Ten things that change about your teeth after 40
The routine that carried you through your thirties stops being enough, and not because you got worse at it. The risks change, and gum recession and dry mouth are the two nobody warns you about.
Somewhere around forty, a lot of people find that the routine which carried them through their thirties stops being enough.
It is not that they got worse at it. The risks changed, and the two biggest ones are things nobody mentions in advance.
1. Gum disease overtakes decay
Through childhood and early adulthood, decay is the main event. After forty, gum disease takes over as the leading cause of tooth loss in adults.
The problem is how it announces itself, which is barely at all. It is usually painless until teeth start to feel loose, and that is very late. The early sign is bleeding when you brush or floss, which almost everyone dismisses as brushing too hard.
Take the bleeding seriously. It is the only warning you reliably get.
2. Receding gums create a new problem
Gums recede over the years, mainly from a history of gum disease and from years of brushing too hard. It is less about age than about accumulation.
What it exposes is root surface, and root surface has no enamel on it. It is softer, it decays considerably faster, and it is far more sensitive.
So you can arrive in your forties with a good dental history and suddenly start getting cavities in places you never had them, at the gum line. That is not carelessness. It is a new surface with different rules.
3. Dry mouth, and the medication nobody connects to it
This is the most underestimated item on the list.
Saliva washes away acid, carries minerals back into enamel and keeps bacteria in check. Reduce it and decay can accelerate remarkably fast.
A great many common medications cause dry mouth as a side effect, including ones for blood pressure, allergies, depression and anxiety, and the connection is rarely made because the tooth problems appear months later.
Tell us what you take. Not because we will change it, but because it changes what we recommend, from high-fluoride toothpaste to shorter check-up intervals. If your mouth is often dry, say so even if you do not think it is relevant.
4. Old fillings start failing at the edges
Fillings do not last forever. Over the years the margins where the filling meets the tooth develop tiny gaps.
Decay then starts underneath, where a toothbrush cannot reach and where you cannot see it. Often the first sign is the tooth cracking or the filling coming out entirely.
This is a large part of what the x-rays at your check-up are looking for, and it is why "nothing hurts" is not evidence of much at this age.
5. Worn-down teeth change your face
Decades of grinding and acid erosion shorten teeth gradually enough that nobody notices.
As they shorten, the lower face loses height. The chin sits closer to the nose and the corners of the mouth turn down, producing lines that read as ageing but are structural.
Rebuilding worn teeth restores the support. Dealing with grinding early, with a night splint, protects the height you still have, which is far cheaper than rebuilding it later.
6. Sensitivity has a cause worth finding
New sensitivity to cold is usually either exposed root surface from recession or thinned enamel from erosion.
Sensitive toothpaste helps with the symptom and does nothing about the cause. Both causes are progressive, so it is worth having looked at rather than managed indefinitely with toothpaste.
7. Check your acidic habits
Erosion is cumulative, and after forty you have less enamel to spare.
Lemon water, sparkling water, wine, juice and vinegar dressings all count. Drink them with meals rather than sipping, use a straw for cold ones, follow with plain water, and do not brush for about an hour afterwards.
Read more: What causes dental erosion
8. Reconsider your brushing
If you have brushed hard for thirty years, your gums have the receipts.
Switch to a soft brush and go gently. An electric brush with a pressure sensor is genuinely useful here, because it corrects a habit you cannot feel yourself doing.
Cleaning between the teeth matters more now than it ever did, because gum disease is the main threat and it starts exactly there. If floss is awkward, interdental brushes are usually easier and often more effective, especially where gums have receded and the gaps are larger.
9. Do not leave a gap unfilled
A missing tooth is not a stable situation. The teeth either side tip in, the tooth opposite drifts, the bite changes and the bone recedes.
Every one of those makes the eventual solution more complicated. If you have lost a tooth, find out your options while the situation is simple. See implants vs dentures.
10. Smoking and alcohol matter more now
Smoking is a major cause of gum disease and it suppresses the bleeding that would warn you. Alcohol dries the mouth, stains, and adds sugar and acid.
Both also raise the risk of oral cancer, which is one of the things we check for at every appointment. That check takes under a minute and it is one of the better reasons to keep going regularly.
What to actually do
Keep going twice a year, or more often if your risk is higher. Mention your medications. Take bleeding gums seriously. Go gentler with the brush than you think you need to.
A full check-up and clean is a fixed $249, covering the exam, the scale and clean, fluoride and any bitewing x-rays you need, with your health fund claimed on the spot.
Read more: Four steps to healthier gums in 30 days
Oral health FAQ
How often should I see a dentist after 40?
Six months suits most people, and some need three or four. The interval should reflect your actual risk: gum disease, a history of decay, dry mouth from medication or fast tartar build-up all argue for going more often. We will suggest a rhythm rather than applying one rule to everyone.
Why do gums recede as we age?
It is not really age doing it. The main causes are years of gum disease and years of brushing too hard, and both accumulate. That is why it shows up in midlife rather than being caused by it, and why a soft brush and a gentle hand matter more than most people think.
Why have my teeth suddenly become sensitive?
Most often because gum recession has exposed root surface, which has no enamel on it and is much more sensitive. Enamel thinning from erosion does the same thing. Either way it is worth having looked at rather than just switching toothpaste, because both have causes that can be addressed.
Can gum disease still be reversed after 40?
The early stage can, at any age. Once bone around the teeth has been lost, that does not come back, though the disease can be stabilised so you keep what you still have. Age does not change the biology here, it just means there has been more time for it to progress.
Does dry mouth really cause that much damage?
Yes, and it is badly underestimated. Saliva washes away acid, carries minerals back to enamel and keeps bacteria in check. Without enough of it, decay can accelerate remarkably quickly. It is very often a side effect of common medications, so it is always worth telling us what you are taking.
