My dentist always gets a chuckle when I say I am going to do all I can to keep my teeth forever! He probably thinks I am just trying to make him feel important.
The fact of the matter is that as a dietitian working with an aging population I have seen firsthand the effect of aging without teeth. Dentures are great but they can’t fully replace our natural teeth.
Unfortunately, as we age we often forget how important taking care of our teeth is. Perhaps we can’t afford going to the dentist regularly for prophylactic cleanings and checkups. We tend to only go when we have a problem.
Because this is such an important concern to the health and well-being of older adults, when I recently came across a report entitled A State of Decay by Oral Health America and Wisdom Tooth Project, I was intrigued to learn more and to share this information with caregivers.
Seniors’ Reasons for Not Accessing Dental Care
Many older adults are having trouble getting dental care for a variety of reasons, according to this report. It is estimated that 23% of older adults have not seen a dental professional in five or more years.
These were some of the reasons given for not seeing the dentist and some of the consequences.
- Limited access to dental insurance
- Lack of affordable dental services
- Lack of fluoridated water in their community
- Absence of education or health prevention programs for dental health in older Americans
- Only 9.8% of Americans retire with dental benefits
- Dental professional shortage; 33 million live where dentists and clinics are in short supply
- 8 out of 10 uninsured seniors can’t pay for a major dental procedure
- 30% lose their teeth
- 50% have untreated cavities
Any of those sound familiar?
Dental Care Issues in States
The report analyzed data from all fifty states on how well they are providing dental care to their aging citizens. Unfortunately, most states are performing poorly overall, according to their evaluation.
- 42% of states provide either no dental benefit or emergency coverage only through Medicaid Dental benefit
- 31% states have high rates of dental provider shortages and are meeting only 40% of dental needs
- Eight states had high rates of edentulism (people with no teeth); West Virginia had 33.8% of its population edentulous
- Thirteen states had 60% or more of their residents without fluoridated water systems; Hawaii and New Jersey had the highest rates of citizens without fluoridation (it has been shown that fluoridation prevents dental caries)
Poor Oral Health a Risk for Older Adults
Older adults, who make up the fastest growing sector of the population, are at increased risk of suffering from poor oral health, including oral cancer, periodontal disease, dry mouth, dental caries, ill-fitting dentures and edentulism. Add to that the lack of access to oral care, being home-bound and living in an institution and we have a recipe for a public health disaster.
The goal is to maintain our natural teeth in a healthy condition so that physical health is not compromised.
When we lose our teeth, have dentures that don’t fit or have poor dentition from dental caries or missing/decayed teeth, we can also lose our ability to enjoy our food and chew properly. Poor nutrition as a result can lead to medical issues. Pain, infection, weight loss, depression, diabetes (associated with periodontal disease) and emergency room visits can result from inadequate oral health.
It was reported that from 2008-2010 greater than four million ER visits involved a dental condition, 101 of these patients diet in the ER and 85% of those seeking care were there for no other reason besides oral care.
Dental Care Coverage
Dental care is not covered in the Affordable Care Act, therefore most seniors are able to get payment for dental care only if their states allows it under their Medicaid program. Medicare or Medigap (supplemental insurance) do not cover dental care.
Private dental insurance is often too costly for older adults. Most seniors report they can’t afford dental insurance, crowns, bridges, fillings or dentures if they sought care. 70% of seniors are estimated to have no dental insurance coverage.
The report found that where states offer dental coverage under Medicaid, few providers are accepting patients due to the reimbursement rates received.
There have been three bills introduced that address the needs of older adults for proper dental care since the original State of Decay report was published in 2003 but none have been passed.
Caregivers Can Make a Difference
When seniors have limited access to dental care due to finances, proximity or motivation, it is up to caregivers to encourage and assist them to get the care they need.
We know the health consequences of poor dental care go much deeper than losing a pretty smile or having sparkling white teeth. Our seniors can suffer with decaying teeth or loss of their teeth.
- We can advocate for our seniors to gain access to benefits through Medicaid programs in their state and to encourage dental professionals to provide affordable care to seniors in their community.
- Lobby government officials to add dental care for seniors in the prevention plan of the Affordable Care Act and added to the benefits obtained under Medicare as the lack of dental care impacts medical status.
- Encourage your municipality to fluoridate the water if it is not already doing so.
- Help your senior practice good oral hygiene, brushing and flossing daily, as well as using a fluoride toothpaste.
- Use antibacterial mouth rinse to prevent gum disease.
- Find financial assistance options to help pay for dental care.
- Find a low cost dental provider near you and see your dental professional regularly.
- Check with your local hospital and ask if they have a dental clinic, many have begun offering this service.
- If there is a dental school near you, they may offer free or reduced cost services by students under the supervision of dentists.
- Check your senior’s medical supplement policy to see if it covers dental.
- Eat a well-balanced diet with adequate sources of calcium and vitamin D to maintain strong teeth.
Taking good care of their teeth, gums and dentures as they age can help seniors stay healthy longer.
If affordability is a problem for your senior, we encourage you to seek alternatives, as listed above, so that they can receive the care and treatment that their teeth need.
We hope that we continue to see states taking control and filling the gaps in dental care accessibility for all our seniors! We look forward to future reports from Oral Health America.