Dr. Steven Katz on Seniors and Smiles

Senior Dental Health and Root Canals with Endodontist Dr. Steven Katz

Host Mike Roth opens Season 8 of Villages Vitality Life: Senior Life Unscripted and interviews Dr. Steven Katz, DDS, MS, an endodontist in private practice in Beachwood, Ohio, adjunct professor at West Virginia University, and immediate past President of the American Association of Endodontists. Katz explains how seniors’ oral health needs change with age due to narrowing root canals, reduced dexterity, and medication side effects like dry mouth or gum inflammation, and discusses how visit frequency depends on individual risk (often twice yearly, more with gum disease). He contrasts routine vs deep cleanings, emphasizes keeping natural teeth for function, health, and social confidence, and notes implants still require thorough maintenance and can fail. Katz advises daily brushing and flossing (typically once daily), using electric toothbrushes if needed, and seeking prompt care for sensitivity, swelling, or pain; he also discusses resorption, the oral-systemic health connection, modern one-visit pain-free root canals, typical cost ranges, and resources like aae.org and SaveYourTooth.com.

00:00 Season Eight Kickoff
00:41 Meet Dr Steven Katz
01:50 Seniors Teeth Changes
03:39 Dental Visit Frequency
04:43 Cleaning Versus Deep Cleaning
06:00 Why Keep Natural Teeth
07:32 Implants Reality Check
09:29 Medicare And Insurance
11:00 Alzheimers Tip Break
12:36 Daily Habits And Tools
15:38 Flossing Questions
17:08 Oral Health Body Health
19:02 Resorption Case Study
20:57 Evidence And Studies
22:44 Back To The Dentist
24:00 Root Canal Visits Costs
25:29 Contact Info And Wrap
26:09 Supporters And Signoff

New FAN MAIL features TXT & Voice Mial

Transcript

Dolores: 0:34

Welcome to Season eight of Villages Vitality

Life: 0:36

Seniors Life unscripted. In this new season, we talk to leaders of clubs and interesting folks who live in and around The Villages. We also talk to people who have information vital to seniors. You will get perspectives of what is happening in and around The Villages, Florida, in addition. We will add more information for all seniors. We are a listener supported podcast.

Mike: 1:02

This is Mike Roth on Villages Vitality, Senior Life Unscripted. I'm here today with Dr. Steven Katz. Thanks for joining me, Steve.

Steven Katz: 1:12

Thanks for having me, Mike.

Mike: 1:13

Dr. Steven Katz is a DDS dentist with an MS degree. He's the immediate past President of the American Association of Endodontists, he's also a Diplomate of the American Board of Endodontics and a member of the American Dental Association. Dr. Katz is in private practice in Beachwood, Ohio. That's in the Cleveland area.

Steven Katz: 1:37

That is correct.

Mike: 1:39

Yeah. Okay. And he's an adjunct professor at the West Virginia University School of Dentistry. That's a heck of a drive, isn't it, Steve?

Steven Katz: 1:48

it's about three hours. Mike? Yes. I'm asked that a lot. So a dear friend of mine is in charge of the endodontics program there, and he asked me to come and to teach periodically. So that's what I do. I don't go every day. I don't even go every week. But I do drive down there periodically and, spend some time with the endodonic residents teaching them?

Mike: 2:12

We're here to talk about teeth and and seniors. So how are seniors teeth different than younger people? Steve.

Steven Katz: 2:19

In some ways, seniors teeth are not any different in that seniors still need to take care of them the way we have always seniors. Need to maintain their routines of flossing and brushing regularly. They need to see their dentist regularly if they have a problem. Just like any age group, they need to see the dentist or sometimes even a specialist. But senior's teeth do differ in some other ways. So one of the things that happens as we mature is inside of our tooth, we tend to get smaller root canals, if you will. So that's my area of expertise. So the root canal system narrows as we age. And we don't necessarily see that in younger patients. The other thing that happens is that seniors can sometimes lose dexterity as they age. And so that would necessitate potentially using an electric toothbrush or something like that. So the way they care for their teeth. Needs to change. It could be related to arthritis in your hands or something like that. And then one of the other things that happens frequently is that seniors can be on medications that can alter the conditions in the mouth. As an example, some anti-hypertensives that are used for blood pressure some medication used for diabetes. They can cause either inflammation of the gums or a drying of the mouth and then that doesn't allow saliva to do what it needs to wash away the debris and things like that. And so seniors need to be concerned about things like that.

Mike: 4:01

You used the word that like you to define regularly. Some dentists around here say that you should see the dentist every three months.

Steven Katz: 4:11

Sure.

Mike: 4:12

When I was younger, I would go to see the dentist twice a year. Which one did you mean when you said regularly?

Steven Katz: 4:19

Regularly is loosely defined. So it really depends on the individual. Typically in the past, the American Dental Association has recommended that you see the dentist twice a year, but that doesn't take into. That subset of patients that have additional issues or problems that require a little more maintenance, so those folks would wanna go to the dentist more often. So it may be once every three months, it may be once every four months. Typically, most patients that don't have gum disease can get by going to the dentist twice a year. But patients that are, again, higher maintenance, typically with gum disease, they probably need to see the dentist more frequently.

Mike: 5:05

Question that comes up regularly is what's the difference between a and a deep

Steven Katz: 5:12

Sure. So a cleaning is pretty superficial. You don't typically get numb for that. They just clean the tartar off of the tooth structure that's exposed above the gums. Okay. When you have a deep cleaning, oftentimes you'll get numb for that, and they'll go down onto the root surfaces, below the gums and clean down there. So deep means exactly what it says. They're going deeper onto the tooth surface to clean areas that are not exposed on top of the gum.

Mike: 5:48

Why would someone need a deep cleaning?

Steven Katz: 5:49

Again, if you get tartar buildup or if you get plaque buildup underneath the gums, then it needs to be cleaned out. For most of us, we're able to keep those surfaces clean and the plaque doesn't get underneath, so we don't have that issue. But there are patients, and again, those are typically periodontal patients or patients with gum problems. They'll tend to get buildup underneath the gums, and they'll need to go to someone to clean that out, to get that deeper cleaning.

Mike: 6:23

Why is it important for people to keep their natural teeth as long as possible?

Steven Katz: 6:27

Nothing really looks or functions or feels like our natural teeth. They're just so important for chewing, for speaking, and for that all important smile. We also know that if you can maintain your teeth for as long as possible, hopefully for your lifetime, that you'll have better cognitive function, improved cardiovascular health, and even improved glycemic health, meaning a blood sugar control. So there's lots of things that are connected to taking good care of your teeth and being healthy in your mouth. The connection between oral health and systemic health, our overall health is really becoming much clearer now and it's so important to hold onto our natural teeth. The other thing, and this is especially true for seniors, we know how important it is to interact and to have a social life. And if you don't have your natural teeth, if you don't feel comfortable smiling, you're not gonna speak with other people. You're not gonna go out and become part of the community and have social interactions. It's just crucial. And in addition to that. You can replace your teeth if you lose them with bridges and implants. However, it's not the same. It just doesn't function the same and also, they're much more expensive than maintaining your natural teeth. So if you can, you should maintain your natural teeth.

Mike: 7:55

Is there a functional de deficiency with implants or additional maintenance that people should be aware of?

Steven Katz: 8:02

Oh, for sure. It's really interesting because when implants first came on the market, maybe 20 years or so ago, they said they would replace your natural teeth. You wouldn't have to take care of them, and they would last a lifetime. Now there's so much more research and it shows that, you know what? Patients that don't take care of their implants, they have the same problems that they do. If they don't take care of their teeth, they get periodontal disease around them. They get gum disease and inflammation around them. They require a lot of maintenance. So if you can hold onto your natural tooth, it's way easier than trying to maintain an implant down the road if you lose your natural tooth. The other thing is, we know Is that. If you lose an implant, if you put an implant in and then it goes bad and it has to be replaced, the chances for success are so much lower. So we like to think of it as pushing or kicking the can down the road as far as we can, right? So it's like hold onto your tooth as long as you can, because once you take it out, it's never coming back. And then you could put an implant in. But again, that's not perfect. They don't work for everybody. They require a lot of maintenance.

Mike: 9:17

What kind of maintenance do implants need?

Steven Katz: 9:19

They, require, routine brushing and flossing. You gotta go to the dentist, you gotta get cleaned around your teeth. It's not, like I said a minute ago, the message used to be that you just stick 'em in there and they're good forever. You don't have to take care of 'em. But that's not true at all. You have to maintain 'em just like a natural tooth.

Mike: 9:38

Okay, but is there any additional maintenance

Steven Katz: 9:41

that you need you. Those are the patients that would need to go to their dentist more frequently. Because they have those kind of issues. So that would require that kind of extra maintenance. Yes.

Mike: 9:51

Does Medicare typically cover the cost of routine dental work?

Steven Katz: 9:55

Unfortunately it doesn't. There are some of the Medicare Advantage plans that. Cover a small amount of dentistry, but I think the typical plan through the government does not pay for dental work on, unfortunately,

Mike: 10:10

Can I ask why?

Steven Katz: 10:11

I that's a conversation for another day with somebody probably from the government. I don't have the answer for that.

Mike: 10:19

What do you think of dental insurance?

Steven Katz: 10:21

Dental insurance is helpful, but people tend to think of dental insurance, like medical insurance, and it's really not that at all. It's a small amount of money that goes towards the payment of your annual costs. If you need a lot of dentistry and extensive amount of dentistry, your insurance is gonna run out. You're gonna use it up for that year because most plants typically only pay. 1500 to maybe $2,000 a year. That doesn't go very far. And those numbers interestingly have not changed over decades. It just, the in the insurance has not changed. On the other hand, I'm not sure that we necessarily would want it to be like medical insurance, because then you have all of the issues that come with that and the cost would get. Overwhelming, I could imagine so. So dental insurance acts as a supplement towards your care. It's really not supposed to be any more than that.

Mike: 11:21

Okay, good. Let's take a a short break here.

Steven Katz: 11:24

Great.

Mike: 11:25

And listen to an Alzheimer's tip from Doctor Craig Curtis.

Dr Craig Curtis: 11:30

We now know that Alzheimer's disease starts about 20 years before the symptoms with the buildup of a toxic protein called amyloid. And so scientists have been on a quest to remove amyloid to see how it affects the disease. The medicine that was recently FDA approved to slow down symptoms in people with Alzheimer's disease memory problems. Works by removing this substance called amyloid out of the brain. And now we're attempting to use those medicines to actually remove amyloid before someone develops symptoms of Alzheimer's disease, such as memory loss and forgetfulness.

Mike roth: 12:11

So that's in that 20 year period before the disease is obvious.

Dr Craig Curtis: 12:16

That's right. Scientists now call it Alzheimer's Pathologic change versus Alzheimer's disease. We're saving the term Alzheimer's disease for when someone is actually experiencing symptoms due to Alzheimer's disease.

Warren: 12:31

With over 20 years of experience studying brain health, Dr. Curtis's goal is to educate The Villages community on how to live a longer, healthier life. To learn more, visit his website, CraigCurtisMD.com, or call 3 5 2 5 0 0 5 2 5 2 to attend a free seminar.

Mike: 12:47

I am back with Dr. Steven Katz, who. Is a dentist and an endodontist as well.

Steven Katz: 12:55

Sure.

Mike: 12:55

Let me ask you, what are some typical tips that you can give our older senior patients to preserve their natural teeth and maintain their oral health over the rest of their lifetime?

Steven Katz: 13:07

I think some of those tips are pretty routine and simple. Like I would say, maintain a healthy lifestyle, get plenty of exercise, drink lots of water, eat correctly. Specific tips are. Take care of your teeth. So brush and floss on a daily basis. Get into a routine so that if you miss it, you feel like you've missed it. And so we find that patients of any age, if they're in a routine, then they have better care that way. So make sure you brush and floss regularly. Keep your appointments. See your dentist regularly. We talked about that already. That's crucial. I think what's probably a little more important for seniors is that if you have a problem, don't wait. So if you break a tooth, go see your endodontist. If you have hot or cold sensitivity, if you have swelling or redness in your gums, go see the endodontist. Okay? We are the dentists that are specific for those types of problems, and we take care of those. The longer you wait, it's only gonna get worse. People think that tooth problems go away by themselves, they don't. So if you're having a problem with a tooth, it's gonna come back and it's gonna be worse the next time, and ultimately it could cause you to lose your tooth. So if you have those kinds of problems, see the dentist right away. In addition to that, like we also spoke about before, I think that for seniors it's important if you have dexterity problems, if you have arthritis in your hands. Buy an electric toothbrush. They're so effective. I use one and I've been using one for years. They just clean your teeth a little bit better. Do you need to have one? No, you don't. But they work a little bit better, so do that.

Mike: 14:58

I think they work a lot better.

Steven Katz: 15:00

There you go.

Mike: 15:01

I've been buying those Sonicare toothbrushes, since they came out and I'm the guy that buss them inside the warranty

Steven Katz: 15:08

Yeah. And so I would highly recommend that. The other thing is

Mike: 15:12

so there are two types. Maybe you can make a recommendation here. The Sonicares brush up and down, then there's another brand I'm sure may name this that, that goes around

Steven Katz: 15:22

yeah so

Mike: 15:23

one is better?

Steven Katz: 15:24

I'm not gonna make a recommendation, but because you mentioned Sonicare. The one that goes in circles is the oral B. Okay. And so personally, so you mentioned you like the Sonicare. I like the Oral B because the Sonicare tickles my gums, so it's a little bit uncomfortable for me. The Oral B does not do that, so that's the one that I use. Either one of 'em is great. I'm not making a recommendation. I don't work for the companies. I get no money from the companies. I think they're both terrific and I think they help at any age especially they would help a senior.

Mike: 15:58

Said that someone should floss, every day. Did that mean once a day, twice a day, or three times a day?

Steven Katz: 16:05

typically, once a day is enough. Now if you tend to get food caught in a lot of different places, you may have to floss more frequently than that, but I'll tell you why. Once a day is enough, it takes 24 hours for plaque to build up. So if your flossing is able to remove the plaque, then you shouldn't have to do it for at least another 24 hours. But again, if you're getting food caught, that's a different story. Then you should floss more frequently.

Mike: 16:34

And what do you think of the difference between the waxed and the inflexed waxed floss? Which one is better?

Steven Katz: 16:40

Neither one is better. Again, it's a personal preference. A lot of it has to do with the tightness of your contacts. So what that means is when you run the floss through your teeth, some flosses go through easily and some are, don't go through as easily. So

Mike: 16:56

That's

Steven Katz: 16:56

find the one that, yeah, you find the one that goes through the best. And it works. Whether it's waxed or not, it makes no difference.

Mike: 17:04

Okay. Is there anything that, such as a a medicated floss that, that is better at taking out the plaque between teeth?

Steven Katz: 17:12

Not that I'm aware of. Nope. It's a, it's purely a manual function, it's not a function of, they'll, some of 'em, I'll have a little bit of minty flavor to them. But it doesn't do anything with regards to removing plaque. It's just that's purely manual.

Mike: 17:28

Dr. Katz what can we do to help save our natural teeth and contribute to our overall dental

Steven Katz: 17:35

Sure. And we talked about that a little bit before, but there's some new evidence recent evidence that really tightens the connection between our mouth health. Our overall body health. So again, we know that if we can maintain our teeth that we have better cardiovascular scores better glycemic scores and better cognitive function. There's a new report that came out of Kings College in London recently that where they treated patients that had a root canal abscess. So they had an infection right in their tooth, and they did a root canal on the tooth, and they saw their scores improve. They measured their scores over a couple of years and they saw their cholesterol level go down. And they saw their sugar level go down as well. And when they looked at other inflammatory markers,'cause remember Mike, everything in the body is related to inflammation. Every disease is inflammatory in nature. So when they looked at these other inflammatory markers, those measurements went down as well. So if we maintain our teeth, if we need a root canal, if we take care of it, if we eliminate the infection, then all of those numbers will improve. How do we do that? All of those things we've talked about up to this point. We take good care of our teeth, we go to the dentist and we see a specialist when we need to. Remember, I think this is important for your audience to know. There's no amount of redness, swelling, pain, hot and cold and sensitivity that should be considered normal, right? People let these things go and they live with them, but that's really not healthy. So if you're having those problems, that's really the time to see the endodontist.

Mike: 19:22

I've had several root canals over the

Steven Katz: 19:24

Yeah.

Mike: 19:25

and they were all relatively successful. but I had a cold sensitivity on one tooth.

Steven Katz: 19:33

Okay.

Mike: 19:33

and I went to the endo dontist and. I, after taking numerous x-rays, he said to me, you got a hold on the root

Steven Katz: 19:41

Okay.

Mike: 19:42

of the tooth and I'm not gonna do a root canal on that'cause it won't be successful. He said, in a year, you're gonna be back complaining and we'll have to pull out the

Steven Katz: 19:51

Okay.

Mike: 19:52

Do you think that was the right diagnosis?

Steven Katz: 19:54

It sounds to me like you probably had a process called resorption. Does that ring a bell when you set a hole?

Mike: 20:02

Oh, unfortunately it does

Steven Katz: 20:04

ring a bell. Yeah, so resorption is the easiest way to describe it is it's a eating away of the tooth structure, un underneath the gum. So in the roots or in the internal surfaces of the tooth, and. It's not always very easy to treat, and if that hole, as he described is pretty large, if it's, or if it's in a place where you can't get to it to repair it, then I think that's the right diagnosis. Yeah, for sure.

Mike: 20:35

Yeah. Do you think that resorption could be caused by calcium deficiencies?

Steven Katz: 20:39

Yeah, personally, I've never seen any evidence that suggests that, we know that resorption is related to trauma. So it could be, if you got hit and it could have been Mike, it could have been years ago when you were a kid or when you were a teenager, it could have been related to orthodontics. Did you have braces when you were a kid?

Mike: 20:59

no. I had braces when I was

Steven Katz: 21:00

40, Okay, so that could have been related to that too.'cause we see resorption in patients that have had orthodontics, either young or old. So it could have been related to either of those things. I have not read that. It's related to a calcium deficiency. Okay.

Mike: 21:15

Okay. A couple of times you made claims about dental health dental health is directly related to physical health overall, whether it was. Capability or stamina? Is there any evidence based with double blind studies that dental health help the rest of the body?

Steven Katz: 21:33

Oh, sure. There's a lot of evidence in fact, it goes back for years. So it started with periodontal and gum health, right? There's studies that show that women that don't ca take care of their teeth have low birth weight babies.

Steve Katz ai: 21:46

babies Okay, so there's a relationship between the mouth and everything else inside of the body. Again the bacteria that is seen in periodontal disease, in gum disease, we see that causing problems elsewhere. So it's been studied extensively and there's a lot of evidence now are it's hard to do like those studies that you're describing, because you can't. Expose one patient. You can't say, okay, we're gonna let you have gum disease, but we're going to fix your teeth and then we're gonna watch you over the next year. We don't do that in this country. So it's hard to do those double blind type studies that you're talking about, but there is a lot of evidence that if you treat and take care of oral health. That your numbers, your markers will improve. And like that study I told you about from Kings College where they did actually measure inflammatory. Glycemic and cholesterol markers, and they saw improvement in every one of them when they treated that root canal abscess. If you have a root canal abscess, the message is get it fixed, take care of it, and it'll improve not only your teeth and your tooth health, but your overall health.

Mike: 23:03

Okay. So a last question for seniors. What's your message to seniors who haven't seen a dentist in years?

Steven Katz: 23:10

Obviously you gotta go to the dentist if the longer that you wait. The problems just compound. And I think that if you're not having any pain and your teeth feel okay, you still need to see the dentist because you need to have your teeth cleaned periodically. We just cannot clean our teeth as well as a dentist can do it. We in between our checkups, we can, and that's why we go a couple of times a year. If you haven't gone in a few years, for sure, you're going to be in need of a cleaning. If you're afraid to go to the dentist, which some people are, I will admit that. The endodontist, when we do root canals now, we have new techniques, new technologies, better anesthetics. The process is literally pain-free. It's like having a small little filling done. It's done in an hour. Patients say to us, I can't believe how un how pain-free that was, how quick it was and I didn't feel anything. And they always feel better afterwards. So I think the message is, don't delay. Get back to the dentist. If you're having a problem, don't be afraid. Call your endodontist. We'll take care of you.

Mike: 24:20

Maybe an additional question here. When I had my root canals, I remember each one is having two visits to the dentist's office. One where he went in and cleaned everything out and they put a temporary filling in. Then I had to go back and he, then he the temporary out and filled it. Is it, has that changed?

Steven Katz: 24:38

you go to an endodontist or to a general dentist?

Mike: 24:41

Yes. Endo

Steven Katz: 24:42

Yeah,

Mike: 24:43

almost every time.

Steven Katz: 24:44

so, typically that's changed over the years. When I first started, back in the late eighties and nineties. We used to do things in two visits, but now most every treatment is done in just one visit. And it only takes about an hour.

Mike: 24:59

What should a root canal cost in your opinion?

Steven Katz: 25:01

It's, that's a geographical thing. So it varies, depending on where you live. And it also and varies depending on. Which tooth it is. A front tooth is gonna be a little less expensive than a back tooth. I'll quote you some numbers. I would say somewhere between 1500 and, 3000, 3,500 maybe in New York City or in LA something like that. Yeah. But it's different every year.

Mike: 25:31

They're quoting around 3000 here in The Villages.

Steven Katz: 25:34

For which tooth is it for a molar?

Mike: 25:36

Back

Steven Katz: 25:37

Yeah. Seems high but again it can depend on a lot of factors But I don't know, what anybody else charges in that area, so it's just based on all of that.

Mike: 25:47

That's what I thought

Steven Katz: 25:47

yeah.

Mike: 25:48

Good. If someone has any questions for you Dr. Katz, are you willing to take emails or

Steven Katz: 25:55

for sure.

Mike: 25:56

Do you have a website that people should look at? I,

Steven Katz: 25:58

the, website would be aae.org or it would be $$ FindMyEndodontist.com. or you can send me the emails.

Mike: 26:09

What email address do you want 'em to send to me?

Steven Katz: 26:11

Yeah, just send 'em to you and then you could forward 'em to me.

Mike: 26:14

Okay. So you can send them to mike@rothvoice.com and then I'll forward them over to Dr. Katz. Good. Dr. Katz, thanks for being with us today.

Steven Katz: 26:23

Sure. Thank you for having me. It's been a pleasure.

Mike: 26:25

Good.

Steven Katz: 26:26

All right. Sounds great. Okay. Thank you. Bye.

Speaker: 26:29

Remember, our next episode will be released

next Friday at 9: 26:31

00 AM. Should you wanna become a major supporter of the show or have questions, please contact us at mike@rothvoice.com. This is a shout out for supporters, Tweet Coleman, Ed Williams, Duane Roemmich, Paul Sorgen, and Dr. Craig Curtis at K 2 The Villages. We'll be hearing more from Dr. Curtis with short Alzheimer's tips each week. If you know someone who should be on the show. Contact us at mike@rothvoice.com. The way our show grows is with your help. Text your friends about this show. If you enjoyed listening, use the fan mail button on our homepage, VillagesVitality.Life to leave comments, be sure to include your name, email, and phone number. We thank everyone for listening. The content of the show is copyrighted by Roth Voice 2026, all rights reserved.