Oral Health Care of Our Aging Population

Geriatic dentist near me
Emerging Oral Health Concerns

Two important oral health care concerns emerging in the United States are disparities in the oral disease burden and the inability of certain segments of the population to access oral healthcare.[1]  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.  Population projections for the United States indicate that the elderly will constitute an increasing percentage of the population as we proceed into the 21st century.

In 2001, the population of the United States was almost 278 million, and 12.6% of the population was 65 years of age or older. By 2015, the population increased to 312 million (3.08 million in 2010) and 14.7% of the population will be aged 65 years or older.  In 2030, which is within the practice lives of students currently enrolled in dental schools, the population will have increased to more than 350 million, and 20% of the population—1 of every 5 members of the US society—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.[2]

The challenges faced by both the dental profession and the nation as a whole regarding provision of oral health care services to older adults are the subject of a recent report prepared by Oral Health America.[3]  All 50 states were surveyed to determine the level of Medicaid coverage for dental services, and the report concludes that financing oral health care services for the elderly will be a major challenge to our future.  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.  Given our current economic circumstances and resulting problems with Obamacare, it will be highly unlikely that our government resources will be adequate to gear up for the impending problem of oral health in the elderly.

They suffer from chronic disorders that either directly or indirectly affect oral health, including autoimmune disorders such as pemphigus and pemphigoid.[4] 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.[5]  The reduction in saliva adversely affects their quality of life, the ability to chew, and leads to significant problems of the teeth and their supporting structures.

The elderly consistently have difficulty performing routine oral hygiene 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 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 to resorb over time.  In addditon to continued resorbtion of bone, improperly fitted dentures adversely affect chewing, leading to poor nutrition resulting in a shorter life expectancy.  Furthermore, those without teeth remain susceptible to oral cancer, mucosal diseases, and alterations in salivary gland function.

Geriatric Dentist near meSo for the vast majority of seniors residing in a long term care facility, financing of and access to 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 any dental services whatsoever, let alone the most appropriate treatments.  Clearly, there must be a response to the increasing oral health concerns of the elderly who present with special needs, especially those who are home bound or living in long term  facilities burdened with other chronic disorders.

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 our aging population.  And the need for a coordinated effort to address their oral healthcare needs suggested by demographic trends and 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.

Seniors who have contributed so vitally to our society’s well-being, deserve to be treated with the best oral health care we have to offer.

Dr. Scheinfeld is a prosthodontist specializing in geriatric care. In addition, Dr. ZoAnna Scheinfeld and Dr. Hanna Orland have extensive nursing home experience.

Novy Scheinfeld, DDS, PC

ZoAnna Scheinfeld, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

and

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

www.rightsmilecenter.com

info@rightsmilecenter.com


[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.

Elderly Patients in Sandy Springs

Geriatric Dentist near me

More than 250,000 Americans turn 65 each month.  By 2030, 67 million Americans or close to 20% of the population will be 65 or older. Thanks to decades of better preventive care, these people are keeping more of their teeth than their predecessors, even into their eighties and nineties.

Yet the need to understand the geriatric patient has never been greater than it is today.  And treating an older patient is much more complex because they will have a combination possibly of decay, periodontal disease and other global health issues to take into consideration.

A large number of older patients have chronic medical conditions that impact oral health, particularly if they are on medication that causes dry mouth.  Or, these patients may have difficulties with brushing and flossing because of declining vision, coordination, and cognition, further negatively impacting their oral health.  Some are just fatigued and thus unmotivated to maintain their oral health.

With these issues in mind, you’ve got a patient that has complex clinical needs and complex medical needs, and you’ve got to balance the two.  As a consequence, you are inhibited by circumstances to do everything you want for this patient because of their medical history. Maybe you have to come up with a more creative treatment plan. Our experience has found that there needs to be more time and attention paid to the over 65 population.

Senior citizens also have limited access to dental insurance, preventing many of them from getting the care they need. Often retired, seniors aren’t covered by any employer and for some unknown reason Medicare does not cover routine dental care in its basic benefits. Only 12% of Medicare beneficiaries have some kind of dental insurance coverage. 

So one of our issues is education about the importance of oral healthcare.  We see this as particularly a challenge with somebody who’s on a fixed income—how and when they’re going to spend their money. I think that once you get patients into the office, you can talk to them about home care. So much of dentistry, or oral disease, is preventable. If we can be of assistance, please contact us.

Novy Scheinfeld, DDS, PC

ZoAnna Scheinfeld, MS, DMD

Hanna Orland, DMD

Howard Abrahams, DDS

290 Carpenter Drive, 200A

Sandy Springs, GA 30328

404-256-3620

And

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

info@rightsmilecenter.comwww.rightsmilecenter.com

Dentist Serving Dunwoody – Older patients have special dental needs

Dunwoody Dentist near me

Mouths, like people, are affected by years as well as by genes. If you’re over 60, your oral chemistry is changing—and thorough examinations of gums and salivary glands can be a lifesaving early detector of oral cancer or other disease.  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.  They generally require multiple medications, and common side effects of the more than500 medications used to treat their overall health issues usually reduce salivary flow.[1]   Usually 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.

The elderly may also have difficulty performing routine oral hygiene 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 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 to resorb over time.  Besides the continued resorption of bone, improperly fitted dentures can adversely affect chewing, leading to poor nutrition.  In addition, those without teeth remain susceptible to oral cancer, mucosal diseases, and alterations in salivary gland function.

As early as 55 patients are developing twice as many cavities as children do. All these health issues and their medications that create reduced saliva and cause dry mouth have become an open invitation for tooth decay and periodontal disease.  Does the patient have to make a choice between his or her general health verses their oral hygiene?  They shouldn’t have to.

What should you expect from a visit to your dental hygienist?  Along with your dental cleaning you may need professional scaling and root planing to remove harmful plaque and calculus deposits.  Your hygienist should also record the depths of your periodontal pockets (that space between your teeth and gums where decay and periodontal disease flourish).

Keeping track of you is a key part of the hygienist’s job. It includes keeping your dental chart and health history current, making preliminary oral inspections, and creating tooth impressions.

Your hygienist is also an educator—someone who can teach you preventive dentistry skills—brushing and flossing techniques that make for healthy, trouble-free gums and teeth, regardless your age or your onset of other health issues. Together, you two can make an unbeatable team!

Specializing in Geriatric Patients, Dr. Scheinfeld was trained in prosthodontics at Emory University School of Dentistry.

Novy Scheinfeld, DDS, PC

ZoAnna Bock, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

and

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

www.rightsmilecenter.com

info@rightsmilecenter.com


[1] 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 Dentist: Poor Dental Health May Cause Dementia

Sandy Springs Dentist near meA recent analysis led by NIA scientists suggests that bacteria that cause gum disease are also associated with the development of Alzheimer’s disease and related dementias, especially vascular dementia. The results were reported in the Journal of Alzheimer’s Disease. This supports a 2013 study from the University of Central Lancashire School of Medicine and Dentistry. The2013 UCLS was the first to pinpoint a specific gum disease bacteria in the brain. In 2013, Researchers looked at donated brain samples of 10 people without dementia and 10 people with dementia. They found the bacteria Porphyromonas gingivalis in the brains of four of those with dementia.

Previous lab studies have suggested that this is one mechanism influencing the cascade of events that leads to dementia, but large studies with people have not been conducted until recently to confirm this relationship. The 2020 NIA Intramural Research Program team examined whether gum disease and infections with oral bacteria were linked to dementia diagnoses and deaths using restricted data linkages with Medicare records and the National Death Index. The team compared different age groups at baseline, with up to 26 years of follow-up, for more than 6,000 participants.

The analysis revealed that older adults with signs of gum disease and mouth infections at baseline were more likely to develop Alzheimer’s during the study period.[1]

The findings suggest that oral infection preceded the diagnosis of the patient’s dementia. This indicates that maintaining one’s oral hygiene may be a factor in reducing the incidence of dementia. Call now for your hygiene check up.

Novy Scheinfeld, DDS, PC

ZoAnna Bock, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive 200A

Sandy Springs, GA 30328

404-256-3620

And

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

info@rightsmilecenter.com

www.rightsmilecenter.com


[1] https://www.nia.nih.gov/news/large-study-links-gum-disease-dementia Beydoun M, et al. Clinical and bacterial markers of periodontitis and their association with incident all-cause and Alzheimer’s disease dementia in a large national surveyJournal of Alzheimer’s Disease. 2020;75(1):157-172. doi: 10.3233/JAD-200064.

Dentist Sandy Springs: Oral Health and Alheimer’s

Sandy Springs dentist near meWhat does the health of your mouth have to do with your overall health? In a word, plenty. A look inside or a swab of saliva can tell your doctor volumes about what’s going on inside your body.

Researchers are also discovering new reasons to brush and floss. A healthy mouth may help you ward off medical disorders. The flip side? An unhealthy mouth, especially if you have gum disease, may increase your risk of serious health problems such as heart attack, stroke, poorly controlled diabetes, preterm labor, and now, Alzheimer’s.

Your mouth is a window into what’s going on in the rest of your body, often serving as a helpful vantage point for detecting the early signs and symptoms of systemic disease — a disease that affects or pertains to your entire body, not just one of its parts. Systemic conditions such as AIDS or diabetes, for example, often first become apparent as mouth lesions or other oral problems. In fact, according to the Academy of General Dentistry, more than 90 percent of all systemic diseases produce oral signs and symptoms.

If you don’t brush and floss regularly to keep your teeth clean, plaque can build up along your gumline, creating an environment for additional bacteria to accumulate in the space between your gums and your teeth. This gum infection is known as gingivitis. Left unchecked, gingivitis can lead to a more serious gum infection, Alzheimer’s. Now, more than ever, research is indicating that sustained oral health may lead to a prevention of Alzheimer’s disease.

Novy Scheinfeld, DDS, PC

ZoAnna Scheinfeld, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive, 200A

Sandy Springs, GA 30328

404-256-3620

and

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

www.rightsmilecenter.com

info@rightsmilecenter.com

Sandy Springs Dentist: Gum Disease May Lead to Alzheimer’s

Sandy Springs dentist near meIn a new study, researchers have found that a bacterium largely responsible for gum disease also contributes to the development of Alzheimer’s disease.

A bacterium involved in gum disease boosts Alzheimer’s toxicity.

According to data from the National Institute of Dental and Craniofacial Research, 8.52 percent of adults between 20 and 64 years of age in the United States have periodontitis (gum disease).

Gum disease is a widespread problem that can lead to more negative outcomes, from tooth loss to an increased risk of cancer.

Now, emerging evidence suggests that one of the bacteria involved in periodontitis could also contribute to the accumulation of toxic proteins in the brain, which scientists have associated with the development of Alzheimer’s disease.

These findings have emerged from a new study in mice that researchers from Cortexyme, Inc., a pharmaceutical company that aims to develop new therapeutics for Alzheimer’s disease, have conducted.

The results of the research — whose lead author is Dr. Stephen Dominy, Cortexyme co-founder — appear in the journal Science Advances.

Now more than ever, your maintaining your oral health may be the key to your healthy life.

Novy Scheinfeld, DDS, PC

ZoAnna Scheinfeld, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive, 200A

Sandy Springs, GA 30328

404-256-3620

and

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

www.rightsmilecenter.com

info@rightsmilecenter.com

Sandy Springs Dentist: Older Patient’s Special Needs

Sandy Springs dentist near meMouths, like people, are affected by years as well as by genes. If you’re over 60, your oral chemistry is changing—and thorough examinations of gums and salivary glands can be a lifesaving early detector of oral cancer and now, possibly Alzheimer’s.

Patients over 55 develop twice as many cavities as children do. Many times that’s because medications seniors take reduce saliva flow and dry the mouth—an open invitation for tooth decay and periodontal disease.

What should you expect from a visit to your dental hygienist? Along with your dental cleaning you may need professional scaling and root planing to remove harmful plaque and calculus deposits. He or she may also record the depths of your periodontal pockets (that space between your teeth and gums where decay and periodontal disease flourish).

Keeping track of you is a key part of the hygienist’s job. It includes keeping your dental chart and health history current, making preliminary oral inspections, and creating tooth impressions.

We are educators—someone who can teach you preventive dentistry skills—brushing and flossing techniques that make for healthy, trouble-free gums and teeth. Together, we can make an unbeatable team!

Novy Scheinfeld, DDS, PC

ZoAnna Scheinfeld, MS, DMD

Hanna Scheinfeld, DMD

290 Carpenter Drive, 200A

Sandy Springs, GA 30328

404-256-3620

and

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

info@rightsmilecenter.com

www.rightsmilecenter.com

Sandy Springs Dentist: Special Needs Patients

special-needs patientsSpecial needs patients with physical and/or mental impairment may not be able to clean their teeth and keep their mouths healthy.  Caregivers may also have difficulty adequately cleaning the teeth of a special needs patient.  Certain products can help protect the teeth by supplying the minerals, calcium and phosphate needed to help prevent the loss of their teeth.

One such product, MI Paste[1] is designed to help strengthen tooth enamel, restore minerals that keep teeth healthy and improve saliva flow. From an application stand point, no special tools or implements are needed to apply the product, just consistency.

Ask our dental professionals about these types of products to help you or someone you’re caring for to maintain their oral health.  If we can answer any of your questions or concerns, please feel free to contact us.

Novy Scheinfeld, DDS, PC

ZoAnna Bock, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

and

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

info@rightsmilecenter.com

www.rightsmilecenter.com

 


[1] MI Paste does not contain fluoride.

Dentist East Cobb: How Much Do Teeth Cleanings Cost?

East Cobb dentist near meSo you got a mailer coupon from a dentist that says they only charge $49.95 for a regular cleaning & $19.95 for an exam & x-ray.  Seems kind of a cheap gimmick?  And a lot of the times it might be, it just depends on the practice.

Does your physician offer you coupon rates? Not that I know of.  So if its a dentist, you might want to question why they are giving away services.  Usually, it’s a loss leader, something they use to get you in and pressure you into other dental procedures.

On the other hand, if it’s a new practice, providing discounted services is one of the few methods a new practice has to introduce itself to the surrounding community.  It’s no different than a new restaurant trying to showcase its menu.  The genuine intent is to build a relationship by showcasing their practice.

Teeth cleanings will vary widely, depending on where you go and the quality of the practice you see.  With respect to continuing care (on your next 6 month visit), a teeth cleaning charge is going to range somewhere around $65 to $89, but it can be more if there’s a need to do a full mouth root scaling.

Often dental insurance will cover some or all of this cost for a specific number of cleanings per year.  The exam is $45 to $55 and the 4 basic bite wing x-rays are around $59 to $72.  And depending on your insurance this might be covered anywhere from 60 to 100% after a small deductible is met.   Periodic X-rays ($32 -$135) are needed to see if any problems are developing inside the teeth or around the jaw bone, and are generally required before cleaning the teeth of a new patient (which is why some practices offer coupons to defray the initial cost of a first visit). These are also often covered by dental insurance.

The main goal of a professional teeth cleaning is to prevent gum disease, which is the primary cause of tooth loss.  Dental hygiene is imperative, and cleaning your teeth is the first step toward their long term preservation.  In a standard cleaning, a dental hygienist removes soft plaque and hard tartar from above and below the gum line on all the teeth. The process requires one office visit and usually takes about 30 to 60 minutes.

The more extensive deep cleaning process called scaling and root planing is done by quadrants (upper right, upper left, lower right, lower left) at a cost of about $100-$400 per quadrant depending on the severity of the problem or $400-$1,600 for the entire mouth, but more often than not, if the mouth is in such poor health the dentist will refer the patient out to a periodontist.   And generally, most dental insurance includes these procedures.

Again, the goal is a healthy mouth which an integral part of your overall health.  Oh, and by the way, just because you had your teeth cleaned professionally, the jobs not done.  You have to do your part and brush and floss daily if you want to keep them.   If you have additional questions, feel free to email or call our office.  Our goal here is to create an informed and healthy patient.

Novy Scheinfeld, DDS, PC

ZoAnna Scheinfeld, MS, DMD

Hanna Orland, DMD

290 Carpenter Drive, 200A

Sandy Springs, GA 30328

404-256-3620

and

3781 Chamblee Dunwoody Road

Chamblee, GA 30341

770-455-6076

www.rightsmilecenter.com

info@rightsmilecenter.com

 

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