The oral health of older Americans is in a state of decay, according to a new national report released today by Oral Health America (OHA). A "State of Decay," a state-by-state analysis of oral health-care delivery and public health factors impacting older adults, reveals more than half of the country received a “fair” or “poor” assessment when it comes to minimal standards affecting dental care access for older adults. Florida and Arizona, areas with large older adult populations, rank in the bottom five states due to a shortage of oral health coverage, a strained dental health work force, and deficiencies in prevention programs.
“While we are seeing improvements in certain areas of older adult dental care, there is still a lack of progress in advancing the oral health of such a vulnerable population,” said Dr. Ira Lamster, a public health professor at Columbia University. “Older adults face significant health challenges if their oral health is poor, and there is no coordinated program to help fund necessary services.”
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A "State of Decay" gave a rating of “fair,” “poor,” “good,” or “excellent” based on state level data analyzing five variables impacting older adult oral health: adult Medicaid dental benefits, inclusion of older adult strategies in state oral health plans, edentulism (loss of teeth), dental health professional shortage areas, and community water fluoridation.
The final evaluations in the report for each state are mixed, with several states performing well in some variables, but still in need of improvement in other important areas. The report emphasized a call to action on:
- Persistent lack of oral health coverage across much of the nation. Forty-two percent of states (21 states) provide either no dental benefits or provide only emergency coverage through adult Medicaid Dental Benefits.
- Strained dental health work force. Thirty-one states (62%) have high rates of Dental Health Provider Shortage Areas (HPSAs), meeting only 40% or less of dental provider needs.
- Tooth loss remains a signal of suboptimal oral health. Eight states had strikingly high rates of edentulism, with West Virginia notably having an adult population that is 33.8% edentate.
- Deficiencies in preventive programs. Thirteen states (26%) have upwards of 60% of their residents living in communities without water fluoridation (CWF), despite recognition for 68 years that this public health measure markedly reduces dental caries. Hawaii (89%) and New Jersey (86.5%) represent the highest rates of citizens unprotected by fluoridation, an unnecessary public peril.
Daily, 10,000 Americans retire and only 2% do so with a dental benefit plan. The "State of Decay" analysis provides a tool for states to use in addressing shortfalls in oral health status, dental professional access sites, dental benefits for low-income adults, and population-based prevention, all of which affect the oral health of older adults, the fastest growing segment of the American population.
To help older adults and their caregivers address oral health needs and overcome many of the barriers to accessing affordable dental care, OHA launched toothwisdom.org. The website is a first-of-its-kind online tool that connects older adults to dental care and educates on the importance of maintaining oral health with age. The American Dental Hygienists’ Association (ADHA) and Special Care Dentistry Association (SCDA) supported OHA and the launch of the website by encouraging their members to provide meaningful articles for the toothwisdom.org.
"Dental hygienists have the opportunity to assist older Americans with the oral health challenges they may face as they age,”" said Ann Battrell, executive director of the American Dental Hygienists’ Association. "We’re all committed to sharing the message that oral health matters and changing the common misperception that with age comes a decline in oral health."
Toothwisdom.org offers oral care resources by state, including direct links to dental care, caregiving support, financial tools, social services, and transportation.
A "State of Decay" and toothwisdom.org are part of Oral Health America’s Wisdom Tooth Project™, an initiative designed to meet the oral health challenges of a burgeoning population of older adults with special needs, chronic disease complications, and a growing inability to access and pay for dental services.
