Recommendations Aim to Improve Oral Healthcare for Older Adults

Dentitry Today


Despite their unique challenges with access to care, mobility, aging, and health complexities, little attention has been paid to the oral health of older adults, according to the Center for Oral Health (COH).

The group’s latest report, “A Healthy Smile Never Gets Old,” examines the oral health needs of this population and offers recommendations for improving access to care as well as their oral and overall health and well-being.

“Research clearly demonstrates that properly addressing dental problems prevents various medical complications and reduces overall healthcare spending,” said Sahiti Bhaskara, BDS, MPH, COH director of public policy research.

“However, in contrast to the growing awareness about children’s oral health needs, the oral health of older adults has received relatively little attention and few public health or policy interventions,” said Bhaskara. “This report is designed to shed light on older adults’ oral health and what can be done to improve health outcomes.”

Between January 2016 and September 2017, COH conducted oral health screenings on 2,372 older adults at 36 skilled nursing homes and 51 community sites including adult day care and senior centers in California. According to these screenings:

  • Half of the older adults residing in skilled nursing homes have untreated tooth decay.
  • One in three older adults in California’s skilled nursing facilities have lost all their teeth.
  • Nearly 40% of skilled nursing home residents cannot chew because they lack functional contact between their upper and lower back teeth. 
  • 46% of community-dwelling older adults screened need treatment for tooth decay and/or periodontal disease. 
  • Older adults who had lost all their natural teeth in rural counties were twice as likely to lack any dentures as their urban counterparts.

The report included five key policy recommendations:

  • Break down healthcare silos by increasing cross-professional communication and training and adopting an integrated approach to improve the health of older adults.
  • Expand the use of innovative practices in oral health including the use of silver diamine fluoride for dental disease management among older adults at high risk of dental caries and using mobile systems of dental care delivery to eliminate transportation barriers.
  • Prioritize older adults’ access to care and ability to pay for services through inclusion of benefits in Medicare, increasing reimbursement rates, and prioritizing preventive services in Medi-Cal. 
  • Include older adults in pilot dental programs and oral health initiatives aimed at healthy aging and convene a statewide partnership or advisory committee of stakeholders to focus on the oral health needs of older adults. 
  • Promote specialized clinical and didactic education programs in the oral healthcare of older adults for all oral health professionals during their training as well as advanced and specialty residency programs in geriatric dentistry.

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