Integrating Oral and General Health Screening at Senior Centers for Minority Elders

Abstract

Racial/ethnic and socioeconomic disparities regarding untreated oral disease exist for older adults, and poor oral health diminishes quality of life. The ElderSmile program integrated screening for diabetes and hypertension into its community-based oral health activities at senior centers in northern Manhattan. Findings were that minority seniors were willing to be screened for primary care sensitive conditions by dental professionals, and a high level of unrecognized disease was found (7.8% and 24.6% of ElderSmile participants had positive screening results for previously undiagnosed diabetes and hypertension, respectively). Dental professionals may screen for primary care sensitive conditions and refer patients to health care providers for definitive diagnosis and treatment. The ElderSmile program is a replicable model for community-based oral and general health screening.

A Community-Based Oral Public Health Approach to Promote Health Equity

“…15 Descriptions of this community-based program, which was targeted to racial/ethnic minority older adults, 7,15 reported previously on oral health outcomes for this underserved population, 16 including determinants of self-reported oral health. 17 Exploratory spatial analyses based upon program intake information that argued for place-based interventions 18,19 are available elsewhere.…”

“…16 Program staff conduct chairside glycosylated hemoglobin A1c (HbA 1c ) and blood pressure (BP) screening (both systolic BP [SBP] and diastolic BP [DBP]) on ElderSmile participants who consented to undergo testing. 15 Program staff then made referrals, when indicated, on an individual basis to community-based treatment centers (if there was no medical home) or to patients’ own primary care providers.…”

“…In November 2010, the focus of this initiative was expanded to include general health, that is, community-based education and screening for diabetes and hypertension were added to the oral health activities that remain its core functions. 15 Importantly, data collection is ongoing, which permits the assessment of relationships between oral and general health, and progress in achieving health equity for its largely racial/ethnic minority, socioeconomically disadvantaged older adult participants over time. Our study had 2 objectives: (1) to examine the relationships between general health conditions (diabetes and hypertension) and missing teeth in the ElderSmile population, and (2) to determine if an ordinal logistic regression model that used 3 response categories for missing teeth (edentulous or 28 missing teeth of a total of 28 teeth, excluding third molars; limited functional capacity or 9–27 missing teeth; and functional dentition or 0–8 missing teeth) provided more information while retaining ease of interpretation compared with a binary logistic regression model that used 2 response categories (edentulous and dentate).…”

Calidad de vida y su relación con la salud oral en personas de la tercera edad

“…Aunque existe preocupación de algunas entidades que realizan diagnósticos en salud oral y general para brindar tratamientos oportunos que mejoren las condiciones de esta población, aun así todavía existen múltiples falencias a nivel mundial en cuanto a la prestación de servicios de salud para esta comunidad específica [44].…”

“…Los cambios sociales y biológicos como el envejecimiento de la población o la falta de cobertura de los servicios odontológicos, han dejado en la exclusión a las personas mayores [44].…”