The short answer: Losing teeth isn’t an inevitable part of getting older, but aging does raise some risks. Enamel wears down over a lifetime, gums tend to recede and expose the roots to decay, severe gum disease is most common after 65, and dry mouth, usually caused by medicines rather than age itself, becomes more frequent. The average age at an oral cancer diagnosis is 64. Brushing twice a day with fluoride toothpaste, cleaning between your teeth, managing dry mouth and health conditions, and seeing a dentist regularly keep most of these problems in check.
Many people now keep their natural teeth for life, but tooth loss is still common in later years. In the United States, more than 1 in 7 adults aged 65 or older (15%) have lost all their teeth, and about a quarter (26%) have 8 or fewer, which makes it harder to eat meats, fruits and vegetables. Total tooth loss is more common among older adults with lower incomes or less education and among those who smoke (Centers for Disease Control and Prevention, 2024).
This article explains how aging changes the teeth and gums, which problems become more common, and what older adults and their caregivers can do about them, from daily care and dentures to implants.
Prefer to watch? Here is this article as a 5-minute video.
More short videos: see them all on our Videos page or subscribe on YouTube.
What happens to your teeth as you age?
Enamel wears down
Teeth gradually wear over a lifetime. A systematic review estimated that the share of adults with severe tooth wear rises from 3% at age 20 to 17% at age 70, and that wear increases significantly with age (Van’t Spijker et al., 2009).
Gums recede and expose the roots
Gum recession is common in adults, tends to increase with age and happens even in people with good oral hygiene. Exposed roots are often linked with sensitivity, decay and other damage near the gumline (Cortellini & Bissada, 2018). Our guide to why teeth become sensitive covers what helps.
Healing slows down
Wounds in the mouth tend to heal more slowly with age. In one study, small wounds on the roof of the mouth closed more slowly in adults aged 50 to 88 than in adults aged 18 to 35, even after excluding people who took medicines or had health conditions, which may matter for recovery after dental procedures (Engeland et al., 2006).
Why do older adults get decay on the roots of their teeth?
As gums recede, more of each root is exposed, and those surfaces can decay (Cortellini & Bissada, 2018). Dry mouth, which is more common in older adults, adds to the risk because saliva normally helps protect teeth against decay (Plemons et al., 2014).
Early root decay can often be stopped without a drill. For these lesions, the American Dental Association’s guideline on nonrestorative treatments includes options such as prescription-strength 5,000 ppm fluoride toothpaste or gel and 38% silver diamine fluoride (Slayton et al., 2018). A 2024 Cochrane review concluded that silver diamine fluoride probably helps prevent new decay on exposed roots (Worthington et al., 2024). See whether a cavity can heal on its own for more on stopping decay early.
Is gum disease more common in older adults?
Yes. In a national US survey, an estimated 42% of adults aged 30 or older who still had teeth had periodontitis, the advanced form of gum disease, and 7.8% had severe periodontitis. Severe periodontitis was most common in adults aged 65 or older and in smokers (Eke et al., 2018). The guide to gum disease and bleeding gums explains the signs and treatment.
Some chronic conditions that become more common with age are linked to gum health. Diabetes and periodontitis affect each other: people with diabetes who have gum disease tend to have higher blood sugar, and treating gum disease is safe for them and can modestly improve blood sugar control, at least in the short term (Sanz et al., 2018). In women after menopause, low bone density has been linked to greater loss of the tissues that attach the gums to the teeth (Penoni et al., 2017). Our article on how oral health affects your body covers these links.
Is dry mouth a normal part of aging?
No. Dry mouth is not a normal part of aging, but it is a common side effect of medicines, including some taken for high blood pressure, depression and bladder-control problems (National Institute of Dental and Craniofacial Research, 2024). It is more common in studies of older adults (Agostini et al., 2018), who are also more likely to take several medicines, and a systematic review found strong evidence that 56 drugs cause dry mouth or reduced saliva (Wolff et al., 2017).
Sipping water and chewing sugar-free gum or sucking sugar-free candies can help (National Institute of Dental and Craniofacial Research, 2024), and options such as saliva substitutes and prescription saliva stimulants are available (Villa et al., 2015). The full guide to saliva and dry mouth covers causes and treatments.
Does the risk of oral cancer rise with age?
Mostly, yes. The American Cancer Society estimates about 60,480 new cases of oral cavity and oropharyngeal cancer in the United States in 2026. The average age at diagnosis is 64, although just over 1 in 5 cases occur in people younger than 55, and these cancers are much more common in men than in women (American Cancer Society, 2026). Tobacco use and alcohol misuse are major risk factors (Reibel, 2003; Warnakulasuriya, 2009).
How should older adults care for their teeth?
Brush twice a day and clean between your teeth
Brush twice a day for at least two minutes with fluoride toothpaste, and clean between your teeth every day, using interdental brushes where they fit and floss where the gaps are too tight. A rechargeable electric toothbrush can reduce plaque and gum inflammation slightly more than a manual one, and if you have gingivitis, an antibacterial mouthwash can add extra benefit (Chapple et al., 2015). Fluoride toothpaste prevents decay better than toothpaste without fluoride (Walsh et al., 2019).
If arthritis makes brushing hard
A thicker handle is easier to grip. The National Institute of Dental and Craniofacial Research suggests making a toothbrush handle bigger with foam tubing or an ergonomic grip, or trying a power toothbrush or a multiple-sided toothbrush (National Institute of Dental and Craniofacial Research, 2018). Our comparison of electric and manual toothbrushes can help you choose.
Limit sugar, tobacco and alcohol
A diet rich in starchy staple foods, fruits and vegetables and low in free sugars protects both oral and general health, and limiting sugars remains important for preventing cavities (Moynihan, 2005). Tobacco is a major risk factor for gum disease and oral cancer (Reibel, 2003), alcohol misuse is, with smoking, a major risk factor for oral cancer (Warnakulasuriya, 2009), and both can dry out the mouth (National Institute of Dental and Craniofacial Research, 2024).
Keep up regular checkups
How often you need a checkup depends on your risk, so let your dentist set the interval. A Cochrane review found little to no difference in outcomes between six-month checkups and intervals tailored to each person’s risk for adults who attend regularly (Fee et al., 2020). Tell your dentist about your health conditions and every medicine you take. In the United States, Original Medicare doesn’t cover routine dental care such as cleanings, fillings, extractions, dentures or implants (Medicare, n.d.), so check what coverage you have.
How do you care for dentures?
Take dentures out at night and brush them before putting them in a cup of water. Keep them in water whenever they’re out of the mouth, and change the water every day (National Institute of Dental and Craniofacial Research, 2018).
Are dental implants an option for older adults?
Often, yes. A systematic review of prospective studies in people aged 65 and older found that about 96% of implants were still in place after five years and 91% after ten, with few complications, and concluded that age alone should not rule out implant treatment (Srinivasan et al., 2017). For what the procedure involves, see do dental implants hurt.
How can caregivers help with oral care?
If you help someone else brush, make sure they are sitting in a chair or upright in bed, and position yourself where you can see all the surfaces of the teeth and gums. Use a small amount of fluoride toothpaste, or brush with water if the toothpaste bothers them (National Institute of Dental and Craniofacial Research, 2018).
Good oral care in nursing homes is often linked with preventing pneumonia, but the evidence is still uncertain. A 2022 Cochrane review of six trials found too little evidence to say whether professional oral care reduces pneumonia compared with usual care, and the trials were at high risk of bias (Cao et al., 2022).
What it means for you
If you still have most of your natural teeth
Daily brushing with fluoride toothpaste and cleaning between your teeth remain the foundation (Chapple et al., 2015). Ask about extra fluoride if you have receding gums or dry mouth (Slayton et al., 2018).
If you take several medicines
Ask your doctor whether any of them could cause dry mouth, and never stop a medicine on your own (Wolff et al., 2017). Let your dentist know too, so they can watch for decay.
If you care for an older relative
Make brushing part of the daily routine, adapt the toothbrush if gripping is hard, and take dentures out at night (National Institute of Dental and Craniofacial Research, 2018).
Questions to ask your dentist
- Do I have any root decay or receding gums?
- Would a prescription fluoride toothpaste help me?
- Could my medicines be affecting my mouth?
- Did you check for signs of oral cancer today?
- How often should I come in?
When to see a dentist
Book a dental visit if:
- Your gums bleed, look swollen or seem to be pulling back from your teeth.
- A tooth feels loose or sensitive, or your bite has changed.
- Your mouth feels dry most of the time.
- You have a sore, lump or red or white patch in your mouth that hasn’t healed.
- Your dentures feel loose, rub or cause sore spots.
For severe pain, swelling or a broken tooth, see what to do in a dental emergency.
The bottom line
Aging brings worn enamel, receding gums, slower healing and a higher risk of root decay, severe gum disease and oral cancer, and dry mouth from medicines is common. None of this makes tooth loss inevitable. Brushing twice a day with fluoride toothpaste, cleaning between your teeth, managing dry mouth and chronic conditions, caring for dentures properly and seeing a dentist at the interval they recommend can keep your mouth healthy for life.
References
Agostini BA, Cericato GO, Silveira ERD, Nascimento GG, Costa FDS, Thomson WM, et al. (2018). How common is dry mouth? Systematic review and meta-regression analysis of prevalence estimates. Brazilian Dental Journal, 29(6), 606–618. https://doi.org/10.1590/0103-6440201802302
American Cancer Society. (2026). Key statistics for oral cavity and oropharyngeal cancers. https://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/about/key-statistics.html
Cao Y, Liu C, Lin J, Ng L, Needleman I, Walsh T, et al. (2022). Oral care measures for preventing nursing home-acquired pneumonia. Cochrane Database of Systematic Reviews, 11(11), CD012416. https://doi.org/10.1002/14651858.CD012416.pub3
Centers for Disease Control and Prevention. (2024). Tooth loss facts. https://www.cdc.gov/oral-health/data-research/facts-stats/fast-facts-tooth-loss.html
Chapple IL, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D, et al. (2015). Primary prevention of periodontitis: Managing gingivitis. Journal of Clinical Periodontology, 42(Suppl 16), S71–S76. https://doi.org/10.1111/jcpe.12366
Cortellini P, Bissada NF. (2018). Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. Journal of Periodontology, 89(Suppl 1), S204–S213. https://doi.org/10.1002/JPER.16-0671
Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. (2018). Periodontitis in US adults: National Health and Nutrition Examination Survey 2009–2014. Journal of the American Dental Association, 149(7), 576–588.e6. https://doi.org/10.1016/j.adaj.2018.04.023
Engeland CG, Bosch JA, Cacioppo JT, Marucha PT. (2006). Mucosal wound healing: The roles of age and sex. Archives of Surgery, 141(12), 1193–1197. https://doi.org/10.1001/archsurg.141.12.1193
Fee PA, Riley P, Worthington HV, Clarkson JE, Boyers D, Beirne PV. (2020). Recall intervals for oral health in primary care patients. Cochrane Database of Systematic Reviews, 10(10), CD004346. https://doi.org/10.1002/14651858.CD004346.pub5
Medicare. (n.d.). Dental services. https://www.medicare.gov/coverage/dental-services
Moynihan PJ. (2005). The role of diet and nutrition in the etiology and prevention of oral diseases. Bulletin of the World Health Organization, 83(9), 694–699. https://pubmed.ncbi.nlm.nih.gov/16211161/
National Institute of Dental and Craniofacial Research. (2018). Oral health and aging: Brushing tips for caregivers. https://www.nidcr.nih.gov/sites/default/files/2018-08/Brushing-508_0.pdf
National Institute of Dental and Craniofacial Research. (2024). Dry mouth. https://www.nidcr.nih.gov/health-info/dry-mouth
Penoni DC, Fidalgo TK, Torres SR, Varela VM, Masterson D, Leão AT, et al. (2017). Bone density and clinical periodontal attachment in postmenopausal women: A systematic review and meta-analysis. Journal of Dental Research, 96(3), 261–269. https://doi.org/10.1177/0022034516682017
Plemons JM, Al-Hashimi I, Marek CL; American Dental Association Council on Scientific Affairs. (2014). Managing xerostomia and salivary gland hypofunction: Executive summary of a report from the American Dental Association Council on Scientific Affairs. Journal of the American Dental Association, 145(8), 867–873. https://doi.org/10.14219/jada.2014.44
Reibel J. (2003). Tobacco and oral diseases: Update on the evidence, with recommendations. Medical Principles and Practice, 12(Suppl 1), 22–32. https://doi.org/10.1159/000069845
Sanz M, Ceriello A, Buysschaert M, Chapple I, Demmer RT, Graziani F, et al. (2018). Scientific evidence on the links between periodontal diseases and diabetes: Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. Journal of Clinical Periodontology, 45(2), 138–149. https://doi.org/10.1111/jcpe.12808
Slayton RL, Urquhart O, Araujo MWB, Fontana M, Guzmán-Armstrong S, Nascimento MM, et al. (2018). Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association. Journal of the American Dental Association, 149(10), 837–849.e19. https://doi.org/10.1016/j.adaj.2018.07.002
Srinivasan M, Meyer S, Mombelli A, Müller F. (2017). Dental implants in the elderly population: A systematic review and meta-analysis. Clinical Oral Implants Research, 28(8), 920–930. https://doi.org/10.1111/clr.12898
Van’t Spijker A, Rodriguez JM, Kreulen CM, Bronkhorst EM, Bartlett DW, Creugers NH. (2009). Prevalence of tooth wear in adults. International Journal of Prosthodontics, 22(1), 35–42. https://pubmed.ncbi.nlm.nih.gov/19260425/
Villa A, Connell CL, Abati S. (2015). Diagnosis and management of xerostomia and hyposalivation. Therapeutics and Clinical Risk Management, 11, 45–51. https://doi.org/10.2147/TCRM.S76282
Walsh T, Worthington HV, Glenny AM, Marinho VC, Jeroncic A. (2019). Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database of Systematic Reviews, 3(3), CD007868. https://doi.org/10.1002/14651858.CD007868.pub3
Warnakulasuriya S. (2009). Causes of oral cancer: An appraisal of controversies. British Dental Journal, 207(10), 471–475. https://doi.org/10.1038/sj.bdj.2009.1009
Wolff A, Joshi RK, Ekström J, Aframian D, Pedersen AML, Proctor G, et al. (2017). A guide to medications inducing salivary gland dysfunction, xerostomia, and subjective sialorrhea: A systematic review sponsored by the World Workshop on Oral Medicine VI. Drugs in R&D, 17(1), 1–28. https://doi.org/10.1007/s40268-016-0153-9
Worthington HV, Lewis SR, Glenny AM, Huang SS, Innes NP, O’Malley L, et al. (2024). Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults. Cochrane Database of Systematic Reviews, 11(11), CD012718. https://doi.org/10.1002/14651858.CD012718.pub2
References checked October 2026 · Editorial policy · Report a correction
Discover more from HappyTeeth.Care
One email a month with new guides and one study, explained. Join and get a free printable dental emergency card. No spam, unsubscribe any time.
