Dentist Sandy Springs: Oral Health Care of Our Aging Population

Two important oral health care concerns emerging in the United Statesare disparities in the oral disease burden and the inabilityof certain segments of the population to access oral healthcare.[1]  Older Americansare becoming a larger segment of our population and suffer disproportionately from oral diseases, with the problembeing particularly acute for individuals in long term care facilities.  Populationprojections for the United States indicate that the elderlywill constitute an increasing percentage of the population aswe proceed into the 21st century.  In 2001, the population ofthe United States was almost 278 million, and 12.6% of the populationwas 65 years of age or older. By 2015, the population is expectedto increase to 312 million (3.08 million in 2010) and 14.7% of the population willbe aged 65 years or older.  In 2030, which is within the practicelives of students currently enrolled in dental schools, thepopulation will have increased to more than 350 million, and20% of the population—1 of every 5 members of the US society—willbe 65 years of age or older.  This large segment of our population is further compounded by the elderly populationcontinuing to become increasingly diverse in terms of race, ethnicity,financial resources, and living conditions.[2]

The challenges faced by both the dental profession and the nationas a whole regarding provision of oral health care servicesto older adults were the subject of a recent report preparedby Oral Health America.[3]  All 50 states were surveyed to determine the level of Medicaidcoverage for dental services, and the report concludes thatfinancing oral health care services for the elderly will be a majorchallenge to our future.  Medicare does not provide any coverage for dentalservices, and only 1 of 5 Americans aged 75 years or older hasany type of private dental insurance.  Given our current economic circumstances it will be highly unlikely that our government resources will be adequate to gear up for the impending problem of oral health for the elderly.

The elderly suffer from chronic disorders that can directlyor indirectly affect oral health, including autoimmune disorderssuch as pemphigus and pemphigoid.[4] They generally requiremultiple medications, and common side effects of the more than500 medications used to treat their overall health issues usually reduce salivary flow.[5]   Usually the reduction in salivacan adversely affect their quality of life, the ability to chew, and lead to significant problems of the teeth andtheir supporting structures.

The elderly may also have difficulty performing routine oralhygiene procedures because of physical limitations, such as Parkinson’s or rheumatoid arthritis.  In addition,oral infection is now recognized as a risk factor for a numberof systemic diseases, including cardiovascular diseases, cerebrovascular diseases,diabetes, mellitus, and respiratory disorders.  Also,it is important to note that once people have lost their teeth and are using complete dentures, their oral healthneeds do not decrease.   Our jaws are not static and may continue toresorb over time.  Besides the continued resorbtion of bone, improperly fitted dentures can adversely affectchewing, leading to poor nutrition.  In addition, those without teeth remainsusceptible to oral cancer, mucosal diseases, and alterationsin salivary gland function.

So for the vast majority of seniors who will reside in a long term care facility, financingof oral health care services will be a formidable challenge.Given that medicare does not provide coverage for routine dental services including exams,and in the absence of private insurance or personal resources,a large portion of this group will not be able to afford anydental services whatsoever, let alone the most appropriate treatments.  Clearly, there must be a response to the increasing oral healthconcerns of the elderly who present with special needs, especiallythose who are homebound or living in long term  facilities burdenedwith other chronic disorders.

While effective preventive measures exist for younger populations(water fluoridation, dental sealants and parents), no preventive measureshave been devised to address the expected increase in oral healthneeds of the aging population.  And the need for a coordinated effort to address the oral healthcare needs of the elderly suggested by demographic trendsand epidemiological data necessitates our planning for what might be considered a crisis or at least a paradigm shift in oral health care delivery for the elderly.  Such a plan must consider contributions from the dental profession, possibly through the efforts ofthe American Dental Association (ADA) and its state and localassociations; the dental schools, with involvement of the American Dental Education Association; federal, state, and local health authorities; and assistance from national organizations andfoundations that focus on health care.  The dental profession has an opportunity to take a leadership role in the delivery of health care services to the seniorswho have contributed so vitally to our society’s well-being and who deserve to be treated with the best oral health care we have to offer.

Dr. Scheinfeld is a prosthodontist specializing in geriatric care.

Novy Scheinfeld, DDS, PC                                                                                          

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328


Related Articles

[1]Oral Health in America: A Report of the Surgeon General. Rockville, Md: National Institute of Dental and Craniofacial Research; 2000.

[2] Wikipedia and 2010 Census.                                                                                


[3] A State of Decay: The Oral Health of Older Americans. Chicago, Ill: Oral Health America; 2003:1–8.

[4] Stoopler ET, Sollecito TP, De Ross SS. Desquamative gingivitis: early presenting system of mucocutaneous disease. Quintessence Int.2003;34:582–586.

[5] Fox PC, Eversole LR. Diseases of the salivary glands. In: Silverman S, Eversole LR, Truelove EL, eds. Essentials of Oral Medicine. Ontario, Canada: BC Decker; 2002:260–276.



Sandy Springs: Dental: Teeth Grinding

Sandy Springs Dentist near meMost people probably grind and clench their teeth from time to time. But occasional teeth grinding (bruxism) does not usually cause harm. It’s when teeth grinding occurs on a regular basis the teeth can be damaged and other oral health complications can arise.

Why Do People Grind Their Teeth?[1]

Although teeth grinding can be caused by stress and anxiety, it often occurs during sleep and is more likely caused by an abnormal bite, missing or crooked teeth.

How Do I Find Out if I Grind My Teeth?

Because grinding often occurs during sleep, most people are unaware that they grind their teeth. However, a dull, constant headache or sore jaw is a telltale symptom of bruxism. Many times people learn that they grind their teeth by their loved one who hears the grinding at night.

If you suspect you may be grinding your teeth, talk to our dentist.  She can examine your mouth and jaw for signs of bruxism, such as jaw tenderness and abnormalities in your teeth.

Why Is Teeth Grinding Harmful?

In some cases, chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. The chronic grinding may wear their teeth down to stumps. When these events happen, bridges, crowns, root canals, implants, partial dentures, and even complete dentures may be needed.

Not only can severe grinding damage teeth and result in tooth loss, it can also affect your jaws, result in hearing loss, cause or worsen TMD/TMJ, and even change the appearance of your face.

What Can I Do to Stop Grinding My Teeth?

Your dentist can fit you with a mouth guard to protect your teeth from grinding during sleep.Sandy Springs dentist near me

If stress is causing you to grind your teeth, ask your doctor or dentist about options to reduce your stress.  Attending stress counseling, starting an exercise program, seeing a physical therapist, or obtaining a prescription for anti-anxiety or muscle relaxants are among some of the options that may be offered.

Other tips to help you stop teeth grinding include:[2]

  • Avoid or cut back on foods and drinks that contain caffeine, such as colas, chocolate, coffee and so-called energy drinks.
  • Avoid alcohol. Grinding tends to intensify after alcohol consumption.
  • Do not chew on objects that are not food. So avoid, finger nails, pencils and pens. Also avoid chewing gum as it allows your jaw muscles to get used to clenching and may tend to make you more likely to grind your teeth.
  • Train yourself not to clench or grind your teeth. If you notice that you clench or grind during the day, position the tip of your tongue between your teeth. This practice trains your jaw muscles to relax.
  • Relax your jaw muscles at night by holding a warm washcloth against your cheek in front of your earlobe.

Novy Scheinfeld, DDS, PC

ZoAnna Scheinfeld, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive, 200A

Sandy Springs, GA 30328



3781 Chamblee Dunwoody Road

Chamblee, GA 30341


[1] Webmd was utilized as a source.

[2] Ibid.