Maintaining healthy teeth throughout adulthood is not simply a matter of brushing more often. Gum health, early diagnosis, medication, diet, hormonal changes and everyday habits can all influence oral health as people grow older. According to Ibiza-based dentist Dr José Luis Rull, losing teeth should not be regarded as an inevitable consequence of ageing.

In an interview published by Periódico de Ibiza y Formentera on 9 November 2026, the director of Clínica Dr. Rull discussed the changes that can affect the teeth and gums over time, particularly from the age of 40. He highlighted the importance of recognising warning signs early, identifying the causes of dental problems and adapting preventive care to each individual.

His central message is that appropriate prevention and timely treatment can help people retain their natural teeth throughout their lives.

Ageing Does Not Automatically Mean Tooth Loss

Dr Rull explains that there is no sudden or universal change in oral health when someone reaches 40. Rather, problems may become more noticeable as the effects of accumulated habits, illnesses and other factors emerge over time.

These can include increased tooth wear, gum disease and older dental restorations beginning to deteriorate. Medication, general health conditions and changes in lifestyle can also influence the condition of the mouth.

He challenges the longstanding belief that losing teeth is simply part of getting older. With preventive care and treatment when problems first appear, many people can maintain their natural teeth well into later life.

The Spanish General Council of Dentists also stresses that tooth loss should not be accepted as an inevitable consequence of ageing, highlighting the importance of oral hygiene, regular check-ups and appropriate treatment throughout life.

Bleeding Gums Should Not Be Ignored

One of the warning signs Dr Rull particularly highlights is bleeding during toothbrushing.

Some people experience bleeding gums for years without seeking advice, assuming that it is normal or caused by brushing too hard. However, healthy gums should not bleed regularly.

According to Rull, frequent bleeding commonly indicates inflammation. This may be gingivitis, an early form of gum disease, or periodontitis, a more advanced condition affecting the tissues and bone that support the teeth.

The distinction matters. Gingivitis can generally be reversed with appropriate care, while periodontitis can cause progressive loss of supporting bone. Once lost, this bone does not regenerate spontaneously.

Persistent bleeding should therefore be assessed by a dental professional rather than treated simply with mouthwash for a few days.

What Does It Mean When a Tooth Starts Moving?

A tooth that becomes loose is another sign that deserves professional attention.

Periodontitis is one possible cause because the disease progressively damages the bone supporting the teeth. However, it is not the only explanation. Trauma, infections and excessive forces on the teeth can also contribute to mobility.

An important point in Rull's explanation is that a mobile tooth does not automatically need to be removed.

Depending on the underlying cause and the extent of the damage, treatment may help stabilise the tooth and preserve it for years. Early assessment is particularly important because periodontal disease can progress without causing significant pain.

Dental Wear and Sensitivity Have Several Possible Causes

Dental wear and sensitivity are frequently attributed to bruxism, the grinding or clenching of teeth. Rull cautions that this is not always the correct explanation.

Teeth can wear through contact with one another, certain habits and exposure to acids. Frequent consumption of acidic drinks and gastro-oesophageal reflux can contribute to the loss of dental structure.

Sensitivity can develop when dentine, the layer beneath the enamel, becomes exposed. This may happen through tooth wear or gum recession, although other causes also need to be considered.

The dentist emphasises that identifying the cause is essential. Restoring worn teeth or treating sensitivity may address the symptoms, but if the underlying factor remains, the problem can continue.

Why Persistent Dry Mouth Needs Attention

Saliva plays a much wider role than simply helping people speak, eat and swallow. It also helps neutralise acids, protects teeth against decay and contributes to controlling microorganisms in the mouth.

When saliva production decreases, the risk of dental caries, infections and discomfort affecting the oral tissues can increase.

Dr Rull identifies several possible contributors to dry mouth, including certain medications such as some antidepressants, antihistamines and treatments for high blood pressure. Medical conditions can also affect saliva production.

For this reason, persistent dry mouth should not automatically be dismissed as a normal consequence of ageing. It may require assessment to identify the underlying cause and reduce the risk of further oral health problems.

The Connection Between Oral Health and General Health

The relationship between oral health and the rest of the body is another important subject in the interview.

Rull uses diabetes as an example. People with poorly controlled diabetes have a greater risk of developing periodontal disease, while treating gum disease may help improve blood glucose control.

He also refers to research associating periodontitis with cardiovascular disease. However, he makes an important distinction: an association between two conditions does not necessarily establish that one directly causes the other.

In particular, he cautions against claiming that treating gum disease will prevent a heart attack.

The wider message is that oral health should be considered part of overall health, rather than treated as an entirely separate aspect of healthcare.

Brushing More Often Is Not Always Enough

Even people who brush their teeth several times a day can develop cavities or gum problems if their cleaning technique is incomplete.

One common issue is failing to clean properly between the teeth. A conventional toothbrush cannot reach every surface, allowing plaque to accumulate in spaces where additional cleaning is needed.

Depending on the individual, Rull recommends using interdental brushes or dental floss alongside regular brushing.

He also highlights the importance of fluoride toothpaste and dietary habits. The frequency of sugar consumption matters, not simply the total amount consumed.

Importantly, not everyone has the same risk of developing tooth decay or periodontal disease. Oral hygiene recommendations should therefore be adapted to each person's needs and circumstances.

Menopause, Hormonal Changes and Stress

Hormonal changes and stress can also influence oral health, although their effects vary between individuals.

During menopause, some women may experience dry mouth, discomfort affecting the oral tissues or changes in their gums. Hormonal changes can influence how tissues respond to inflammation, but this does not mean every woman will develop dental problems.

Stress may contribute to habits such as clenching the teeth during the day. It can also affect eating patterns and make people less consistent with their oral hygiene.

However, Rull cautions against attributing every problem to stress. Bruxism, for example, is complex and does not always have a direct relationship with psychological stress.

Understanding a patient's oral health therefore requires looking beyond the teeth themselves and considering their general health, medication, habits and lifestyle.

Prevention and Early Diagnosis Remain Essential

The advice shared by Dr Rull reflects a wider principle supported by the Spanish General Council of Dentists: maintaining oral health requires consistent care, early detection and professional follow-up.

Its recommendations include brushing at least twice a day for two minutes with fluoride toothpaste, cleaning between the teeth, maintaining a balanced diet, staying hydrated and attending dental check-ups even when there is no pain.

Regular examinations can help identify problems such as tooth decay, periodontal disease and changes affecting the oral tissues before they become more complicated.

Ultimately, the message is that healthy teeth are not simply a matter of age. Prevention, appropriate daily care and timely professional attention can make a significant difference to oral health throughout life.