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Geriatric Oral Health Care Delivery in the United States of America

  • Dental Public Health (R Collins, Section Editor)
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Abstract

The growing elderly population (≥65 years) imposes great challenges to oral health delivery systems. In the USA, the elderly continue to exhibit a high prevalence of chronic oral disorders. Further, poor dental access has long remained a concern and a barrier toward oral health improvement. Lack of dental insurance is a prominent contributor to the access problem. The main reason for the lack of dental insurance is the loss of employer benefits after retirement and the current transition to a national insurance program (Medicare) with insignificant dental benefits. Dental care needs to be established earlier in life through an appropriate model of care that considers the level of dependency of the elderly. The goals of dental treatment for the elderly are different from those for any other age group, and there is an increased need for the provision of dental care in regions with large elderly populations. This paper provides an overview of the challenges imposed on the health care delivery system in the USA with regard to the provision of oral health care to older adults and discusses consideration for future improvement.

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References

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  1. Ortman JM, Velkoff VA, Hogan H. An aging nation: the older population in the United States, current population reports. Washington DC: U.S. Census Bureau; 2014. p. 4.

    Google Scholar 

  2. Kiyak AH, Reichmuth M. Barriers to and enablers of older adults’ use of dental services. J Dent Educ. 2005;69:975–86. This manuscript studies determinants of dental service utilization.

    PubMed  Google Scholar 

  3. David S. Oral health in America. A Report of the Surgeon General. Office of Public Health and Science. United States Department of Health and Human Services; 2000.

  4. Healthy People 2020—Improving the Health of Americans. http://www.healthypeople.gov.

  5. Dye BA, Thornton-Evans G, Li X, Iafolla TJ. Dental caries and tooth loss in adults in the United States, 2011–2012. NCHS data brief, no 197. Hyattsville, MD: National Center for Health Statistics; 2015.

  6. Dye BA, Li X, Beltrán-Aguilar ED. Selected oral health indicators in the United States, 2005–2008. NCHS data brief, no 96. Hyattsville, MD: National Center for Health Statistics; 2012.

  7. Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91:914–20.

    Article  CAS  PubMed  Google Scholar 

  8. Medicare payment advisory committee. Report to the Congress: Medicare and the Health Care Delivery System, June 2015. http://www.medpac.gov/documents/reports/june-2015-report-to-the-congress-medicare-and-the-health-care-delivery-system.pdf. Accessed 8 Jun 2016.

  9. Cubanski J, Swoope C, Boccuti C, Jacobson G, Casillas G, Griffin S, et al. A primer on Medicare: key facts about the Medicare program and the people it covers. Kaiser Family Foundation; 2015.

  10. Centers for Medicare and Medicaid Services. Medicare and You, 2016. Washington DC: Department of Health and Human Services; 2016.

    Google Scholar 

  11. Manski RJ, Goodman HS, Reid BC, Macek MD. Dental insurance visits and expenditures among older adults. Am J Public Health. 2004;94:759–64. This manuscript studies the effect of age, income and dental coverage on dental service utilization and expenditure.

    Article  PubMed  PubMed Central  Google Scholar 

  12. National Center for Health Statistics. Health, United States, 2014: with special feature on adults aged 55–64. 2015; Kaspir Commission on Key Facts. Oral Health in The United States: Key Facts. Kaiser Family Foundation. 2015.

  13. Burt BA, Eklund SA. Dentistry, dental practice, and the community. 6th ed. St. Louis: Elsevier/Saunders; 2005.

    Google Scholar 

  14. Guay AH. Access to dental care: the triad of essential factors in access-to-care programs. J Am Dent Assoc. 2004;135:779–85.

  15. Guay AH. Access to dental care: solving the problem for underserved populations. J Am Dent Assoc. 2004;135:1599–605. This manuscript deliberates on factors linked to improvement of dental access with emphasis to the underserved populations.

    Article  PubMed  Google Scholar 

  16. Manski RJ, Moeller J, Chen H, St Clair PA, Schimmel J, Magder L, et al. Dental care utilization and retirement. J Public Health Dent. 2010;70:67–75. doi:10.1111/j.1752-7325.2009.00145.x. This manuscript studies the effect of dental coverage status, and retirement on dental service utilization.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Rudd R, Horowitz AM. The role of health literacy in achieving oral health for elders. J Dent Educ. 2005;69(9):1018–21.

    PubMed  Google Scholar 

  18. Munson B, Vujicic B. Supply of dentists in the United States is likely to grow. Health Policy Institute Research Brief. American Dental Association; 2014.

  19. Manski RJ, Macek MD, Moeller JF. Private dental coverage: who has it and how does it influence dental visits and expenditures? J Am Dent Assoc. 2002;133:1551–9. This manuscript studies the effect of socio-demographic status and private dental coverage on dental service utilization and expenditure.

    Article  PubMed  Google Scholar 

  20. Mariño R, Schofield M, Wright C, Calache H, Minichiello V. Self-reported and clinically determined oral health status predictors for quality of life in dentate older migrant adults. Community Dent Oral Epidemiol. 2008;36:85–94. doi:10.1111/j.1600-0528.2007.00378.x.

    PubMed  Google Scholar 

  21. Hämäläinen P, Rantanen T, Keskinen M, Meurman JH. Oral health status and change in handgrip strength over a 5-year period in 80-year-old people. Gerodontology. 2004;21:155–60.

    Article  PubMed  Google Scholar 

  22. Joshipura KJ, Willett WC, Douglass CW. The impact of edentulousness on food and nutrient intake. J Am Dent Assoc. 1996;127:459–67.

    Article  CAS  PubMed  Google Scholar 

  23. Sheiham A, Steele JG, Marcenes W, Finch S, Walls AW. The relationship between oral health status and body mass index among older people: a national survey of older people in Great Britain. Br Dent J. 2002;192:703–6.

    Article  CAS  PubMed  Google Scholar 

  24. Murray TW. Epidemiology of oral health conditions in older people. Gerodontology. 2014;31:9–16. doi:10.1111/ger.12085.

    Article  Google Scholar 

  25. Pretty IA, Ellwood RP, Lo EC, MacEntee MI, Müller F, Rooney E, et al. The Seattle Care Pathway for securing oral health in older patients. Gerodontology. 2014;31(Suppl 1):77–87. doi:10.1111/ger.12098. This manuscript developed a care pathway to maintaining oral health and explains the levels of dependency in elders with their appropriate assessment, prevention, treatment and communication.

  26. Pretty IA. The life course, care pathways and elements of vulnerability. A picture of health needs in a vulnerable population. Gerodontology. 2014;31:1–8. doi:10.1111/ger.12092. This manuscript developed a contextual model to assess the oral health needs with vulnerability integrated.

    Article  PubMed  Google Scholar 

  27. Harris-Kojetin L, Sengupta M, Park-Lee E, Valverde R. Long-term care services in the United States: 2013 Overview. Vital Health Stat 3. 2013;(37):1–107.

  28. US Department of Health and Human Services. Oral health in America: a report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health. 2003;63:74–94.

  29. Helgeson MJ, Smith BJ. Dental care in nursing homes: guidelines for mobile and on-site care. Spec Care Dentist. 1996;16:153–64.

    Article  CAS  PubMed  Google Scholar 

  30. Henry RG, Ceridan B. Delivering dental care to nursing home and homebound patients. Dent Clin N Am. 1994;38:537–51. Review.

    CAS  PubMed  Google Scholar 

  31. Dolan TA. Identification of appropriate outcomes for an aging population. Spec Care Dentist. 1993;13:35–9.

    Article  CAS  PubMed  Google Scholar 

  32. Kay E, Nuttall N. Clinical decision making—an art or a science? Part II: making sense of treatment decisions. Br Dent J. 1995;178:113–6.

    Article  CAS  PubMed  Google Scholar 

  33. Jones JA, Brown EJ, Volicer L. Target outcomes for long-term oral health care in dementia: a Delphi approach. J Public Health Dent. 2000;60:330–4. This manuscript developed a list of targeted treatment outcomes for long-term care.

    Article  CAS  PubMed  Google Scholar 

  34. Kemper P, Komisar HL, Alecxih L. Long-term care over an uncertain future: what can current retirees expect? Inquiry. 2005–2006;42:335–50.

  35. Ettinger RL. Oral disease and its effect on the quality of life. Gerodontics. 1987;3:103–6.

    CAS  PubMed  Google Scholar 

  36. Wyatt CC. A 5-year follow-up of older adults residing in long-term care facilities: utilisation of a comprehensive dental programme. Gerodontology. 2009;26:282–90. doi:10.1111/j.1741-2358.2009.00305.x.

    Article  PubMed  Google Scholar 

  37. MacEntee MI. Oral care for successful aging in long-term care. J Public Health Dent. 2000;60:326–9.

    Article  CAS  PubMed  Google Scholar 

  38. Yoon MN, Steele CM. Health care professionals’ perspectives on oral care for long-term care residents: nursing staff, speech–language pathologists and dental hygienists. Gerodontology. 2012;29:e525–35. doi:10.1111/j.1741-2358.2011.00513.x.

    Article  PubMed  Google Scholar 

  39. Matear DW. Demonstrating the need for oral health education in geriatric institutions. Probe. 1999;33:66–71.

    CAS  PubMed  Google Scholar 

  40. Warren JJ, Hand JS, Kambhu PP. Family member and guardian acceptance of dental services for nursing home residents. Spec Care Dentist. 1992;12:259–65.

    Article  CAS  PubMed  Google Scholar 

  41. Petersen PE, Yamamoto T. Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol. 2005;33:81–92.

    Article  PubMed  Google Scholar 

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Acknowledgments

Judith A. Jones is funded as a Senior Fellow of the Santa Fe Group.

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Correspondence to Judith A. Jones.

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AA Al-Sulaiman and JA Jones declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Dental Public Health

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Al-Sulaiman, A.A., Jones, J.A. Geriatric Oral Health Care Delivery in the United States of America. Curr Oral Health Rep 3, 164–170 (2016). https://doi.org/10.1007/s40496-016-0093-z

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