A rapidly growing elderly population needs more access to oral health care services, according to a recent report.

But progress is being made in some areas to better care for aging teeth.¹

The report A State of Decay, Vol. IV is the latest in a series published by Oral Health America (OHA) that surveys the state of oral health in older adults in the United States.

It found that 33% of older adults have lost 6 teeth or more, and sociodemographic factors play a critical role in oral health outcomes.¹

“Tooth loss and poor oral health are not inevitable during the aging process,” Karen Tracy, vice president of strategic alliances and integrated communications for the Gerontological Society of America, said in a statement.

Education, gender, income, and race all factor into oral health care, according to the report.

Twenty-five states received poor overall scores in the report, with Wyoming, Delaware, West Virginia, New Jersey, Arkansas, Texas, Oklahoma, Louisiana, and Tennessee receiving the least favorable scores. Earning “excellent” scores for oral health in older adults were Minnesota, Wisconsin, Iowa, Connecticut, and Colorado.¹

“Oral health for older adults is in fragile condition,” Caswell Evans, associate dean for prevention and public health sciences at University of Illinois at Chicago College of Dentistry, said in a statement.¹ “Oral health for seniors is important for their diet, nutrition, self-esteem, socialization, and freedom from pain, among many other benefits.”

Many older adults regularly use several OTC or prescription medications, or both, making them more vulnerable to adverse reactions, drug interactions, and medication errors, according to the American Dental Association (ADA).²

The most frequently taken OTC medications by older adults include analgesics, laxatives, vitamins, and minerals.²

The typical aging patient’s baseline health state can be compromised by comorbid conditions, such as diabetes mellitus and hypertension, as well as the physiological changes associated with aging.² Dental conditions associated with aging include coronal and root caries, dry mouth, and periodontitis.²

The ADA places a “seal of approval” on many OTC oral health products, including mouth rinses and toothpastes containing fluoride, and ingredients for combating bad breath, gingivitis, and plaque, as well as for teeth whitening. The organization has also placed its seal of approval on Sensodyne toothpaste for sensitivity control and on a variety of sugar-free chewing gums that help reduce cavities.

For relief of oral discomfort, the ADA recommends Benzodent Dental Pain Relieving Cream (Focus Consumer Healthcare) and Professional Strength Kank-A Mouth Pain Liquid (Blistex).² For a tooth that has been knocked out, the ADA has approved Save-A-Tooth (Phoenix-Lazarus), a device that keeps a tooth alive for 24 hours, until a dentist can replant it.³

In addition to OTC products for teeth, the ADA has recommendations for dentures, including adhesives and cleansers. Efferdent Anti-Bacterial Denture Cleanser (Complete Clean and Fresh & Clean), Efferdent Overnight Denture Cleanser, and Medtech Products’ Effergrip Denture Adhesive have all received the ADA seal of approval. They are joined on the ADA’s list by Adhesadent Denture Adhesive Cream (Dr. B Dental Solutions) and Fresh’n Brite Denture Cleaning Paste (Revive Personal Products).²

Adults 65 and older are expected to account for a greater patient population in dental practices in the coming years as the demographic increases in size.² Since the OHA’s previous report, in 2016, state advocates have implemented actions based on A State of Decay findings, and more states have commissioned surveys to better measure older adults’ oral health. State oral health plans (SOHPs), such as those recently implemented in Alabama, California, Iowa, and Mississippi, have increased the percentage of people in areas served by community water fluoridation and are covering a larger number of adult dental services under Medicaid.¹

In addition to SOHPs, some states, including California and Iowa, are offering support for all 13 common dental benefits for Medicaid beneficiaries 65 years and older.¹ Other entities, such as the University of Alabama (UA) at Birmingham School of Dentistry, are creating local programs to enact further oral health improvements. The UA program is reaching into some of its more rural and vulnerable communities.¹