Soft Tissues

• The Mouth
• Mouth Surface
• The Tongue
• Teeth
• Osteorporosis can effect the mouth
• Arthritis of the TM joint
  

The Mouth

The corners of the mouth (also referred to as commissures or angles) may break and fissure with aging due to loss of tissue elasticity, mineral and/or vitamin deficiency or an infection. Cheeks may sag from loss of muscle tone and facial height may be diminished due to loss or wear of teeth, resulting in accentuated facial lines and tissue folds. The folded and fissured corners of the mouth may be exposed to constant moisture as a result of saliva pooling in these areas. Microorganisms such as Candida albicans, staphyloccoci and streptoccoci often infect these moist, fissured lesions (see pictures below)

Acute Oral Lesions

Mouth Surface

As we age, there is some atrophy of the oral mucosa and the mouth tissues are typically thinner, smoother and less elastic (Richman & Arbarbanel, 1943; Shklar, 1966; and Kydd & Daly, 1982).

The Tongue

The tongue may become lobulated, coarse or flat, and red. The tongue also looses some of its papillae (Frantzell et al 1945) which can contribute to diminished taste and occasionally the sensation of a burning tongue. Zinc deficiency has been associated with the loss of taste and smell (Gorsky, Silverman and Chinn, 1991).

Teeth

With aging, the enamel of the teeth is subjected to mechanical and chemical wear. It becomes more brittle which may result in hairline fractures. Undermining decay and/or previously placed fillings may also cause fractures in older teeth. Aging enamel loses its surface texture and appears flatter and more yellowed. Staining can also be caused by food, drugs, tobacco products, poor oral hygiene, necrotic pulpal tissue, arrested decay and corrosion products from filling material. To see a graphic illustration of the anatomy of a tooth, click the link.

The roots of aging teeth may appear glass like. Changes in the aging pulp make the tooth less sensitive and diminished blood flow slows the healing potential. The root surface of the tooth is covered with cementum that triples in thickness between the ages of ten and seventy-five (Zander & Hrzeler 1958). Receding gingival tissue may expose the altered (i.e. thicker) cementum and eventually lead to loss of the tooth due to periodontal disease.

Root Surface of an Older Adult

Osteorporosis can effect the mouth

Osteorporotic changes with advancing age also occur in the bones that surround the oral cavity. The bone becomes more brittle and less dense. Edentulous bony ridges become atrophic and dentures may need to be modified to compensate for the shrinking ridge.

Arthritis of the TM joint

The jaw joint is called the temporomandibular joint (TM joint, where your jaw ends). It may be affected by osteoarthrithis or rheumatoid arthritis. Wear-related damage to the joint and/or perforation of the cartilage disc within the joint may cause the joint to make noise, cause irregular movement and at times may lead to pain during jaw movement or at rest.