Certified dental assistants will come into contact with patients of differing ages and oral health. Older adults pose the largest problem to dental health in the United States. According to the Centers for Disease Control and Prevention, over one-third of adults aged 65 and older have untreated dental problems.1 As adults continue to age there are certain things to be taken into consideration pertaining to their oral health.
Water fluoridation projects are fairly new
Fluoride was first added to water in 1945 to fight tooth decay.2 With fluoride in 70 percent of community water supplies, improved dental health is on the rise especially when combined with other products that contain fluoride, like toothpaste.2 But for older Americans who didn’t grow up with fluoridation of any kind, oral health is a growing concern. Today, 25 percent of Americans 60 years and older have no remaining natural teeth, the CDC says.1 Periodontal (gum) disease affects 23 percent of 65 to 74 year olds and is one of the leading causes of tooth loss, along with tooth decay.1
In addition, 31,000 Americans, primarily the elderly, are diagnosed with oral or pharyngeal cancer every year with a poor prognosis: 56 percent of white patients and only 34 percent of African Americans hit the five-year survival mark.1
Many seniors don’t have dental insurance
According to Oral Health America, nearly 70 percent of older Americans do not have dental insurance.3 Many lost that coverage post-retirement and with a fixed income, have to decide how to spend their money. Medicaid, the federal-state health plan for low-income Americans, including seniors, only covers dental care in certain states.3 Often seen as an optional benefit, dental insurance covered by Medicaid sees very low numbers of reimbursement.1
Without coverage, seniors face a variety of problems that will persist if their oral health is not under control. Older Americans who take multiple drugs, especially those with chronic illnesses like diabetes, are at a higher risk for oral disease, as these medications can cause dry mouth or decreased saliva production.1
New approaches to dentistry for older adults
Improved ways to help senior citizens cope with oral health issues will fall mainly on the shoulders of dental health care professionals, according to Gordon Christensen, co-founder of the Clinician’s Report, as reported by the journal Inside Dental Assisting.4 As a new generation of insured, dental care-knowledgeable people rises, there’s a serious need to find a solution for those suffering from oral health problems, especially those lacking dental insurance.
More oral care workers are coming across elderly patients who are experiencing secondary decay after potentially already having had one or more restorations. Better preventative measures, as well as stronger techniques for restoring already-decaying adult teeth, need to be developed for aging patients.4 These procedures also have to be more cost-efficient for those seniors with limited or no dental coverage. Christensen believes treating a patient’s oral issues as they arise is the best solution for now, instead of doing full-mouth dentistry on an older patient.4 This way, not only is the older adult seeing a dental worker regularly to treat occasional problems, but the cost of the service stays as low as possible.
Oral health professionals will play a large role for future senior citizens
For patients young and old, a healthy mouth reflects a healthy well-being. The realization that diseases, like diabetes, have an effect on dental health and that oral health has an impact on overall health is causing dentists to rethink their philosophy as a whole.4 Whereas practice was once geared toward repairing the problem, the new model will focus on a full wellness plan.
By putting together a wellness plan for aging patients, dentists and dental assistants can take various elements, like risk factors that may complicate treatment, into consideration for a patient’s health.4 For elderly patients already suffering from oral issues, the focus will be on maintaining their current, healthy state or to find another way so they can preserve their quality of life.
Oral health professionals, including certified dental hygienists will need to learn how to manage senior patients differently.4 Keeping physical limitations, potential drug interactions and additional time for procedures in mind, dentists will be able to help geriatric patients sustain proper oral health.
1“Oral Health for Older Americans,” Centers for Disease Control and Prevention, July 10, 2013. http://www.cdc.gov/oralhealth/publications/factsheets/adult_oral_health/adult_older.htm
2“U.S. updates water fluoridation guideline for the first time in 53 years,” Lenny Bernstein, The Washington Post, April 27, 2015. http://www.washingtonpost.com/news/to-your-health/wp/2015/04/27/u-s-updates-water-fluoridation-guideline-for-the-first-time-in-53-years/
3“A State of Decay,” Oral Health America, 2013. http://www.toothwisdom.org/action
4“Aging populations and the need for dentistry,” Allison M. DiMatteo, Inside Dental Assisting, Jan/Feb 2012. https://www.dentalaegis.com/ida/2012/02/aging-populations-and-the-need-for-dentistry