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APHA Scientific Session and Event Listing

Barbara J. Smith, PhD, RDH, MPH, Periodontics and Oral Medicine, University of Michigan, 1011 N. University Avenue, Ann Arbor, MI 48109-1078, 734-741-9205, smithbj@umich.edu

Healthy People 2010 identified oral health care barriers facing LTCF residents: multiple chronic diseases and medications, diminished self-care, and inadequate access to dental care. Only 19 % of all nursing home residents received dental services in 1997. A survey of all Michigan nursing homes (n=402) and alternative LTC facilities (ALTC) i.e. assisted living (n=2275), was conducted in 2005-6 to determine directors' of nursing and facility administrators' perceptions of oral health barriers. In both facility types, key barriers perceived were unwillingness of dentists to treat residents at nursing facilities and financial concerns of residents/residents' families. Traditional dental delivery is ill-equipped to meet the needs of the frail elderly. Apple Tree Dental (ATD) has developed an effective system for overcoming many of the barriers to care experienced by institutionalized elderly. Analysis of dental utilization data of 26,242 nursing homes residents seen by ATD 1986-2005, illustrates extensive treatment needs in a population that relies heavily on Medicaid as the financial resource for dental care. Over time, dentition patterns of those receiving care have changed from one of primarily edentulous individuals to a much more dentate population. The cohort of individuals first examined in 1986 by ATD had a mean of 3 teeth. In 2005, those receiving initial exams had a mean of 13. Denture services are being replaced with restorative services on natural teeth. Despite remarkable efficiency and a non-profit status allowing grant-seeking to subsidize care, the existing Medicaid system inadequately supports ATD's efforts and continues to be a disincentive for other providers.

Learning Objectives: At the end of this session, the attendee within the context of basic human rights, be able to

• articulate the extent of oral disease within the frail elderly population
• identify factors contributing to the poor oral health status of the frail elderly in institutions
• recognize key barriers to care that must be addressed/eliminated to incorporate oral health as a basic human right for the frail elderly

Keywords: Long-Term Care, Oral Health

Presenting author's disclosure statement:

Any relevant financial relationships? No