Dental Education Lecture: Cavities in Senior Citizens

Cavities can happen in anybody if he or she does not practice good oral care.  Senior citizen is no exception.  Mrs. Li (in her sixties) has suffered toothache for quite a while because of recent heavy snow in Atlanta.  But it is difficult in the beginning to figure out which tooth has problems.  She thinks that the tooth with root canal in upper jaw is a culprit (Fig.1 the tooth with a huge filling: white shadow).  X-ray shows that the tooth in the back (actually a wisdom tooth) has a large caries (arrowheads).  This is a bad guy, which needs to go.  Since the pain is long-standing, it takes five shots to numb the tooth completely.  The cavity is obvious when it turns 90 degrees toward us (arrowhead in Fig.2, between crown (C) and root (R)).  The cavity between the teeth is difficult to be found either by the patient or the doctor.  It happens simply because Mrs. Li does not use dental floss.

Mrs. Zhang also seeks help immediately after the heavy snow.  She knows exactly which tooth bothers her, but she does not know why.  Detailed exam, including X-ray, reveals that there is a cavity between teeth (arrowheads in Fig.3), very hidden: deep near the gum line (arrowhead in Fig.4).  It is very difficult to fix the cavity near the gum line.  We have to take it out.

When we get old, it is easy to get cavities near the gum line and between the teeth, if we do not have good oral habit on persistent basis.

Xin Wei, DDS, PhD, MS 1st edition 01/22/2011, last revision 01/23/2011