Increasing older adults' access to dental services

Objective: Older adults experience significant barriers to accessing dental care. Outreach/screening in senior centers presents an opportunity for linking community and dental services.

Method: Fall semester 2010, associate student dentists and supervising faculty from New York University College of Dentistry screened 184 adults over age 60 at senior centers in New York City. If care was needed, referrals were made. Six weeks later seniors were contacted to determine if they received needed care. If not, they were interviewed regarding barriers to obtaining dental services.

Results: Dentists screened 184 adults, average age 75 years. 53% had Medicare; 29% Medicare and Medicaid; 5% Medicaid; 7% private insurance; and 6% uninsured. 39% had Medicaid or private dental insurance.

Seniors averaged 16 of 28 teeth. 47% used dentures/partials, averaging nine years old.

89% of the seniors screened (N=164) needed follow-up care (cavities, periodontics, oral pathology, denture/partials). They averaged two cavities. 70% said they would seek care at NYU, 27% said they go to a community dentist, and though 41% had a dentist, only 15% said they would seek care from their own dentist.

77 seniors have been followed-up: 35 have received care, and 24 of those who did not agreed to be interviewed. 39% of the seniors reported financial issues prevented them from receiving care; 15% cited transportation issues; and 12% lacked people to help them make/keep/get-to an appointment or navigate the system.

Conclusion: Bringing dentistry into the community and linking senior centers and dental services can ameliorate poor access to care.