A wise person once said that while everyone wants a long life, no one wants to be old. But of course, aging happens to us all. Thanks to improved healthcare, it is projected that one of every five Americans will be in the sixty-five-and-older age group by 2030.[1]
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The improved health includes dental health. The dental health of today’s aging Americans – the “baby boomer” group – is so much better now that one dentist says many people are retiring with a full set of teeth. “It’s much more common nowadays,” she said, “to see a 65-year-old wearing braces instead of dentures.”[2]
If the projections about an aging population are accurate, it will be the first time ever that people who are sixty-five and older will outnumber children who are under the age of five. But time will inevitably take its toll. Braces or no, the expanding segment of older Americans means that many dental practices will face new challenges in providing care. The Center for Dental Anesthesia in Alexandria has always made geriatric dentistry a focus.[3]
Age Differences
There are many things to consider when dental professionals formulate care for older patients. In an article published on the New York University College of Dentistry website, dental hygienist Candace Yamakawa wrote: “It is important to realize that as providers you cannot group together all patients from age sixty to one hundred years old with the same simple title of ‘elderly.’” The chronological age of a patient, she says, doesn’t automatically correspond to presumed physical and mental abilities.[4]
Older Americans are, in fact, generally divided into the following categories:
- Young-Old. The sixty-five to seventy-four-year old group is relatively healthy and active.
- Old-Old. Those aged seventy-five to eighty-four tend to be a mix of people still in good health, and those in declining health.
- Oldest-Old. The frailest of the elderly, this group consists of people eighty-five and older. It is a rapidly growing segment.[5]
Geriatric Dental Issues
No matter what category of old age someone falls into, certain conditions may develop that were not in question during a younger period of life.
- Changes in teeth
- Gum disease
- Nutrition
- Salivary issues
- Systemic disease
The very young and very old
special needs populations require
special attention due to occasional
increased medical concerns. That
is why a team approach is always
a necessity.– Dr. Zeyad Mady
Older adults are also more likely to be taking more medications to control more medical conditions, and be coping with issues like hearing loss and declining vision. “In the mouth itself,” adds Barbara Smith, Ph.D., RDH, MPH., “the teeth tend to be more brittle and may have decay around the root surfaces.”[6]
The good news is that geriatric dentistry has advanced in recent years. Preventive and restorative dentistry can minimize, if not eliminate, these problems.
OSCAR
Dentists who are developing treatment plans for older patients are advised to take many things into consideration: how the patient functions in their environment, and how dental health fits into it; if the patient is able to maintain the care they receive; and what social support systems they have.[7]
It usually takes more time to care for an older patient than a young one. They may find it challenging just to get to the dental office, for example, and their cases tend to be more complex. Older patients may also be transitioning from one age category to the next. Addressing these matters one-on-one with individual patients can help in the decision-making process.[8]
One approach to developing a treatment strategy is summarized in the acronym OSCAR.
- Oral and dental needs
- System factors
- Capability
- Autonomy
- Reality[9]
OSCAR outlines the essential factors that dentists need to consider when developing treatment plans for their older patients.
Perhaps most important, dental professionals are advised to never stereotype their older patients. “Don’t assume that just because someone is older that you know what their needs and preferences are. And don’t limit their options based on their age.”[10]
High-Quality Care
Aging may be inevitable, but poor dental health is not. Yet historically, dental health has fallen by the wayside in an aging population. This appears to be changing, as more and more older Americans are keeping their teeth.
But there is no denying that aging brings with it new issues. Dental health care is more complicated in older people than it is in children, teenagers, and young adults. Dental issues in older people tend to be cumulative, often a result of less-than-rigorous oral health care from their younger days.[11]
At the Center for Dental Anesthesia, we have built our practice by focusing on high-quality dental care to a diverse clientele, including geriatric patients. Dr. Zeyad Mady and Dr. James Geren have both had comprehensive training and are committed to outstanding patient care.
Geriatric patients come to the Center with a variety of issues, including Parkinson’s or Alzheimer’s. We welcome those with underlying medical issues like high blood pressure, diabetes, or heart problems, as well as those who are in treatment or recovery from cancer.
At the Center for Dental Anesthesia in Alexandria, we are committed to treating patients with many different special needs. Our doors are open to the general public, as well. We believe that no one should be without quality dental care. Please call our office to schedule an appointment.
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Notes
[1] Increasing 65+ demographic: “Taking Care: How Dentists Should Prepare for treating Aging Patients,” by Frances Moffet. Referred to hereafter as “Taking Care.”
[2] “Taking Care.” Quote attributed to Linda C. Niessen, DMD, MPH, MPP, and dean and professor at Nova Southeastern College of Dental Medicine in Ft. Lauderdale, FL. Baby boomers are typically defined as those born between 1946 and 1964, according to the Merriam-Webster online dictionary:
https://www.merriam-webster.com/dictionary/baby%20boomer
[3] Number of aging Americans, and sixty-five year old age group outnumbering five-and-under: “Taking Care.”
[4] “Dentistry and the Compassionate Approach,” by Candace Yamakawa. Referred to hereafter as “Understanding.”
https://www.nyu.edu/classes/keefer/EvergreenEnergy/yamakawac.pdf
[5] “Geriatric oral health concerns, a dental public health narrative,” published in International Journal of Community Medicine and Public Health, February 2019.
[6] “Taking Care.”
[7] “Taking Care.”
[8] “Taking Care.”
[9] “Taking Care,” citing Clinical Practice of the Dental Hygienist, 10th edition.
[10] Michael Helgeson, DDS, and Barbara Smith, Ph.D., RDH, MPH, in “Taking Care.”
[11] “The Oral Health of Older Americans,” by Clemencia M. Vargas, DDS, PhD; Ellen A. Kramarow, PhD; and Janet A. Yellowitz, DMD, MPH.
https://www.cdc.gov/nchs/data/ahcd/agingtrends/03oral.pdf
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Contact Center for Dental Anesthesia:
703-379-6400
Location (Tap to open in Google Maps):
5284 Dawes Ave
Alexandria, Virginia
22311
