Adults age 50 and older with at least one chronic health condition face a greater risk of tooth loss, according to the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR).
The CDC examined data from 6,283 adults taken between 1999 and 2004 and from 7,443 adults between 2011 and 2016 who had a dental exam, examining chronic conditions including fair or poor general health, any arthritis, rheumatoid arthritis, asthma, diabetes, emphysema, heart disease, liver condition, and history of stroke.
The prevalences of edentulism, severe tooth loss, and a lack of functional dentition were 10.8%, 16.9%, and 31.8%, respectively. Although the prevalence of a lack of functional dentition largely decreased from the first time period to the second, the association between tooth loss and having a chronic condition remained.
Dental caries and periodontal disease are the leading causes of tooth loss, the CDC said, and both are preventable. After controlling for covariates such as race, ethnicity, and income, people with chronic conditions had higher levels of unmet dental treatment needs that people who did not have chronic conditions.
Extensive tooth loss can lead to poor diet, resulting in weight loss of obesity, the CDC said. It also can impede speech and detract from physical appearance, hindering social contact, intimacy, and self-esteem, the CDC continued.
Traditional Medicare does not cover routine dental care, the CDC said, so older adults with chronic conditions might have difficulty accessing clinical dental care because they lack dental insurance. People with low household incomes also might lack access due to limitations in the dental safety net, the CDC said. Chronic conditions may limit patient mobility as well, also making access to dental care and oral hygiene at home more challenging, the CDC said.
According to the 2017 Medical Expenditure Panel Survey, more than 40% of adults age 65 and older had a past-year visit to a physician’s office but not to a dentist. Better integration and collaboration between all providers could improve healthcare outcomes, the CDC said.
Healthcare professionals can play a key role in helping patients with chronic conditions keep their natural teeth, the CDC said, by educating these patients about their higher risks of tooth loss and the importance of preventive care at home or in a dental office.
Also, the CDC said, primary care providers could screen patients for common dental conditions and refer them for necessary care. Nonprofit organizations can play a role in educating their constituents about higher risks of tooth loss as well, the CDC said.
Between 2016 and 2018, the CDC said, it funded programs in six states to enhance the understanding of connections between chronic disease and oral health in state health department programs. Also, several states initiated pilot projects to implement strategies for better coordination of medical and dental care.
The CDC currently supports medical-dental integration activities to increase bidirectional messaging and referrals for dentists and primary care providers serving patients with prediabetes, diabetes, and hypertension.
Information from these activities could be used to develop effective approaches to reduce the high prevalence of tooth loss among people with chronic conditions and support better chronic disease management, the CDC said.