Older Adults and Oral Health
Oral health, regardless of age, is integral to overall good health. Oral health is an important but often overlooked aspect of an older adult’s general health. Daily oral hygiene, ability to access routine professional oral health services, and oral health education are all key factors that can improve the oral health of older Americans. According to the Centers for Disease Control and Prevention, one-fourth of persons age 65 and older have no remaining teeth. Nearly one-third of older adults have untreated tooth decay. Severe gum disease is associated with chronic disease and severe health conditions including diabetes, heart disease, stroke and respiratory disease.
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Older Adults and Oral Health: Inspiring Community-Based Partnerships for Healthy Mouths Webinar (May 15, 2013)
This webinar explores the oral health status of older adults in the U.S., provides useful resources and highlights two innovative community approaches to improving oral health access for older adults.
Who’s Leading the Leading Health Indicators? (August 20, 2012)
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Oral Health Problems
Whether caring for natural teeth or dentures, daily oral hygiene can mean older adults will be free of oral pain, can maintain a well balanced diet, and will enjoy interpersonal relationships and a positive self-image. Without practicing good oral health, advancing age may put older adults at risk for a number of oral health problems, including:
- Dry mouth
- Diminished sense of taste
- Root decay
- Gum disease
- Uneven jawbone caused by tooth loss
- Denture-induced tissue inflammation
- Overgrowth of fungus in the mouth, known as thrush
- Attrition (loss of teeth structure by mechanical forces)
- Oral Cancer
Oral health problems in older adults make it more difficult for them to consume a healthy diet. Oral health related physical factors directly affecting nutrition include: changes in chewing ability, dry mouth commonly caused by a side effect of medicine, untreated tooth decay, loose or missing teeth, dentures or implants, and ill-fitting bridges or dentures. Regular oral health care can improve and prevent oral health problems.
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Accessing Affordable Dental Care
Good oral hygiene, choosing a healthy lifestyle and getting regular dental check-ups are all important steps to a healthy mouth. While it can be difficult for older adults to access typical health care settings; it can be especially difficult to access the oral health care system. Barriers to accessing affordable oral health care include:
- Living on a fixed income
- Cost of oral health care
- Limited dental insurance for retirees (not included in Medicare)
- Oral Health programs that offer affordable services
- Mobility limitations / Transportation
- Translation for immigrant older adults
Accessing dental care can be especially difficult for nursing home residents. Paying for dental care using Incurred Medical Expenses (IME) helps long-term care residents get dental treatment and allows dental practices to get reimbursed for services. IME is routinely used for eyeglasses and hearing aids, but many people are not aware that it is also available for dental treatment. Members of the ADA’s National Elder Care Advisory Committee hosted a webinar on September 20, 2012 to educate dentists on using Incurred Medical Expense (IME) billing:
Webinar: Reimbursement for treating long-term care patients.
Two additional resources on IME include:
Paying for Dental Care: A How-To Guide and
Suggested Steps for Residents and their Representatives.
Resources are available to help overcome the barriers to accessing affordable oral health care. The Health Resources and Services Administration funds Community Health Clinics (CHC) which care for people, even if they have no dental health insurance. The majority of CHCs provide dental services. Find a federally funded health center near you, where you pay what you can afford, based on your income.
If transportation is a barrier to receiving care, the Eldercare Locator can direct you to your local Area Agency on Aging (AAA). The majority of AAAs provide some form of transportation assistance or referral.
Other options to help overcome barriers include:
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From developing public private partnerships to providing information clearinghouses, the Aging Service Network and its partners are working to help address the oral health needs of older adults. A number of innovative oral health programs, some funded with Older Americans Act Title III funds, include:
Virtual Dental Home Demonstration Project
The Pacific Center for Special Care at the University of the Pacific, Arthur A. Dugoni School of Dentistry (Pacific) is demonstrating a new model of care. By creating a "Virtual Dental Home" in sites throughout California, Pacific hopes to deliver oral health services in locations where people live, work, play, go to school and receive social services. The Pacific Center has partnered with a number of funding organizations to implement this demonstration project to bring much-needed oral health services to these underserved populations. These populations range from children in Head Start Centers and elementary schools to older adults and adults with disabilities in residential care settings and nursing homes.
Oral Health for Caregivers
Developed by Washington Dental Service Foundation, Oral Health for Caregivers is a training curriculum that provides critical oral health information for those who care for older adults. With an emphasis on prevention, the program introduces oral health concepts and skills in an easy-to-understand format that can be used to educate caregivers. The curriculum is up-to-date and provides a high-quality Continuing Education learning opportunity. The training is currently offered free of charge in Washington for Home Care Aides, Adult Family Home providers, and caregivers for developmentally disabled adults.
Louisiana Smiles for Life Program
This education-based program is specifically geared toward independent older adults. It is supported by the Louisiana Department of Health and Hospitals Oral Health Program (OHP) and the Governor’s Office of Elderly Affairs (GOEA). The program was developed as a part of the LA Oral Health Coalition’s Oral Health for the Elderly Task force and was a collaborate effort between the OHP, the GOEA and the Capital Area Agency on Aging to address the educational needs of persons participating in Councils on Aging (COA) congregate meals program. Included in the Louisiana Smiles for Life Program Manual is information on how to get the Louisiana Smiles for Life Program started in a local non-profit group, Meal Site or Senior Club. Information is in a “lesson plan” format on nutrition, denture care and the overall importance of oral health and hygiene. Groups or COAs wanting to present the program may do so by downloading the manual.
Central Plains Area Agency on Aging Smiles for a Lifetime Program
This program is a comprehensive oral health care program for older Kansans in partnership with Central Plains AAA, serving multiple counties.
Share your innovative oral health program! The Administration on Aging would like to acknowledge the work of the Aging Services Network in enhancing the oral health of older adults across the country. Let us know about innovative oral health programs in your community. If you would like to submit your oral health program, please email Danielle Nelson.
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- Washington Dental Service Foundation, Senior Oral Health
- Area Agency on Aging Oral Health Toolkit
- CDC, Oral Health
- Healthy People 2020, Oral Health
- HRSA, Oral Health
- HRSA, Rural Oral Health Toolkit
- MouthHealthy Initiative, ADA
- National Cancer Institute, Oral Cancer
- NIDCR Information for Older Adults
- NIH Senior Health: Gum (Periodontal) Disease
- Resource Highlights: Mobile and Portable Dental Services
- Senate Hearing on the Dental Crisis in America, Health Education Labor & Pensions (HELP) Subcommittee on Primary Health and Aging held a hearing, “Dental Crisis in America: The Need to Expand Access”
- Senate Subcommittee Report “Dental Crisis in America: the Need to Expand Access” (PDF)
- The Guide to Community Preventative Services, Oral Health
- WomensHealth.gov: Oral Health Fact Sheet
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