The year 2030 marks an important demographic turning point in U.S. history according to the U.S. Census Bureau’s 2017 National Population Projections. By 2030, all baby boomers will be older than age 65. As the world’s population continues to age, dental issues within that growing population will also increase because there is a correlation between age and dental neglect. Death by dental neglect may become an epidemic for the Baby Boomer generation.
Poor oral health is a risk factor for falls in the elderly and falls are becoming an increasingly major public health problem. One recent study by the Graduate School of Dentistry at Kanagawa Dental University in Japan revealed that having a low number of teeth and not using dentures were associated with a higher frequency of falls. The longitudinal study involving 4,425 community-dwelling older people showed that those having ≤19 teeth without dentures had a significantly higher risk for incident falls than those having ≥20 teeth. The results of the study suggest that older people reporting poor oral function, including difficulty eating tough foods, dry mouth, and choking, are more likely to experience falls. Moreover, having fewer teeth and not using dentures were independent predictors of falls in older females. (PLoS One)
It’s not just falls that are a concern for the elderly. According to the NIH, one in ten older adults will die of aspiration pneumonia when their oral health is ignored. Aspiration pneumonia is caused by inhaling the bacteria found in dirty/old dentures, rotting teeth, and gum infection. Also, any of the medications prescribed to older adults place them at higher risk for Xerostomia, also known as dry mouth. Dry mouth causes a great deal of dental decay if not treated.
Clearly, seniors need proper and regular dental care. However, they have unique obstacles that could prevent them from going for a traditional visit to the dentist, including cognitive impairment, hearing loss, vision loss, low motivation, physical limitations, difficulty traveling, and loss of mobility. Additionally, familiar surroundings are essential to the aging population to reduce anxiety and deliver optimal care. Access to care for seniors requires a new focus and commitment by the dental support community.
One company that is addressing the needs of this growing segment is Smiles by Delivery. Founded in 2012 by Elaine Mamola, RDH, the delivery model makes in easier for seniors to access care. It provides on-site care at large retirement communities, memory care facilities, care homes or private homes to those who are unable to visit traditional dental practices. Mamola took advantage of cutting edge technology and the growing field of tele-dentistry to create the mobile dental practice. Taking the dental equipment to the patient’s room or bedside is optimal care, especially for dementia patients. In a few short years the practice has grown immensely and served thousands of seniors and she has plans for expansion: more cities, more vans, and more dental teams.
Smiles by Delivery works closely with senior communities and mobile physicians, and their biggest challenge is educating the community leaders on the importance of dental care for our seniors. While they are available for emergencies, they prefer to partner with assisted living and skilled nursing senior communities and mobile medical groups to catch problems before they become emergencies. They work out of nursing offices, activity rooms, empty apartments, and bedside on a regular visitation schedule for dental cleanings every 30 or 60 days. The dental office, which can be set up in a patient’s home in 10 minutes, has state-of-the-art dental equipment with digital x-rays and photos, fully reclining dental chairs, and does not even require access to water. They also train caregivers in oral hygiene care.
Another organization offering similar services is 360care, which focuses on serving the vision, dental, podiatry and audiology needs of nursing homes, long-term care and short-term rehabilitation facilities in 16 states. 360care provides routine dental care as well as a full scope of dental services at facilities. Their equipment allows them to perform exams, cleanings, digital x-rays, fillings, and extractions as well as complete denture services, limiting the expense associated with sending residents out for care. They also offer electronic health records, accept Medicaid, and offer a unique insurance product that covers services not usually covered by Medicaid.
These are just two examples of dental groups who are committed to improving seniors’ quality of life and addressing disease management. Many DSO models are focused on underserved segments of our population and the over 65 segment is growing faster than any other. Due to the growing demand for such services, there is room for more dental groups and DSOs to enter this segment. Many DSOs should be well-suited to serve this patient population effectively and efficiently as the need for house-call dentistry increases. This delivery system may eventually be incorporated into many DSOs.