Innovations in Geriatric Oral Health Care.

Older adults are retaining their teeth and need strategies for a lifetime of oral health care. Daily prevention and professional preventive care have the most significant impacts on reducing oral disease in the aging population. Providers of oral health care extend beyond traditional dental professionals to include caregivers and health care providers through teledentistry and interprofessional collaboration. Dental and aging organizations advocate for the inclusion of a dental benefit in Medicare to address access to care. Innovations in geriatric oral health care involve advances in clinical oral health care, delivery and models of care, funding, research, education, and policy.

Innovations in Geriatric Oral Health Care.

Older adults are retaining their teeth and need strategies for a lifetime of oral health care. Daily prevention and professional preventive care have the most significant impacts on reducing oral disease in the aging population. Providers of oral health care extend beyond traditional dental professionals to include caregivers and health care providers through teledentistry and interprofessional collaboration. Dental and aging organizations advocate for the inclusion of a dental benefit in Medicare to address access to care. Innovations in geriatric oral health care involve advances in clinical oral health care, delivery and models of care, funding, research, education, and policy.

Dallas County Dental Society: a tradition of integrity and care since 1908.

The Dallas County Dental Society is approaching 100 years of service to dentists and patients. Begun with a focus on continuing education, the society now manages the large and successful Southwest Dental Convention. Member services, community programs, and leadership are among the hallmarks of the society. Its driving force has been a sustained effort on strategic planning and its implementation.

Envisioning success: the future of the oral health care delivery system in the United States.

The elimination of oral health disparities in the US will require enhancing access to oral health care services. The workshop convened in 2009 by the Institute of Medicine on the "US Oral Health Workforce in the Coming Decade" highlighted both the current workforce's failure to meet the nation's needs as well as the promising opportunities presented by various workforce strategies to significantly enhance access and improve oral health outcomes. In this article, we have briefly reviewed and expanded on the contributions in this special issue of the Journal of Public Health Dentistry, with the goal of identifying common themes and providing a framework for evaluation. There are several key areas where change is critically needed in order to ensure successful implementation of any new workforce models. These areas include a) the public and private financing of dental care, b) the dental educational system, and c) state and federal policies.

From the laboratory to the operatory.

The market for dental technology is expected to continue its growth, but to change in direction toward products based on biology. As the dental industry considers potential new technologies, it must consider the following components in the development process: patent protection of concepts, the clinical relevance of innovations, an overall business plan, the regulatory environment, manufacturing issues, testing required by the Food and Drug Administration, and marketing. The theory of diffusion of innovations proposed by Everett Rogers can be used to predict characteristics of technologies that will diffuse quickly and those users who will adopt innovations quickly or reluctantly.

Oral health for people with special needs: consensus statement on implications and recommendations for the dental profession.

In November 2004, the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry, with support from the California Dental Association Foundation, hosted a conference to explore the issue of oral health for people with special needs. This conference was held in conjunction with the joint meetings of Pacific's Statewide Task Force on Oral Health for People With Special Needs and Pacific's Statewide Task Force on Oral Health and Aging. These groups of interested stakeholders meet several times a year to discuss the increasing problems faced by people with disabilities, elderly individuals, and other special populations in obtaining access to oral health services and maintaining good oral health. The purpose of this conference was to explore the changing population of people with special needs, analyze the implications for the dental profession and society, and describe systems and strategies that might lead to improved oral health for these populations. This conference also served as a forum for developing oral health recommendations as a part of the California Commission on Aging's Strategic Plan for an Aging Population. Seven nationally recognized speakers presented draft papers on various aspects of this topic. These presentations are published as the additional papers in this and the next issue of the Journal. There was time for audience reaction and discussion with the speakers. The speakers and a designated group of reactors then developed this consensus statement and recommendations for addressing these issues.

Older adults--implications for private dental practitioners.

Currently, 35 million people are over the age of 65 in the United States. This number is expected to double to 70 million by 2030 (Figure 1). In California, 3.7 million people are over the age of 65, and this number is expected to increase to 6.4 million in the next 20 years or within the practice lifetime of students presently enrolled in California's dental hygiene and dental schools. The oldest old, those over age 85, are the fastest-growing segment of the United States and California's population. California's aging population will reflect the diversity of the state in general. Table 1 lists California's 65-plus population by age and ethnic/racial categories. By 2030, one in five Americans and Californians will be 65 years or older. Women who reach age 65 can expect to live an additional 19 years of life, while men can expect to live an additional 16 years. The gap in life expectancy between men and women is narrowing due to improvements in medical care, preventive health services, and healthier lifestyles. Figures 2-4 show the improvements in life expectancy at birth, age 65, and age 75 for the U.S. population. In the United States, there are an estimated 1.8 million nursing home beds used by 80 percent of the residents over age 65. A report by the U.S. General Accounting Office estimated that 43 percent of all Americans over age 65 will reside in a nursing home at some time in their life. California currently has approximately 100,000 residents living in one of the 1503 nursing home facilities throughout the state. Nursing home care in California accounts for 5.6 billion dollars. In 1998, the U.S. General Accounting Office reported that one in three California nursing homes was cited for serious or potentially life-threatening care problems. With an aging imperative in California, this paper will discuss the implications of an aging society on maintaining oral health throughout one's life, and the ability of dental professionals to meet the oral health needs of this population.

Quantification of patient fears regarding dental injections and patient perceptions of a local noninjectable anesthetic gel.

Data have shown that 30% of all Americans do not seek dental care and/or treatment unless a problem arises that causes them severe pain. Similar study results have been found in Europe as well. While some studies indicate that cost concerns prevent people from seeking dental care, the fear of pain has been identified as a factor in keeping people from seeing a dentist. A random sample of US and European patients who had recently undergone a scaling and root planing procedure was surveyed via telephone interview to quantify data on patient concerns and fears regarding anesthesia administered by injection, as well as to determine patient interest and price perception of an anesthetic gel product. The survey also provided data on the patient's experience and perception about the scaling and root planing procedure. Responses from the study population showed that patients find the injection painful and do not like the prolonged numbness. Additionally, based on the patients surveyed, they experience injection anxiety before appointments, and a significant number of them cancel appointments or simply do not seek treatment because they are afraid of the injection. Finally, the study also demonstrated that, while not eliminating dental anxiety completely, the availability of a new noninjectable anesthetic would assist in relieving patient fear, with almost half of the patients surveyed being more likely to seek treatment if only the new noninjectable anesthetic was used. Additionally, most patients surveyed would be willing to pay for the noninjectable anesthetic out of their own pockets if it was not covered by their health insurance.