Despite major advances in dentistry and the ability to prevent many oral healthcare issues, dental disease remains a significant and widespread public health problem in America, and the problem is no more severe than among lower-income seniors, who are struggling to make ends meet and for whom seeing a dentist is a luxury most cannot afford.
This was the subject of a panel discussion I participated in at the 2016 Aging in America Conference #AiA16 in Washington, DC, where increasing attention is being paid to oral health issues as a leading health indicator and how those who need care the most may be the least likely to get it.
Medicare, the largest health provider for people 65 and older, does not cover routine dental care and dental services under Medicaid vary state by state. Further, where a Medicaid dental benefit does exist, access to it is extremely limited due to low reimbursement rates for dentists. About half of the Medicare Advantage plans offer a dental benefit. Low-income seniors are falling through the cracks.
Oral health has maintained a secondary status in our health system despite the fact that poor oral health in seniors has been linked to poor nutrition, heart disease, breast cancer, cognitive decline, diabetes and stroke. As a society we seem more willing to address the medical consequences of poor oral health in the hospital or emergency room than to deal with it in the dentist’s chair where it belongs and where it is far less complicated and costly to prevent or treat.
According to the American Dental Association (ADA), in 2012, there were nearly 2.2 million visits to the emergency room due to dental issues, costing the U.S. health care system $1.6 billion at an average cost of $749 per visit. The ADA estimates that 79 percent of these visits “could be diverted to community settings” and that patients would not only receive better care, but could save the healthcare system millions of dollars.[i]
In downtown San Diego, the Gary and Mary West Foundation and West Health Institute, in cooperation with Serving Seniors, will open the Gary and Mary West Senior Dental Center, a unique community dental clinic that combines access to high-quality, affordable oral healthcare with comprehensive clinical and social services within a senior wellness center.
Our goal is to ensure older adults achieve and maintain long-term dental and overall health, regardless of their ability to pay for services. We hope to demonstrate through this integrated and coordinated care model that it makes far more clinical and economic sense to address dental issues than ignore them.
But we’re not just treating teeth, we’re treating people. Every person that comes to the dental clinic will receive a Comprehensive Geriatric Assessment (CGA), a tool designed to evaluate a senior’s functional ability, physical health, dental health, mental health, and socio-environmental circumstances.
This helps us go beyond solving issues in isolation and facilitates access to the broader range of services that can improve the overall health and wellness of seniors. Through the Gary and Mary West Senior Dental Center, seniors have access to more than 30 nonprofit organizations with community-based services that cover nutrition, mental health, health and wellness, housing and social services. We think this community-based model can work for seniors and not only bring smiles back to their faces, but help them enjoy a new level of health and wellness and quality of life.
If improvements in access to dental care, affordability, education and awareness do not occur, oral disease and related health issues may rise to become as big a public health issue as falls, lack of mobility, and cognitive and memory problems among older adults. We must act and employ new models of care that are both affordable and effective. Standing by is no longer an option.
For more information visit www.WestHealth.org