Dunwoody Dentist: New Directions in Oral Health Care

Dunwoody dentist near meThe hygienist plays an intricate role in your oral health care.  At a minimum the role includes periodontal disease evaluation, taking x-rays and a patient’s periodontal charting.  Traditionally, they engaged in cleaning and flossing the teeth under the theory that at healthy mouth was primarily necessary for the patient to keep their teeth.  While this is still the case,  discoveries in the last decade have uncovered the correlation between periodontal disease and other health related issues such as diabetes, Alzheimer’s, cardiovascular disease, pregnancy related problems that assigns new priorities to the role of the hygienist and your dental visits.  These correlations have caused a new focus on evaluating a dental patient and new signals related to their overall health.   “The American Academy of Periodontology seeks to educate the public about research findings which support what dental professionals have long suspected: Infections in the mouth can play havoc elsewhere in the body. For a long time it was thought that bacteria was the factor that linked periodontal disease to other infections in the body; however, more recent research demonstrates that inflammation may link periodontal disease to other chronic conditions. Research has shown, and experts agree, that there is an association between periodontal diseases and other chronic inflammatory conditions, such as diabetes, cardiovascular disease and Alzheimer’s disease. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions.” [1]

The U.S. Surgeon General agrees that oral health is a strong indicator of one’s overall health and well-being.[2]  Often, diseases give their first warning signs in the form of a patient’s oral problems.  Without consistent care and monitoring, several oral health problems can result.  Immediate risks include gingivitis, cavities, tooth decay, and other gum diseases which can eventually result in various types oral cancer.  There is a “silent epidemic”[3] that can be avoided by regular treatment at home and dental visits at least twice each year.  While practicing good oral hygiene at home is vital to your health, there is only so much that personal oral maintenance can do.  A normal person can easily overlook conditions that could greatly complicate or even end one’s life.  Thus, visiting your dentist for regular checkups is vital to a healthier smile.

“Routine dental exams uncover problems that can be easily treated in the early stages, when damage is minimal”.[4]   Now that it is known that gum disease can be a major risk factor for heart disease, stroke, and certain forms of cancer, regular visits to your dentist can help prevent and treat this disease.  By treating conditions early and learning from our dentist how to prevent oral diseases, you can achieve better health and ultimately better quality years of life.

Novy Scheinfeld, DDS, PC

ZoAnna Scheinfeld, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328                                                                                            

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

 

Serving residents in East Cobb, Roswell, Alpharetta, Johns Creek, Dunwoody, Buckhead and surrounding communities.

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[2](CDC, 2006).

[3](U.S. Surgeon General).

[4](American Dental Association [ADA], 2008).

Dentist: Roswell, GA : 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 resorption 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 contributionsfrom the dental profession, possibly through the efforts ofthe American Dental Association (ADA) and its state and localassociations; the dental schools, with involvement of the AmericanDental Education Association; federal, state, and local healthauthorities; and assistance from national organizations andfoundations that focus on health care.  The dental profession has an opportunity to take a leadershiprole in the delivery of health care services to the seniorswho have contributed so vitally to our society’s well-beingand who deserve to be treated with the best oral health carewe 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

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com

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[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.