Two important oral health care concerns emerging in the United States:
- Disparities in the oral disease burden, and
- The inability of certain segments of the population to access oral health care.
Older Americans are becoming a larger segment of our population and suffer disproportionately from oral diseases, with the problem being particularly acute for individuals in long term care facilities.
Not only do we see elderly patients in our Sandy Springs who are usually brought here by assisted living and nursing home facilities, but Dr. Orland visits numerous assisted living facilities outside of our immediate area. By 2030, 1 of every 5 members in the US will be 65 years of age or older. This large segment of our population is further compounded by the elderly population continuing to become increasingly diverse in terms of race, ethnicity, financial resources, and living conditions.
The challenges faced by both the dental profession and the nation as a whole regarding provision of oral health care services to older adults needs a specialized and experienced team of dentists to address the issues. Medicare does not provide any coverage for dental services, and only 1 of 5 Americans aged 75 years or older has any type of private dental insurance and 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 directly or indirectly affect oral health, including autoimmune disorders such as pemphigus and pemphigoid. They generally require multiple medications, and common side effects of the more than 500 medications used to treat their overall health issues usually reduce salivary flow. And the reduction in saliva can adversely affect their quality of life, the ability to chew, and lead to significant problems of the teeth and their supporting structures.
In addition, particularly for geriatric patients, oral infection is now recognized as a risk factor for a number of 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 health needs 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.
While effective preventive measures exist for younger populations (water fluoridation, dental sealants and parents), no preventive measures have been devised to address the expected increase in oral health needs of the aging population. We have developed the expertise to take a leadership role in the delivery of health care services to the seniors who 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.
Novy Scheinfeld, DDS, PC
Hanna Orland, DMD
ZoAnna Scheinfeld, MS, DMD
290 Carpenter Drive, 200A
Atlanta (Sandy Springs), GA 30328
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 Oral Health in America: A Report of the Surgeon General. Rockville, Md: National Institute of Dental and Craniofacial Research; 2000.
 Wikipedia and 2010 Census.
 A State of Decay: The Oral Health of Older Americans. Chicago, Ill: Oral Health America; 2003:1–8.
 Stoopler ET, Sollecito TP, De Ross SS. Desquamative gingivitis: early presenting system of mucocutaneous disease. Quintessence Int.2003;34:582–586.
 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.