When we talk about the art of aging, we focus a lot on our hearts, brains, muscles, and even our gut. Our gums? They don’t exactly get top billing. Yet what happens inside your mouth may say more about your overall health than you think.
On this episode of Next Question, Katie explores what your gums could reveal about the rest of your body, the possibility that you might be brushing too hard, and how often you should go to the dentist. Her guide is William Giannobile, DDS, DMSc, dean of the Harvard School of Dental Medicine and an internationally recognized expert in periodontology and regenerative medicine.
One thing Dr. Giannobile wants to make clear from the start? Losing teeth isn’t inevitable as you get older. “We’re designed to keep our teeth for a lifetime," he explains. Find out how to better protect your chompers below.
How does your oral health change as you age?
Something you may notice as you get older is reduced saliva flow, which Dr. Giannobile says can happen because of certain medications and aging itself. “When our saliva flow decreases, our ability to swallow, speak, and chew is impaired,” he explains. Over time, difficulty chewing and swallowing can affect how well people eat and, in turn, their nutrition.
Another shift happens beneath the surface. “As we think about getting older, our bone mass decreases,” Dr. Giannobile says, pointing specifically to postmenopausal women who may develop osteopenia or osteoporosis. “The total amount of bone that we have within the oral cavity is decreasing.” Because that bone helps anchor your teeth in place, its weakening can leave teeth with less support and may increase the risk of tooth loss, especially when other factors like gum disease are present.
And when it comes to cleaning your teeth, harder isn’t necessarily better: While gum recession may be more common with age, Dr. Giannobile says overly aggressive brushing can contribute to the problem. That’s where having live feedback can help: The Oral-B iO Series 2 toothbrush, for example, has a built-in gum pressure sensor that alerts you if you’re brushing too hard, taking some of the guesswork out of your routine.
How does gum disease impact the rest of your body?
Scientists are increasingly studying what happens when bacteria associated with gum disease spread beyond the mouth. “There’s a great deal of evidence demonstrating that these bacteria found in the oral cavity…travel throughout the body,” Dr. Giannobile says. To wit, researchers have detected bacteria associated with periodontal disease in cardiovascular tissue, and scientists are also investigating connections between oral bacteria and brain health.
Inflammation may be an important part of that relationship. "Infection in the mouth can cause the elevation of many different markers,” he explains, including inflammatory markers associated with other chronic diseases.
“I’m not saying that they’re causing heart disease,” Dr. Giannobile says of periodontal infections, “but they’re exacerbating many of these diseases.”
Does your mouth have a microbiome?
Yes, your mouth has its own microbiome — a community of bacteria that helps keep it healthy.
Dr. Giannobile explains that when we have a healthy balance, the oral microbiome and substances produced by our salivary glands help keep the oral cavity functioning as it should. Dry mouth, tooth decay, and periodontitis can disrupt that environment.
It’s another reason Dr. Giannobile sees oral health as part of a much larger picture. “The oral cavity is the window into the body,” he tells Katie. “When you see someone with good oral health, it usually is a sign of overall health.”
What should you do to protect your teeth and gums?
For brushing, gentler is better. “I advise people to use the softest brush you can,” he says. He also recommends electric or sonic toothbrushes, which he says can effectively clean plaque while limiting damage from overly aggressive brushing.
And more isn’t necessarily better: Dr. Giannobile recalls treating a patient who brushed eight times a day and damaged his gums in the process. His recommendation? “Two or three times a day is sufficient.” Then there’s addressing what your toothbrush can’t reach. Flossing and water flossers won’t reverse gum recession, but they can help remove plaque. And it probably goes without saying, but don’t skip the dentist. Depending on the individual situation, Dr. Giannobile says some people may need professional cleanings several times a year.
Ultimately, the goal isn’t a perfect set of pearly whites. It’s maintaining a healthy mouth for as long as possible, and giving oral health a bigger place in the longevity conversation.
Listen to Katie’s full conversation with Dr. Giannobile on Next Question to hear more about gum disease, dry mouth, the oral microbiome, brushing and flossing, bad breath, dental implants, whitening, and what your dentist may be able to tell you about your overall health.
This interview has been condensed and edited for length and clarity.
