Integrating Oral Health into Primary Care: Perspectives for Older Adults

Nelson, Suchitra; Kim, E G R; Kaelber, David C.

doi:10.1177/00220345231165011

J Dent Res

2023

DOI: 10.1177/00220345231165011

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Integrating Oral Health into Primary Care: Perspectives for Older Adults

Suchitra Nelson

E G R Kim

David C. Kaelber

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Cited by 4 publications

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“…Their findings point to the need for comprehensive solutions beyond the medical realm to reduce risks of isolation and promote well-being in marginalized aging populations. Nelson et al (2023) propose recommendations for integrating oral health into primary care for older adults. The authors recommend electronic health record-embedded workflows prompting oral health screening, counseling, and referrals.…”

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Aging and Oral Health: Biological and Sociobehavioral Perspectives

Colombo

2023

J Dent Res

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As the life expectancy and growth of the aging population increase globally, efforts to promote healthy longevity become more important. Holistic policy guidelines and actions have been designed to advocate and fortify healthy aging at multiple levels. Oral health, a fundamental contributor of overall health and well-being, forms a core part of the noncommunicable disease agenda within the sustainable development goals set by the World Health Organization. Aging significantly heightens the risk of myriad oral disorders and other noncommunicable diseases. As of 2019, oral disorders accounted for 8.9 million disability-adjusted life-years in individuals older than 60 y. In addition to the development of multidisciplinary aging-friendly policies to promote healthy aging, basic biology and translational research has been encouraged that focuses on deciphering the underlying mechanisms involved in age-related physical and cognitive decline or dysregulation of oral tissues. Given the relevance of oral health aging as a critical component of the One Health Initiative, this special issue encompasses a collection of articles dedicated to recent advances in the behavioral and social implications of age-related oral diseases and tooth loss on several aspects of the quality of life of adults as they age. Furthermore, it includes articles detailing molecular mechanisms associated with cellular aging and their implications for oral tissue health, periodontal disease severity, and the regenerative potential of stem cells.

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Aging and Oral Health: Biological and Sociobehavioral Perspectives

Colombo

2023

J Dent Res

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Dentition and weight status in community‐dwelling older adults

Zelig,

Lyon,

Touger‐Decker

et al. 2024

Gerodontology

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Background/ObjectiveTooth loss is common among older adults and can affect dietary intake and weight status. This study investigated associations between dentition status and body mass index (BMI) in older adults.Materials and MethodsThis was a cross‐sectional study of data from a convenience sample of older adults (65–89 years) treated at an urban U.S. dental school clinic. Clinical and demographic data were obtained from electronic health records. Dentition status was determined based on data from odontograms. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of having a non‐normal weight status for each measure of dentition status, after adjusting for covariates.ResultsPatients (n = 1765) were 54.1% female, 51.5% White, 41.6% African American and 22.5% Hispanic/Latino. The median (interquartile range [IQR]) age was 71 (67.0–75.0) years; the mean (±SD) BMI was 28.5 (±5.7) kg/m2; 72.5% were overweight or obese. The median (IQR) number of remaining teeth was 20.0 (13.0–24.0); the median numbers of anterior and posterior occluding pairs of teeth were 5.0 (2.0–6.0) and 2.0 (0.0–5.0), respectively; and 44.9% had a functional dentition (≥21 teeth). Having a higher number of remaining teeth and more posterior occluding pairs were associated with lower odds of obesity (OR = 0.980, 95% CI = 0.964, 0.997, p = .022 and OR = 0.931, 95% CI = 0.885, 0.980, p = .006, respectively). Lack of a functional dentition was associated with higher odds of obesity (OR = 1.400, 95% CI = 1.078, 1.818, p = .012), after controlling for covariates.ConclusionOlder adults with tooth loss ‐ especially loss of posterior occlusion and lack of a functional dentition ‐ were more likely to be obese than of normal weight.

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Implementation of a 4Ms approach in age‐friendly oral health care at an Academic Specialty Care Dental Clinic

Arany,

Cavalcanti,

Phildor

et al. 2024

J American Geriatrics Society

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BackgroundImplementing the Age‐Friendly Health System (AFHS) framework into dental care provides a significant opportunity to link oral health to healthy aging. This project aimed to implement the AFHS 4Ms (what matters, medications, mentation, and mobility) in the provision of oral health care. This article describes the planning, integration, training development, and outcome measurements supporting a 4Ms approach at an academic dental clinic.MethodsThe Eastman Institute for Oral Health (EIOH) implemented screening instruments based on the 4Ms framework recommended for ambulatory care clinics by the Institute for Health Care Improvement (IHI). These ambulatory instruments were integrated into the workflows of a Specialty Care Clinic through the development of a plan–do–study–act cycle, utilization of available clinic resources, and creation of interdisciplinary collaborations.ResultsThis project demonstrated the feasibility of implementing an AFHS checklist and tracking forms in dental practice by integrating available resources and prioritizing the 4Ms elements. This effort necessitated interdisciplinary collaborations between dental, medical, and social service professionals. It also created a new age‐friendly focused education and training curriculum for dental residents and faculty.ConclusionsThis pilot project is the first to establish dental standards for AFHS implementation, adapting the 4Ms assessment and metrics to oral health. This AFHS underscores key oral health processes, including assessment, planning, and personalized oral health care, adapted to the unique needs of the older adult population, especially those with cognitive impairment.

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Integrating Oral Health into Primary Care: Perspectives for Older Adults

Cited by 4 publications

References 26 publications

Aging and Oral Health: Biological and Sociobehavioral Perspectives

Aging and Oral Health: Biological and Sociobehavioral Perspectives

Dentition and weight status in community‐dwelling older adults

Implementation of a 4Ms approach in age‐friendly oral health care at an Academic Specialty Care Dental Clinic

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