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SACRAMENTO, CA — April 9, 2004 — Government officials, dentists, and senior advocacy groups heard reports about seniors with chipped teeth, infected gums, decaying teeth, and poorly–fitted dentures at a meeting of the California Task Force on Oral Health and Aging (Sacramento Bee, March 19, 2004). About three–quarters of the elderly residents in California nursing homes are not being treated for these serious dental problems, according to the statistics presented.
Besides being painful, untreated dental conditions may lead to malnutrition and social isolation. One dental hygienist cited the case of a nursing home patient who stayed in her room most of the time during the 18 years of her residency because she was ashamed of her loose dentures. When she finally was fitted with an adequate pair of dentures, the resident became more sociable and the quality of her life improved. Another patient lost 26 pounds in eight months because poor dentures prevented her from chewing properly, a California attorney reported.
Nursing home residents often need help with daily dental care. If a patient has arthritis, for example, he or she may find it hard to use a toothbrush. Flossing teeth may be even more difficult. Seniors with Alzheimer’s disease or other forms of dementia need assistance with routine hygiene, including brushing their teeth properly. In an understaffed nursing home, these dental tasks may be performed inadequately or not done at all.
About five percent of nursing home residents take an average of at least eight drugs a day. These drugs may have the unwanted effect of decreasing the amount of saliva and causing a dry mouth. In turn, a dry mouth increases the risk of oral disease because saliva is needed to attack germs, aid digestion, buffer acids, and help rebuild tooth enamel (Basic Oral Health Concerns, Dr. Fred Ferguson).
Older Americans are more prone to tooth decay. In California, the state Commission on Aging estimates that seniors have a 300 percent higher rate of cavities than children. The extent of gum (periodontal) disease also increases with age. About 23 percent of Americans between the ages of 65 to 74 have severe periodontal disease and eventually about 30 percent of seniors lose all their natural teeth, according to the Centers for Disease Control and Prevention. Oral cancers are most common in the elderly, resulting in some 8,000 deaths per year.
Medicare does not pay for routine senior dental care. Sadly, Medicaid, the federal–state health insurance program for low–income people, funds dental care in some states, but reimbursements are low. Participants at the California state conference, which included the University of the Pacific School of Dentistry and the state Commission on Aging, hope to recruit families, dentists, doctors, social advocates, and medical groups to lobby hard for improved dental care for California seniors, both in nursing homes and in the community.
For more information about senior dental care and the health issues of the elderly, see Taking Care of Your Teeth and Mouth, a guideline by the National Institute on Aging. If you have a question about the care of a loved one in a nursing home and his or her legal rights, please feel free to contact us at Brayton Purcell. We are experienced in all areas of elder abuse law, including nursing home violations, neglect, and inadequate pain management issues.
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