An Oral Health Epidemic in Seniors Too Easily Dismissed

One of the biggest public health threats facing seniors is staring us right in the face, yet it’s hiding in plain sight. One needs only to look into the faces of older Americans to know what I’m talking about. You can see it in their smiles, or perhaps more accurately, you can see it in their lack of smiles.

Millions of people 65 and older are living with untreated cavities, tooth decay, gum disease, oral pain, and tooth loss due to limited or no access to basic dental care. These dental issues make it difficult for seniors to eat, chew and speak, and the impact on overall general health and well-being is significant.

Studies have shown oral health disease is associated with serious medical conditions including heart disease, stroke, diabetes, cognitive decline and pneumonia. Aside from the physical toll, poor oral health reduces self-esteem and increases social isolation.

According to the CDC, about one-in-five seniors have untreated tooth decay, and experience new tooth decay at a higher rate than children. Seniors are also at higher risk for dry mouth, tooth loss, oral cancer and periodontal disease.

More than 15 years ago, in the first-ever Surgeon General's Report on Oral Health, untreated dental and oral diseases were declared a “silent epidemic.” Unfortunately, the silence has become deafening as seniors today continue to struggle to find dentists willing and able to treat them, and the financial resources or insurance to cover all or part of their care.

Financial difficulties kept 81-year-old Navy veteran Jim Cummings out of the dentist’s chair for more than 20 years, despite years of gum disease, cavities, tooth loss, and a self-consciousness about opening his mouth because of missing teeth.

“It’s just something you learn to live with, but it’s not something I’d recommend,” said Jim. “I should have had it taken care of a long time ago, but I just didn’t have the finances. Sure, it was painful and even embarrassing, but there were always other bills to pay and other things to worry about.”

Jim received treatment at the recently opened nonprofit Gary and Mary West Senior Dental Center in San Diego. The Senior Dental Center is one of the few community dental clinics in the country focused on providing care for low-income seniors, a group particularly hard hit by oral health issues. Demand for services has been overwhelming, as many seniors for the first time in years—and in some cases decades—have access to high-quality and affordable care.

But the care doesn’t stop at the teeth. The Senior Dental Center, located within a popular Senior Wellness Center, links oral healthcare with a suite of nutrition, case management, and wellness services through a coordinated care model that connects the mouth to the rest of the body, to improve overall health and quality of life.

Jim now has a new set of dentures that enables him to eat, and after 20 years, makes smiling less difficult. But it will take more than a happy face to confront the serious issues of poor access and affordability when it comes to oral healthcare for seniors. If we don’t make it a greater priority and change healthcare policy, more and more older Americans—many of whom are living near or in poverty—will be treated for dental issues in emergency rooms, rather than in dental offices or clinics where treatment is less costly and complicated.

Addressing the oral healthcare crisis in America requires collaboration and engagement of community leaders, dentists and other healthcare professionals, government officials, insurers and seniors themselves. A single dental center providing integrated care for vulnerable seniors won’t solve the problem of poor oral health, but it is a model we should build upon.

Seniors with dental problems should explore all their options and raise the issue about improving access to care with community and government officials, healthcare providers, employers and insurers. For resources in your area, visit the Area Agencies on Aging (AAA) locator.

Shelley Lyford, is president and CEO of West Health, a nonprofit dedicated to enabling seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence. Ms. Lyford is also chairman of the board of directors of the Gary and Mary West Senior Dental Center.

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