Just as the media-speak tells us that "avocado is the new peach," so "40 is the new 30," which when you strip away the hype really means that we're all staying younger longer and there is no reason to ignore our oral health. A great smile is an asset at any age and there is every reason nowadays why we should be able to have and keep one for a lifetime.

We all have different personal situations and for those approaching middle age it may be that it provides the first opportunity for some years to take stock of our own health as the family grows and moves away, demanding less time, money and attention, and leaving more for our own needs.

Oral health has been improving considerably in the UK for some years now and both in terms of preventive advice and treatment possibilities it makes very good sense to reassess your own oral health as part of an overall look at general health, welfare and appearance.

The brighter smile

For many of us a bright smile is very desirable. Socially and psychologically it is a huge boost and techniques now available mean that teeth can be whitened with a variety of treatments both in the dental practice and at home. This is where a dental check-up, if you've been putting it off for a while, or taking the opportunity to discuss the appearance of your teeth with your regular dentist, can pay dividends.

As well as whitening or bleaching of teeth, there are other methods of improving appearance. 'Conventional' crowns require removal of a sufficient quantity of hard tooth tissue before being replaced by porcelain 'cap', but a newer technique of using veneers may be appropriate. Here, a minimal amount of enamel is removed from the front surfaces of the teeth (usually the upper front teeth), following which very thin but strong porcelain veneers are cemented into place - rather like false finger nails.

For crooked front teeth, adult orthodontics is increasingly popular, with the use in some cases of 'invisible' braces so as to avoid showing unsightly lines of metal wires and brackets.

Implants

The success and availability of dental implants has also improved markedly in recent years. These metallic (usually titanium) post-like devices retain either single teeth or other restorations such as bridges, and partial or full dentures. They can provide excellent options for both front and back teeth.

White filling materials too have been developed and refined and can now provide very effective replacements for older amalgam (silver) fillings. As with the above treatment possibilities it is worth asking your dentist which of the options are appropriate for you. Combinations of some or all of these techniques can make an enormous difference to your appearance and in many cases provide a renewed confidence and sense of self-identity.

Tooth loss is no longer inevitable. The number of adults in the UK retaining more teeth for longer has never been higher. This trend has been continuing for a number of years and has been highlighted by the regular ten-yearly national Adult Dental Health Surveys. These showed that in 1968 about one third of adults over the age of 16 years had no natural teeth but by the most recent survey in 1998 this had fallen dramatically to about 10 per cent and is set to fall even lower as the generations brought up with good preventive oral care progress into middle and older age.

Gum disease

Gum disease (periodontal disease) has often been cited as one of the main reasons for tooth loss in adults. However, the positive news is that with good oral hygiene and regular dental checks there is every reason why we should now able to keep the majority of our teeth for our lifetimes.

Gum disease (and tooth decay - see below) is caused by plaque, the white sticky deposit that builds up naturally around teeth and which is composed of bacteria whose acidic waste products irritate the gum tissue causing inflammation. It was previously thought that this early form of inflammation (gingivitis) inevitably led to progressive, or chronic, periodontal disease. However, research now shows that the progression is not generally inevitable and can be successfully retarded and treated, even in those who seem to be more susceptible.

Studies have also shown that the progression tends to come in bursts of disease activity, once again demonstrating the benefits of regular check-ups with a dentist and dental team who understand your individual oral health needs, which will include advice on effective and regular plaque removal by brushing, flossing and possibly other techniques.

It is also important to have at least an occasional dental check-up even if you think that there is nothing wrong. Your dentist will be able to confirm that or notice signs of oral and sometimes general health problems that can show in the mouth.

Recession and sensitivity

One consequence of ageing, whether you have gum disease or not, is gum recession in which the gum tissues gradually move down the tooth root surface, making teeth look longer - and indeed being the derivation of the expression "long in the tooth". This can create two possible problems: sensitivity and root caries (or decay).

Sensitivity
This can be effectively treated by your dentist or hygienist using a range of treatments, often backed up with home use of an appropriately formulated 'sensitive' toothpaste. Advice on changes in brushing patterns may also be helpful in this situation.

Root caries
Similar help and advice can be forthcoming for root decay, which might also be the result of a slow-down in saliva production, another consequence of ageing, as well as use of certain medications leading to the feeling of a dry mouth.

Dental decay

The improvement in dental health has also been helped by a rapid fall in dental decay. Although there is still some debate about the main reasons for this, there can be little doubt that the widespread availability of fluoride-containing toothpastes from the 1970s onwards has created generations of decay-free, or very low decay, mouths.

Improved eating habits have undoubtedly also had a beneficial effect as we have understood and implemented diets lower in sugar content as well as using alternatives such as sugar substitutes.

Access to care

There has been considerable publicity recently about the difficulties of accessing NHS dental care in some areas of the UK and this may well continue to be the case for some time to come. However, many people have been pleasantly surprised at the often relatively low cost of non-NHS, or private, treatment, especially as the majority of non-exempt NHS adults already pay 80 per cent of the cost of their treatment.

Dental practices also now increasingly offer a range of other services such as advice on fresh breath and help with smoking cessation as well as the regular sessions on oral hygiene and nutritional advice.

The best way to find a dentist if you don't have one, or if you want to change, is word of mouth. Chat to friends or work colleagues about their dentists. Ask if the practice they go to provides the sort of services mentioned above and whether it has the type of atmosphere you think you would like. Many practices now have websites so it is possible to get a good idea of what is available even before making an appointment. Don't be afraid to ask on the phone about treatments offered and costs - the more forthcoming and friendly the practice, the more likely you are to feel comfortable and confident in their care.

Overall, there has probably never been a better time to take stock of your oral health and assess how you can recapture that winning smile as well as ensure a healthy future for your oral and general health.

Stephen Hancocks is a dentist based in London who writes, edits and publishes extensively on oral health and dentistry in the UK and internationally.