Dental issues plague America’s nursing home residents


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Good oral health is one of the keys to healthy aging, but a sobering new study shows that many U.S. nursing home residents have serious dental problems.

Researchers found that nearly 2 in 10 residents had missing teeth, about 8% had tooth/cavities, and 11% reported pain when chewing.

“Poor oral health can have profound effects, not just on the mouth, but on a person's overall well-being, nutritional intake and overall well-being,” said study author Dr. Natalia Chalmers, chief dental officer at the Centers for Medicare and Medicaid Services. healthy.

Poor oral health can hinder a person's ability to chew properly, ultimately leading to malnutrition. Additionally, bacteria from gum infections can enter the bloodstream, increasing the risk of heart disease and other illnesses, she explains.

This interconnected relationship between oral health and overall health underscores the importance of maintaining oral health,” Chalmers said.

For the study, researchers analyzed oral health data from Medicare beneficiaries living in CMS-certified nursing homes in 2020. Broken natural teeth, pain, difficulty chewing, broken dentures and inflamed gums, among other oral health problems.

There may be many reasons for declining dental health in nursing home residents, but the main reason may be a lack of dental insurance. Chalmers noted that 51 percent of Medicare recipients do not have dental insurance. This may be because traditional health insurance doesn't cover routine dental services like exams, cleanings, and X-rays, nor does it cover more expensive services like fillings, crowns, or dentures, so dental insurance must be paid for separately.

There are some significant differences across racial and ethnic groups. For example, compared with white people, black people are 16% more likely to have no natural teeth or tooth fragments, and 5% more likely to have cavities or broken natural teeth. American Indian or Alaska Native older adults are also more likely to have dental problems than white people.

Those nursing home residents with three or more chronic conditions are more likely to have oral health problems than older adults without chronic conditions. What's more, investigators found that people in rural nursing homes had higher rates of dental problems than people in urban nursing homes.

If your family member lives in a nursing home, it is important to establish clear communication with the nursing home staff about their oral care habits and preferences for aids and toothbrushes and toothpastes, such as whether they prefer a manual toothbrush or an electric toothbrush, and what fluoridation Toothpaste they use,” Chalmers said. “You should make sure the staff is fully aware of your loved one's dentist and the designated contact person in the event of an emergency.”

The findings were published online on September 12 in JAMA Internet Open.

Dr. Bruce Dye is chair of the Department of Community Dentistry and Population Health at the University of Colorado School of Dentistry in Aurora. He wrote an editorial accompanying the new study.

We know that oral health is linked to many chronic diseases, and as more older adults live longer with more chronic conditions, poor oral health will reduce the ability of many of them to enjoy optimal health,” Day said. and the possibility of well-being.

He added that now is the time to take steps to ensure seniors have access to dental care, including making dental insurance more affordable.

There are also things loved ones can do to advocate for the oral health of family and friends in nursing homes, Day suggests.

“Build ongoing relationships with caregivers [your] “I love the person and the director of nursing,” he said. In most nursing homes, the director of nursing works directly with the staff and consulting dentists.

New York City dentist Dr. Saul Presner agrees that more needs to be done to improve access to dental care for people in nursing homes. He is the president of the Academy of Bionic Dentistry, a type of dental conservation dentistry that focuses on preserving natural teeth.

“Providing dental benefits to all Medicare beneficiaries would go a long way toward addressing the lack of good dental care for the nursing home population,” Plessner said.

Additionally, having a dedicated dental treatment area in a nursing home will make it easier for residents to seek care. Other simple solutions include utilizing support staff to help residents with oral care.

“Oral cancer screening by a dentist will help detect the disease early, which, if detected early, can prevent further systemic disease problems,” he advises. “Proper nutrition in nursing homes along with good oral health home care instruction will go a long way toward reducing dental disease.”

More information:
Steffany Chamut et al., Oral Health of Nursing Home Medicare Beneficiaries, JAMA Internet Open (2023). DOI: 10.1001/jamanetworkopen.2023.33367

Journal information:
JAMA Internet Open



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