscene that you have to reading it. You're thinking like why am I taking this again?

Dr. Alex:

Like everything starts with dry mouth and ends with yeah, yeah, yeah, it starts with dry mouth and ends with anal leakage, and like everything in between, it's like holy smoke. I'm just, I need an aspirin.

Jeremy:

It's part of that, though. Just because they're like they want to cover all basis. It's like, if you take this medication, like any of these things could happen to you. But they're not likely. But yeah, it does seem insane. It's like, yeah, taking this medicine to you know help. Some seemingly benign problem can lead to heart failure.

Dr. Alex:

Okay, right to other issues. Right, and the more extreme the potential adverse effect, the more rare, right, but there are a lot of secondary effects that are super common, like almost for everyone, okay, and one of the one of the main ones is dry mouth, or what we call zero stomia, zero stomia, zero stomia is the technical term for dry mouth.

Jeremy:

Interesting.

Dr. Alex:

Zero with an X, x-e-r-o Stomia. I'll take your word for it. I'll take your word for it. Yeah, yeah, just keep it in the bank and, you know, throw it out at a dinner party People are going to be blown away. So it's super important. Like I always really try to drive home this fact with my patients is that saliva in your mouth is like it's like motor oil for your car's engine. Without a proper flow and quality and type of saliva, things go downhill very quickly. All right, so I'm going to take a little bit of a step back.

Dr. Alex:

Why is saliva so important? The we talked a little bit about in previous podcasts about bacteria, right, plack germs in the mouth, right. So what plaque and bacteria does is it eats sugar from your diet, whether it's candy or bread, and it poops acid. So it's byproduct of all that bacteria is acid, and it's the acid in our mouth that leads to all the damage. It's the acid that leads to the hole in our teeth that we call cavities. It's the acid that leads to the breakdown of the tissue that we call gum disease. So we scraped the plaque off to prevent the acid from ever building up. But now saliva buffers that acid. So, okay, you have the bacteria, you're going to eat some sugar or bread or whatever. They're going to eat that sugar, they're going to make the acid and eventually you'll get around to scraping it off your teeth, but in the meantime, saliva is buffering that acid to prevent it from getting out of control and from doing too much harm.

Dr. Alex:

So now, what happens if we shut off the flow of saliva in the mouth, or not even, it doesn't have to be like super, like dry, right, just less saliva than you used to have. Now that acid lingers longer and does more damage, right, and it's an insidious process, right. This happens very slowly and you start taking that hypertension medication and you don't even notice that your mouth is dry, like. I can't tell you the number of times that I'm talking to a patient during their new patient exam and I'm like Jeremy, is your mouth, do you feel like your mouth's dry?

Dr. Alex:

You know, and they're like no talk, feels. I feel normal and I can tell, looking across the room, not enough saliva there, yes, yeah, like their mouth is super dry. They're struggling to talk because of how dry their mouth is and it's not a perceived issue. Now, the effects in the mouth are happening, right, so it rests upon us you know, dennis, and hygienists of the world, and now all of you that know this to stress about the importance of saliva in the mouth. And medications have take a huge toll on just that our body's ability to produce saliva. So medications is huge Basically every I'm sorry, go ahead.

Jeremy:

Oh no, I mean I cut you off. So what do you do if you have this constant dry mouth, lack of saliva? I mean, obviously I know drinking a lot of water is great for you, but what's the solution to fix this?

Dr. Alex:

Yeah, it's tricky, right, because you're not gonna go off the meds that you need in order to control the other things, but doing things in order to minimize the number of meds we need, right, like, if you're on a hypertension medication, okay, like, we can exercise, we can control our diet, we can eat less salt, we can lose some weight, to hopefully get off the medication so that you're not on this pill for the rest of your life.

Dr. Alex:

Because unfortunately, we kind of live in a medical system where the folks, the older we get, like we're on cocktails of medications, like folks are on five, six different kinds of meds and this problem compounds, right, so one medication is bad, two is worse, three, it's one of those classic one plus one equals 11, not two, yeah, as far as the damage that it's doing to our bodies. So making sensible choices, making healthy decisions for our lives is as difficult as that is right. But understanding that the repercussions go beyond. Oh, I'm taking a pill and I'm good. Right, the blood pressure is good. Now, there's no such thing as a free lunch, right, like, the pills help in something, but it's probably maybe dysregulating something else, right?

Dr. Alex:

Yeah, these are conversations that these are conversations that people need to have with their physicians, right, like, how do we maybe try different medications or try lowering the dose of medications, and honestly, having conversations about how do we avoid getting on these meds in the first place, like, hey doc, like do I absolutely need the pill or can I try and lose, you know, 20 pounds over the next three months and maybe I don't need the medication anymore? So I feel like those are very important conversations that we need to have, not only for our overall health and longevity and quality of life, but very specifically here for, you know, our oral well-being too.

Jeremy:

Yeah, I think oftentimes probably more often than not these pills act more like a bandaid than a solution to a problem. And because we live in such a fast-paced, instant gratification society, you know people don't want to do the hard work required and the preventative work required and to avoid having to take these. So they go to the doctor and they're looking for a way to fix a problem quickly and it's like well, just take this pill and it almost masks the underlying condition. In many cases, that is only addressed through preventative treatment, building the right habits for these things long-term, which again requires hard work and don't get me wrong, man, like these medications save lives Absolutely.

Dr. Alex:

Yeah, I'm not discounting it, Like that is not to take anything away from the medications. It's just sometimes we end up like there are other things that we could do to gain the same results that are, overall, a lot healthier for us.

Jeremy:

Yeah, it all goes back to education. It all goes back to so we're here, brother. It all goes back to man how we raised our kids, the habits we're instilling upon them at an early age. It just becomes so much more difficult to change your routines and your habits when the older you get obviously On the North side of 40 now to try to change things that have been ingrained in my brain for decades. It requires an incredible amount of struggle and mental anguish very rewarding when you get to the other side and you make breakthroughs, but it's just so much easier.

Jeremy:

I try to talk to my children about this all the time. It's so funny. I was just not just at a podcast with somebody and I tell my kids all the time. Now I try to impart my 44-year-old wisdom and I tell them about all these life lessons I've learned later in life. And it just goes in one ear out the other. Don't listen to me. Why not 44 years old? I've been here a lot longer than you have on the planet. So I was talking to my mother the other day and I told her the story. I said you know, mom, when I was young, I don't ever remember you sitting down with me and imparting wisdom and telling me life lessons. She's like Jeremy. I used to talk to you about that all the time, no recollection in one year out the other. So it gave me some perspective. So at least I understand when my kids are coming from when they don't listen to me. So I thought that was kind of funny.

Jeremy:

I literally have no recollection of any of those conversations at all.

Dr. Alex:

I was in another world, as most children are, so it is just history repeats itself, man, like we, you know. But yeah, that's, it's the best we can do right is just try to try to and not only, not only tell them, but show them right, like I feel like kids kids frequently pick up more from what they see than what they hear and and just kind of Trying to do the best we can right and and set the example for them and hopefully give them a role model that they want to emulate. But it ain't easy, man, it ain't easy, and the older they get, the harder it becomes, seems like.

Jeremy:

Indeed, indeed, it does. Anything else you want to share on this topic? I'm trying to think, maybe for I guess we just talked about kids for and I know we're talking about aging in, you know we're talking about preventative things but I guess for folks that are Getting elderly now right, that are yeah well, but well beyond where we're at right, maybe 78 years of getting older, like what are some words of wisdom or advice you can give to somebody that you know it's toward the end of their journey to make sure that they Maximize the most of their oral health?

Dr. Alex:

so so definitely, at any stage in life, a lot of the the preventive, you know, at-home care things that we've discussed in the past, it hold true, right, the older we get, we start, you know, entering the realm of some dexterity issues. You know, for older folks it becomes, it becomes harder to brush and floss, right like that. That ability to Do what we need to do in the mouth it kind of diminishes a little bit. So, you know, electric toothbrushes are great. There are toothbrushes with larger handles for folks that struggle to grasp small objects and kind of make that easier. For, you know, the geriatric population, regular checkups, right, more, much more frequent for our older, you know, for our parents and our grandparents then then then, for us, right, like Older folks that have difficulty maintaining a nice, healthy, clean mouth should be seen by a dentist every three months to make sure that things Don't spiral out of control.

Dr. Alex:

You know a couple of Two other things that I wanted to kind of just bring out and put in people's mind to keep in mind. For women specifically, menopause has a huge impact on on oral health, does it really? Yeah, yeah menopause.

Dr. Alex:

That's connected never would have thought. Right. But think about what menopause is, right, it's a huge hormonal dysregulation in the body and that affects everything, right, Like? Think about what happens with women when they're pregnant, right, there are things like pregnancy gingivitis, right, where gums will go out of control simply as a response of the hormones being out of control in the body. So that hormonal imbalance during menopause can also have, you know, pretty significant impacts. If you have gum disease and are entering menopause, it can advance much more quickly during menopause. So make sure to get checked out, make sure to have your dentist or your periodontist do a thorough evaluation and monitor you and go see them every three months to make sure that things are healthy and that the gums are staying, you know, in a relative state of health.

Dr. Alex:

And I'm also going to mention something called cyclical fatigue, right, and cyclical fatigue is a term used by anyone who deals with materials in general. Right, think of the coat hanger effect. And if you take a coat hanger and you bend the wire, the coat hanger will bend. If you bring it back, it'll bend. But do that 50 or 60 times and eventually what happens? It breaks. Yeah well, yeah, well, yeah, the metal itself will just snap and it'll break in two. So that is a result of that cyclical fatigue, right? We're bending and bending and bending and bending and bending and ultimately material fails. The same sort of thing happens in the mouth and it happens with our teeth, right. The more reps we have of chewing and clenching and grinding and talking and brushing and all of those things, the more the materials that our teeth are made out of break down and wear. It happens to crowns and bridges. It happens to fillings, right, and it especially happens I don't know, I feel like any of us that are 35 plus if we ever had fillings as kids.

Jeremy:

we have the big silver fillings in the back that look like massive cavities, you know I don't have those anymore because of my lovely experience that I shared with you, where I won't get into that now.

Dr. Alex:

I got to more actively replacing those.

Dr. Alex:

Got them all replaced with the clear fillings which is great, yeah, but any filling in the mouth isn't as good as the original manufacturer product, right, right? So when you have a big filling in the mouth, that means that you have less tooth structure available on that tooth. Right, the more filling, the less tooth and eventually, if you have a really big filling, you basically have like a little shell of tooth holding that filling in place. Yeah, right. So now when you chew and grind and talk and do all of the things that we do with our teeth, now there's less tooth structure holding that yeah.

Dr. Alex:

Exactly, exactly. So we enter into that cyclical fatigue a lot quicker. So we think we see things like stress, fractures, like cracks, broken teeth I can't tell you the number of like failed silver fillings in the back, that are cracked teeth that we end up having to remove and place an implant because the tooth fails over time. Right, and it's not that the dentist did anything wrong, that the procedure was done beautifully. But materials fail ultimately. Right, and the more stress we put on those things, the less ideal the circumstances are to begin with and the more stress we put on it, the higher the likelihood of failure becomes. Right. So large fillings, crowns, the more dental work we have, unfortunately, the higher the likelihood is that something is going to break down, especially if we're not treating and caring for it properly and getting it checked out and hopefully catching those cracks or stress, fractures or breaks when they're tiny and they're repairable versus now. This becomes a very unfortunate conversation, mr Wolfe, like there's nothing we can do to save these teeth. Let's talk about what the transition looks like.

Jeremy:

Yeah, and I think everything goes back to can hammer this home enough preventative care and brushing flossing, just making sure you don't do what I do sometimes and put off going to the dentist for checkups and get those routine checkups and just do the things that are required to prevent these problems from happening in the future in the first place.

Dr. Alex:

Yeah, and 100% not coming from a holier than now position here. No ivory tower. I'm way overdue for my checkup, but it's important for us to know what the consequences are.

Jeremy:

Well, hey, I know a good dentist, so you're in good hands. Yeah, give me his number, I'll give him a call All right man Always a pleasure, Jeremy, it's great man. All right To our listeners. Thanks for tuning in and we will catch you all on the next episode of word of mouth. Everyone, have a great day and take care Bye, Thank you for joining us on word of mouth.

Jeremy:

Remember a healthy smile is a reflection of your well being. Until next time, keep smiling and caring for your dental health. We'll be back soon with more dental.