Dr Bernard Kurdyk
Maintain your beautiful smile by preserving your teeth and stimulating and regenerating your bones and gums
Losing teeth as we age is not inevitable. As we get older, all of our body’s living structures are subjected to events that they have to deal with. It is their ability to adapt, nourish and protect themselves that allows them to stay healthy over time. The oral cavity, particularly the teeth and gums, is no different. Overall quality of life – grouping together physical, psychological, nutritional and environmental factors, combined with any necessary localised or generalised treatments – will ensure the oral and perioral tissues remain stable and functional throughout a person’s lifetime.
How the mouth ages
The position and/or colour of the teeth can vary according to their physiological wear and tear, i.e. how long they have been used for and any incidents they have incurred (trauma, food-related accidents, such as an unexpected olive stone, etc.). If a tooth breaks or part of it is lost, it can be repaired by a dentist. Modern techniques and materials allow us to restore the tooth’s shape and function in a much more natural-looking way: this is called mimetic restoration. The gum that surrounds and protects the teeth changes in a different way as we age. The gums are actually conjunctive tissue. More precisely, they are made up of a superficial layer (epithelium) and a subjacent layer of conjunctive tissue. This conjunctive tissue, like everywhere else in the body, loses its elasticity, firmness and hydration. Its ability to heal and regenerate itself is reduced.
Collagen production also diminishes over time, which leads to tissue sagging and a loss of impermeability between the gums and teeth. If this is not treated, the gums recede, which is exacerbated by systemic illnesses and/or damaging habits such as smoking or drinking alcohol. The teeth become sensitive to external stimuli, and their roots can start to decay. The shape of the teeth changes: they become longer, which alters the person’s appearance and smile.
Altered bacterial flora
The saliva also changes. It loses its fluidity, becoming stickier, and lower quantities are produced. There is also less gingival fluid. This means that all of the soft tissue is less hydrated, and because the saliva is stickier, it tends to pool more. This all leads to a specific oral microbiota, with the possible development of pathogenic bacteria such as Porphyromonas gingivalis or Fusobacterium nucleatum. Locally, the gums start to bleed. Tooth brushing becomes sensitive or painful, and is less effective. This must be considered an alarm bell, encouraging the person to see a dentist. This situation is amplified in patients with joint pain or mobility issues. It is therefore a good idea to address the patient’s dental hygiene habits: this is where electric and/or hydrosonic toothbrushes come into play. Since the teeth are less hydrated, they become more fragile and prone to breaking.
Generally, we ingest pathogenic bacteria every day, whenever a food bolus is formed in our mouth (every day, we ingest 10% of our oral bacteria), and, in the medium and long term, these bacteria will contaminate the whole digestive tract. Chronic inflammation takes hold, first digestive then more generalised, and this can lead to the development of systemic diseases such as diabetes, cardiac issues and/or neurodegenerative disorders. The impact of a dysbiosis in the oral microbiota has been proven in multiple international publications.
Effective treatment is possible
Losing teeth is no longer an inescapable part of aging. Both the dentist and their patient need to work together to reset the mouth’s homeostasis and maintain a good balance of bacteria (eubiosis). To achieve this, we need to embark on a comprehensive treatment plan, not just considering the patient’s mouth and its alarm signals. The most urgent course of action is to carry out local treatments to get rid of any infections and painful elements. We may also need to take some x-rays. This way, any hotbeds for infection are eradicated, any damaged teeth are restored and any ill-fitting implants are replaced.
A sample of the oral flora can be taken to flag the bacteria, viruses and fungi present, which tells us whether the mouth is eubiotic (healthy) or dysbiotic (unbalanced), and to what extent. Oral hygiene tools, such as toothbrushes, are selected according to the clinical situation. Using sonic or ultrasonic electric toothbrushes may be advisable. The same goes for accessories such as interdental brushes, dental floss or plaque disclosing agents. Next, we can correct any imbalances, locally, by restoring the mouth’s healthy microbiota.
We may carry out treatments to removal the pathogenic dental plaque (curettage), either in the traditional way or using lasers. We can reseed the oral flora with carefully-selected probiotics. Diet plays a major role. Drinking enough water and ensuring you get enough good-quality nutrients and micronutrients enables the tissues to maintain their optimal metabolism. A comprehensive blood, nutrient and micronutrient assessment will highlight any deficiencies, so that we can address and support any weakened functions.
To maintain a healthy diet, a good chewing action is essential. The teeth need to be in good shape and effective!
We can then look at restoring the gingival tissue, if necessary. Various techniques have been described and used. They involve compensating for any tissue modifications and giving the tissues a more suitable shape. Grafts are often used to do this. Nowadays, we can also use biostimulation techniques, particularly lasers. The same goes for the bones: correcting any deficiencies, erasing any local causes of demineralisation, boosting the flora and removing any sources of infection will, as a first step, prevent any atrophy in the alveolar bone, which holds the teeth in the jaw. Secondly, mechanical or laser stimulation reboots the local metabolism to help rebuild solid and efficient bone. All of these treatments together will reset the oral balance for the long term, with the help and cooperation of the patient. Any patients who come to me with age-related issues must be treated holistically. The mouth and oral cavity, which are so visible yet so often neglected or ignored, must be carefully examined.
Resetting the oral function and achieving a nice aesthetic, along with efficient oral microbiota, is the way to restore an optimal systemic metabolism.
Dr Bernard Kurdyk
For over 20 years, I have focused my practice on a comprehensive approach to patient care, particularly through the study of the oral microbiota and the use of lasers to deliver modern, minimally invasive and fully personalised medicine.
Infos: docteur-bernardkurdyk.com
