Despite Some Improvement, Seniors Still Struggle with Oral Health - Report

By Emma Yasinski

Oral Health America recently published its fourth “A State of Decay” report, including more information than ever before about the status of oral health in patients in the United States who are over 65 years of age.

Based on the report, OHA has five policy recommendations for improving oral health among the aging population:

Establish or maintain a comprehensive adult Medicaid dental benefit
Integrate comprehensive dental coverage in Medicare
Expand community water fluoridation
Include specific objectives for older adults in all State Oral Health Plans (SOHP)
Conduct Basic Screening Surveys (BSS) of older adults in all states

The group published the first report in 2003 and since has published new analyses in 2013, 2016, and 2018. The next report is expected in 2020.

“The A State of Decay series was created for two main reasons: to be able to compare the status of older adults across states and to provide state advocates with a tool to approach decision-makers to establish policies that improve the oral health of older adults,” Bianca Rogers, public affairs manager at Oral Health America, told Incisor.

The report measured six main variables in each state: severe tooth loss (loss of 6+ teeth), dental visits, adult Medicaid dental benefits, community water fluoridation, and whether or not the state had developed State Oral Health Plans and conducted Basic Screening Surveys.

Since the last report, published in 2016, several states have taken measures to increase the oral health of their senior populations.

Household income is the strongest predictor of poor oral health.

Several have commissioned surveys to measure the oral health of older adults (Basic Screening Surveys), added goals for older adults to State Oral Health Plans, increased the percentage of people in areas served by community water fluoridation, and covered a greater number of adult dental services under Medicaid.

Still, the report shows that we have a long way to go in terms of improving oral health among the elderly population.

Half of the states were ranked as “fair” or “poor” by the standards the team measured. Overall, a third of older adults in the United States have lost six or more teeth, which can increase the risk for a variety of health problems ranging from gum disease to diabetes and heart disease. Lower-income patients are significantly less likely to visit a dentist regularly.

Additionally, this is the first report to include national data from the CDC on sociodemographic factors impacting oral health. Household income is the strongest predictor of poor oral health.

A Need to Drive Down Costs

Rogers explained that the report inspires her team to focus on solutions.

“When we see income’s impact on visiting a dentist and severe tooth loss it prompts us to think about solutions that drive down cost, whether through policies, interventions or programs,” she said.

But while OHA hopes to drive policy, she emphasizes that dentists can play a critical role as advocates. “Dentists are great advocates because they are able to share the stories of the patients they see in the community. They are also a credible authority on the topic of oral health and can provide that background for legislators and their staff,” Rogers added.

Tools for advocacy can be found at AStateofDecay.org.

Author: Contributing writer Emma Yasinski received her Master of Science (MS) in science and medical journalism from Boston University. Her articles have also appeared at TheAtlantic.com, Kaiser Health News, NPR Shots, and Genetic Engineering and Biotechnology News.

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