Most people who come to us in their seventies and eighties have not been neglecting their teeth. They have been taking medications that dry the mouth, living with dental work placed thirty years ago that is finally reaching the end of its life, and dealing with a body that has changed around a set of teeth that hasn’t.
That is a different set of problems from the ones a thirty-year-old walks in with, and it deserves a different conversation. Dr. Fred Guerra has been practicing in Colorado Springs since 1989 and has treated a great many patients through exactly this stretch of life.
Does Medicare cover dental care?
This is the question we are asked more than any other, and the honest answer is mostly no.
Original Medicare, Parts A and B, does not cover routine dental care. Not cleanings, not fillings, not extractions, not dentures. Part A may cover dental work performed in hospital when it is part of a covered medical procedure, but that is a narrow exception rather than a benefit you can plan around.
Medicare Advantage plans, Part C, often do include dental coverage, and this is where most seniors actually have a benefit. Coverage varies enormously between plans, usually with an annual maximum that a single crown can exhaust. Standalone dental plans are also available separately.
If you are not sure what you have, bring the card to your first visit and we will work it out with you rather than leaving you to decode it. We would rather tell you what your plan pays before treatment than surprise you afterwards.
Dry mouth, and why so many medications cause it
Hundreds of common prescriptions list dry mouth as a side effect: blood pressure medications, antidepressants, antihistamines, diuretics, and drugs for incontinence and Parkinson’s. Take three or four of them together and the effect compounds.
Saliva is not incidental. It buffers acid, washes away food, and carries the minerals that repair early enamel damage. Take it away and decay accelerates, often at the gum line and on root surfaces that were never designed to be exposed. Patients who went fifty years without a cavity can suddenly develop several in a year, and it is not because they stopped brushing.
This is manageable once it is recognized. It is one of the first things we look for.
Root decay and dental work reaching the end of its life
Fillings and crowns do not last forever. A filling placed in 1985 has done well to still be there, and when it finally fails it usually fails underneath, where you cannot see it and it does not hurt until it is significant.
Gum recession compounds it. Where gums have receded, the exposed root surface has no enamel. It is softer, and it decays faster. That combination of old restorations, exposed roots and reduced saliva is why this stage of life needs closer monitoring rather than the same six-month rhythm applied without thought.
We use laser cavity detection and low-radiation digital imaging to find that kind of decay before it becomes a root canal.
Gum disease and the rest of your health
Gum disease becomes more common with age and is the leading cause of tooth loss after sixty. It is also linked to heart disease, stroke and poorer blood sugar control in diabetes, and the relationship runs in both directions, which is why periodontal care matters more here, not less.
It is also largely painless until it is advanced, which is exactly why it goes unnoticed.
Replacing missing teeth
There are three realistic routes, and the right one depends on your bone, your health and your budget rather than on which is newest.
- Dentures are the least expensive and non-surgical, and they can be made quickly. They rest on the gums, so they move, and the bone underneath continues to shrink, which is why they need relining over time.
- Dental implants replace the root as well as the tooth, so the bone is preserved. They cost most and take longest, and require enough bone to place.
- Implant-supported dentures use a small number of implants to anchor a full arch. This is the option most people do not know exists, and for a lot of denture wearers it is the one that changes things: no movement, no adhesive, and the bone loss slows.
If you are currently in dentures that move when you eat, that is the conversation worth having.
When getting to the appointment is the hard part
- We are at 3208 N Academy Blvd, Suite 100, with parking directly outside
- Tell us when you book if you need a longer appointment or more breaks. We would rather schedule it properly than rush you
- Oral sedation is available for longer procedures or if sitting still for a long stretch is uncomfortable. You will need someone to drive you home
- Our VIP amenities exist for comfort during longer visits, not decoration
- If a family member manages your appointments, bring them in. We are happy to explain the plan to both of you
Paying for dental care in retirement
Dental costs land differently on a fixed income, and pretending otherwise helps nobody.
Our Smile 365 VIP Membership covers preventive care at a flat annual cost and includes a discount on treatment. It is designed for patients without dental insurance, which describes a great many people once they leave an employer plan. CareCredit financing is available for larger treatment, including an interest-free plan for the first six months.
Where a treatment plan can be staged over time to spread the cost, we will tell you what genuinely needs doing now and what can reasonably wait.
Oral cancer screening
Risk of oral cancer rises with age, and it is most treatable when caught early. An oral cancer screening is part of a routine exam here. It takes a couple of minutes and it is not something you have to ask for.
Sleep apnea
Obstructive sleep apnea becomes more common with age and is heavily under-diagnosed. If you snore heavily, wake unrefreshed, or your partner has noticed you stop breathing, it is worth investigating. Untreated apnea is associated with high blood pressure, heart disease and stroke.
Diagnosis requires a sleep study ordered by a physician. Once diagnosed, a custom oral appliance is often easier to live with than CPAP, and we bill medical insurance directly for it.
Why patients choose Dr. Guerra
- Practicing in Colorado Springs since 1989
- Former Director of Dental Services at the United States Air Force Academy
- 4.9 stars across 315 Google reviews
- Cone Beam 3D imaging, laser cavity detection and microscope-enhanced dentistry
- Oral sedation available for patients who need it
Common questions
Does Medicare pay for dentures?
Original Medicare does not. Some Medicare Advantage plans contribute, usually within an annual maximum. Bring your plan details and we will check.
I have not been to a dentist in years. Is it too late?
Almost never. We see this regularly and nobody here will comment on it. The exam tells us what is there now; how it got that way is not the subject.
Am I too old for dental implants?
There is no age limit. What matters is bone volume and general health, not the number. A 3D scan answers it properly.
My dentures do not fit like they used to. Why?
The bone underneath continues to shrink after teeth are lost, so a denture that fit ten years ago no longer matches the ridge. Relining, remaking, or implant support are the three ways forward.
Why do I suddenly have cavities after decades without any?
Usually dry mouth from medication, often combined with gum recession exposing root surfaces. It is addressable once identified.
Can I be sedated for a long appointment?
Yes. We offer oral sedation, and you will need to arrange a ride home.
Do you accept patients on a fixed income without insurance?
Yes. The Smile 365 VIP Membership exists for exactly that, and CareCredit is available for larger work.
Talk to us
Call (719) 596-1230 or request an appointment online. If you would rather ask questions before booking anything, say so when you call. That is a normal way to start.
Guerra Dental, 3208 N Academy Blvd, Suite 100, Colorado Springs, CO 80917. Monday to Thursday, 8am to 5pm.