Aging Population By Claire Reilly

Written by: Claire Reilly

The ASDA National Leadership Conference in Chicago this past November opened my eyes to topics that would expand the skills of any aspiring dentist. While most presentations bridged the gap between dental school and being a business owner and leader, the conversation that impacted me the most was on the topic of aging populations. It is not profound to recognize the correlation between medical advancements and increased access to food that would increase the lifespan of humans. But what is its impact on dental care? Dr. Linda Niessen, DMD, professor and founding dean of the College of Dental Medicine at Kansas City University, presented on aging and oral health to bring to light some key areas that we, the future of dentistry, will likely face when we practice. I took notes on Dr. Niessen ’ s presentation and here are some of the points where I feel we, as students, can begin to make the biggest impact. OHI and Dental Goals It’ s normal--with age, comes natural wear and tear on the body. Our vision, our hearing, our cognitive abilities, and our movements become a little worse. As dental providers, we have to take this decrease in function into consideration when we talk to our patients about their oral health habits at home. Perhaps they need a modified toothbrush grip, a wider entrance to accommodate a wheelchair or walker, or a limit on the recline of the dental chair. However, even with the obvious signs of aging, it is still just as important for the patient to have an active role in their treatment plans. And, as a healthcare provider, it is even more important to be in constant communication with their other health care providers. It can feel very overwhelming in clinic when we have a comprehensive exam and the patient shows us their very long list of medications. And it can be so easy for us to present our treatment plan recommendations and give them another very long list of procedures and costs. In clinic, let’ s try to take a step back and evaluate the dental goals of the patient, as well as take time to understand their medical barriers before providing our treatment.

Medicare and Legislation I will be the first to admit, I did not realize that Medicare does not include dental coverage. People are automatically enrolled into Medicare plans at 65 years of age and receive federal funds to cover medical expenses. Of course, there are advanced plans that some choose to buy into that will include dental coverage, but with that additional expense, it could still leave nearly half of the aging population without dental coverage. On the flip side of the coin, there are the extremely poor, aged populations that have dual enrollment in both Medicare and Medicaid to receive medical and dental benefits. But keep in mind, Medicaid is a staterun program, so the political affiliations of the state will dictate how funds are allocated to the program. The Center for Medicare and Medicaid Services (CMS) guidelines list a “ medically necessary dental benefit” for those individuals with medical conditions like organ transplants and cancer. Do you see where I’ m going with all this? It is a hot mess. Dental care can be very expensive, and depending on the treatment suggested, it can be unattainable for many. At Roseman, we see a fair amount of patients over the age of 65 and perhaps it is because we are the best financial option for their care. Personally, I think the best way we can improve legislation is to lobby for the expansion of Medicare. The policies in place feel limited and restrictive-is that the way dental care should be? ASDA has a branch that provides us with the opportunity to learn more about lobbying and ways students can be involved with legislation. If you are interested, reach out to ASDA Legislative Liaison Jody Chiang or ASDA Advocacy Chair Ally Hollenbeck. Volunteering Opportunity I had not given this much thought until this presentation, but how is oral health handled in nursing homes or assisted living facilities? Dr. Niessen made an interesting point that many living in these types of residences are dentally at risk. These facilities have to hold a certain quality assurance standard, but who is directing the oral health standard? This is where we can make a difference! Dentists can “ adopt a nursing home ” and volunteer their time to make a difference to these residents and their community. Moral of the story: Perspective. Respect. Be thankful to be on the right side of the grass. We aren ’t getting any younger!