How to keep teeth for life (and what to do if you can’t)

Did you know that keeping your natural teeth is not only the key to looking younger, but is important for eating, drinking, breathing and speaking. Health writer Paula Goodyer explains how we can keep our teeth for life.

By Paula Goodyer

There’s a reason to keep our natural teeth in our head that has nothing to do with chewing but a lot to do with vanity. 

Our teeth and the bone that holds them in place help support the soft tissue of our face, preventing a sunken look. 

Check out old family photos and you get the picture - tooth loss was often why our great aunties and grandads looked older in their 50s, 60s and 70s than that we do at the same age.

But these days, there’s a good chance of keeping teeth for life if we invest in fighting the tooth decay and gum disease that drive tooth loss.

But while we’re aware of avoiding decay, we’re less savvy about keeping gums healthy, says Dr Mikaela Chinotti of the Australian Dental Association.

“You can have lovely teeth but if the gum, bone and ligaments keeping them in place become damaged by gum disease there’s a risk of tooth loss. There may be no early warning either - gum disease can be painless and there may be no obvious signs until it’s established.”

It’s also more common as we get older.

“Around 50%  of 55 to 74 year olds have moderate or severe periodontitis, a form of gum disease that often causes tooth loss. This figure rises to 69% among the over 75s, and having diabetes or a history of smoking can increase the risk,” Dr Chinotti adds

So what kicks off gum disease?

Insufficient brushing that leaves plaque lingering at the gum line can bring gingivitis, causing inflammation and often bleeding gums - a red flag to see your dentist for professional cleaning. 

For some people, gingivitis progresses to periodontitis which happens when supporting bone is lost from around teeth. 

Open spaces, called pockets, form between gums and teeth, becoming home to bacteria. These bacteria can brew inflammation and sometimes infections that damage gums, teeth and bone, Dr Chinotti explains.

Why it takes more than a toothbrush to keep teeth and gums healthy

Toothbrushes can’t clean between teeth, and any plaque left behind can lead to gum disease and decay.  

Around 75% of us rarely or never clean between teeth, according to ADA surveys -  yet flossing or using interdental brushes daily, together with twice daily brushing, goes a long way towards keeping teeth for life -and keeping breath fresh, she adds.  

Think twice before replacing a biological tooth

Even if a tooth is compromised by decay or gum disease - or you don’t like how a tooth looks - talk to your dentist about whether a replacement is really necessary, stresses Dr Scott Davis, President of the Australian Dental Association, and a specialist in restorative dentistry.

“Although implants and dentures can do a good job, what is biologically yours is better than an artificial replacement,” he says.

“Even if there’s decay or gum disease, it may be possible to treat it and extend the life of the tooth.  Sometimes people don’t like the look of their teeth or think they’re too crowded and want a more perfect look, but it’s important to think carefully before opting to replace it with an implant or denture.” 

Implants, dentures - or both? Best way to replace lost teeth

“If a replacement is necessary, dentures are less costly and can be removed for cleaning which can be an advantage for some elderly people who might struggle to clean implants effectively," Dr Scott says.

Implants can prevent further bone loss from occurring but require more work to keep clean than dentures.

However, it can also be harder to adjust to wearing dentures when you’re 75 compared to when you’re 35. It’s a bit like having to wear shoes if you haven’t worn them for 30 years - the brain can be less plastic with age and we don’t adapt to things so easily.

For people needing multiple teeth replaced, a good option is an over denture which clips on to two or more implants placed in the gum to act as anchors for the denture. This can be more comfortable than a denture that sits only on the gum line.

"A good dental implant can last for decades and be life changing - providing there’s enough bone to keep it in place and that it’s kept clean with brushing and cleaning between teeth, along with regular professional cleaning," he says.

“But don’t think that once the implant is in place it’s all done - good maintenance is critical, and it can be distressing if a dental implant fails,” Dr Davis emphasises.

Dental implants aren’t for everyone - smoking, having uncontrolled diabetes, aggressive gum disease or problems with immunity are factors that don’t make someone a good candidate, he adds.

But if you’re serious about an implant, don’t wait too long after losing the tooth that needs replacing, says Dr Chinotti.

“When you lose a tooth, the ridge of bone that held it in place can shrink so you need to get the implant done while there’s still enough bone. Talking to someone early can help to guide you.”

Tips for finding a good implant specialist

“If you’ve had a long relationship with your dentist and trust their opinion, that’s a good place to start,” she says.

“I’m also a strong believer in talking to friends and family - word of mouth is a good way to find someone,” Dr Davis adds. “If someone is a specialist registered with the Dental Board of Australia and a member of the Royal College of Dental Surgeons you’d expect them to be experienced. But you also want to see someone you feel comfortable with. A second opinion is a good idea too.”

But Dr Chinotti doesn’t recommend going overseas. It might be cheaper to head to Bali or Turkey to get major implants done, but the follow up care will be impossible.

“You need follow up care after an implant, so it’s best to have everything done by the same practitioner from start to finish.”

How much does it cost to replace teeth?

Prices can vary so this is a rough guide only - most dentists will provide a quote. Private health insurance can cover major dental work, but doesn’t usually cover 100% of the cost.

• Single denture - $900.00 - $1,000.00 depending on the material used.
• Full denture, upper or lower - on average, $1,500.00 per denture. Can be more, depending on the materials used. 
• Over denture of full dentures anchored by two implants may cost $7,000 to $9,000.
• Single implant and crown - $4,500 to $7,000. Can be up to $8,500.00 for a complex fitting requiring a bone graft.
• Full jaw of implants - $25,000 to $50,000 per lower or upper jaw.

Read more about dental implants, dentures and gum disease treatment on the Australian Dental Association website.

_{The information on this page is general information and should not be used to diagnose or treat a health problem or disease. Do not use the information found on this page as a substitute for professional health care advice. Any information you find on this page or on external sites which are linked to on this page should be verified with your professional healthcare provider.}