Status of oral disease among Massachusetts seniors: A great unmet need

Background: Oral health is not just essential for general health and wellness, but quality of life. Methods: In 2009, Massachusetts conducted its first statewide oral health assessment of seniors in randomly sampled long term care facilities (LTCF) and state subsidized meal programs (SSMP) to determine their oral health status including tooth loss, untreated decay, treatment urgency, and access to dental care. Results: Of the seniors in the sample (n=1,046), 32% were edentulous (no natural teeth) and 68% were dentate (having natural teeth). Of those dentate seniors (65%) in LTCF, 59% had untreated tooth decay with 34% having major to urgent treatment needs. Of the dentate seniors (81%) at SSMP, 35% had untreated decay. Of all seniors at SSMP, 20% reported not visiting a dentist in at least five years. Discussion: Throughout their lifespan, the senior population has had the benefit of an available oral care system, as well as fluoride in various forms like water fluoridation and toothpaste to prevent tooth loss and decay. Today that is changing with seniors making up an increasing portion of the population who are experiencing disparities in oral and dental diseases due co-morbidities, medication use, economic status and barriers to accessing dental care. Conclusion: Public health polices supporting seniors need to be revised to mandate comprehensive dental care as part of Medicare/Medicaid, the promotion of oral health programs in non-traditional settings, as well as the inclusion of oral health indicators related to licensure of LTCF to eliminate oral health disparities among this at-risk population.