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Our Aging Population and Oral Health
The Importance of Oral Health in Geriatric Primary Care
(MacEntee, M. I., Müller, F., & Wyatt, C., 2011)
The importance of oral health cannot be over emphasized. Oral health is not separate from general health,
maintaining oral health is definitely challenging and diverse in old age. Multiple studies acknowledge mouth health to
overall health and well-being.
Oral health continues to take a back seat to general health even though this
connection has been clearly established.
Addressing poor oral health is critical among older Americans. The lack of routine dental care can contribute to
respiratory infections and other systemic diseases, particularly important when considering the health of vulnerable
patients, and older adults.
Oral problems frequently affect the “elderly” (people aged 65+) population. Missing teeth, dry mouth (xerostomia), and
mastication limitations, contribute to inadequate nutrition that may contribute to an accelerated physical and mental
degeneration. Loose painful teeth or ill-fitting dentures result in a reduced desire or ability to eat.
Dental caries have
been attributed to the reduced salivary flow from diminished function of salivary glands.
Elderly are susceptible
to various pathological conditions such as Candidal infections, periodontal disease, and a decreased rate of wound
Considering the magnitude of this ‘silver tsunami’ - oral health promotion and prevention will need to be addressed.
Family physicians, nurses, physician assistants, and other members of the primary care team are in the perfect
position to address oral health, integration and coordination between medicine and dentistry is critical.
Accommodating this very large segment of the American population with multiple co-morbidities, taking multiple
medications with disastrous side effect, including those for high blood pressure, high cholesterol, pain, anxiety and
depression, Parkinson disease, and Alzheimer disease . . . .
will be critical and will require effective two-way
communication between primary care and dental professionals.
Oral Health Challenges
Facing Older Adults
Access to dental care is one of the greatest challenges facing older
adults. Access to dental coverage is limited. Not addressed by the
Affordable Care Act (ACA). Private insurance is costly, Medicaid is
limited with few providers accepting it, and Medicare does not provide
coverage for routine dental care. Dental insurance is a primary indicator
of whether or not an individual visits the dentist. Close to 70 percent of
older Americans do not have dental insurance.
have been made to address the shortage of oral healthcare providers
by the Health Resources and Services Administration (HRSA)
supporting Federally Qualified Health Centers (FQHCs). Dental Health
Professional Shortages Areas continue to experience unmet
Barriers to Accessing Oral
Health for Older Adults
Lack of insurance coverage
70% of older adults lack dental insurance
Medicare does not cover preventive and outpatient dental
Poor reimbursement by Medicaid (few providers accept it)
Availability of access to oral health services
Limited number of professionals trained in geriatric
Lack of dental professionals interested in this population
Caregivers do not see oral health as a priority
Lack of mobility/transportation
Individual health perceptions & values