The Importance of Oral Health

Oral health has long been shunted to the sidelines of the healthcare system, but as this issue of Generations demonstrates, oral health is interconnected with overall health and well-being. The Fall 2016 issue of Generations includes more than a dozen articles that clearly demonstrate how oral health has become a matter of public neglect, what the effects of oral health are upon overall health, and what policy changes might work to ensure oral healthcare becomes part of the healthcare system and is funded, likely through Medicare.

In “Oral Health and Older Adults: A History of Public Neglect,” guest editor Michèle J. Saunders provides a comprehensive look at policy around oral healthcare in the United States and how it has evolved. Disparities in oral healthcare exist for underserved and vulnerable older adults. Since 1988, many studies have been conducted and reports written with recommendations for ameliorating such disparities by the Surgeon General, IOM, CDC, and HHS, but the lack of public financing for preventive or routine oral healthcare for older adults enrolled in Medicare or Medicaid has prevented action on these reports’ recommendations. Saunders argues that now is the time to support publicly funded oral healthcare for this vulnerable, underserved population.

Good oral hygiene maintenance and interventions can reduce risks of diabetes, cardiovascular and pulmonary disease, and increase quality of life. Lea E. Erickson, in her article, “The Mouth-Body Connection,” addresses the way elders’ health is compromised by a lack of oral healthcare, including how many medications cause dry mouth, which can contribute to cavities, periodontal disease, and fungal infections, and how the ability to be free of pain, to adequately speak, chew, taste food, and smile without embarrassment is key to quality of life as we age.

Older adults are a growing percentage of the rural population in the United States, and they are at special risk for oral health problems because access to dental care is an ongoing challenge in rural America. The University of Washington School of Dentistry’s Regional Initiatives in Dental Education (RIDE) program, described in “Growing the Dental Workforce to Serve Rural Communities: University of Washington’s RIDE Program,” by Frank A. Roberts and colleagues, delivers intensive, community-based education that prepares dentists to meet the needs of rural and underserved populations. Of those graduates who have completed their training, 70 percent are practicing in rural or underserved areas.

In “Oral Healthcare Advocacy: Finally on the Upswing,” Jessica Nagro writes about movements afoot to reform the way Medicare, Medicaid, and private insurance cover dental care. Such legislation shows promise in increasing access, advancing education, and expanding training opportunities to improve the state of oral health for America’s older adults.

The nonprofit Gary and Mary West Senior Dental Center in San Diego sits within an existing senior wellness center, an arrangement which improves accessibility and comprehensive care coordination—both of which are key to improving low-income elders’ oral health. Karen Becerra and Vyan Nguyen, in their article, “The Gary and Mary West Senior Dental Center: An Integrated Model of Dental, Health, and Wellness Care for Older Adults,” describe how the Center came to be, and the remarkable work it does in screening, triaging, and caring for older adults’ dental needs. The Dental Center is working toward financial sustainability through a combination of insurance reimbursement, grants, donations, and sliding-scale fees.

ASA is pleased to offer this latest issue of Generations, which is reaching ASA members and subscribers in November. Single copies can also be purchased from our website.


Inside this Issue

Oral Healthcare and the Aging Adult

Oral Health And Older Adults: A History of Public Neglect
By Michèle J. Saunders
Read on AgeBlog

A Small Trip Through Tooth Lore, or Where Did the Tooth Fairy Come From?
By Michèle J. Saunders

Why Older Adults Have Teeth: A History of Dental Care and Its Improvements
By Matthew J. Messina

The Mouth−Body Connection
By Lea E. Erickson
Read on AgeBlog

The Symbiotic Relationship Between Oral Health, Nutrition, and Aging
By Ronni Chernoff

Dental Amalgam: An Inexpensive and Safe Option for Filling Cavities
By Matthew J. Messina

Flouride, Dental Caries, and Safety
By Matthew J. Messina

Oral Hygiene and Self-Care in Older Adults with Dementia
By Melanie V. Taverna, Carol A. Nguyen, and Beatriz M. Hicks

Forensic Dentistry: A Public and Social Service
By Michèle J. Saunders

Building and Training the Professional Workforce

Nursing Facility Dentistry
By Sarah J. Dirks

Building the Ideal Interdisciplinary Team to Address Oral Health
By Janet A. Yellowitz

A Comprehensive Geriatric Dentistry Teaching and Service Program
By Ronald L. Ettinger and Howard Cowen

Ethical Issues in Oral Healthcare for Older Adults
By Stephen K. Shuman and Mary K. Owen

Growing the Dental Workforce to Serve Rural Communities: University of Washington’s RIDE Program
By Frank A. Roberts, Arthur C. DiMarco, Susan M. Skillman, and Wendy E. Mouradian
Read on AgeBlog

Financing of Oral Healthcare

Financial Roadblocks to Oral Health for Older Adults
By Jean Calvo, Elisa M. Chávez, and Judith Jones

Oral Healthcare Advocacy: Finally on the Upswing
By Jessica Nagro
Read on AgeBlog

The Santa Fe Group Strategy: How Medicare Can Integrate Health and Oral Care for Older Americans
By Elisa M. Chávez, Jean Calvo, and Judith Jones

Innovative Program Models Delivering Oral Care to Older Adults

The Gary and Mary West Senior Dental Center: An Integrated Model of Dental, Health, and Wellness Care for Older Adults
By Karen Becerra and Vyan Nguyen
Read on AgeBlog

On Lok PACE: Where Oral Healthcare Is an Integral Part of Healthcare
By Elisa M. Chávez and Bonnie Lederman

Alpha Omega–Henry Schein Cares Holocaust Program Meets Dental Needs of Survivors
By Michael Wiseman


Glossary of Terms
Compiled by Michèle J. Saunders