Health Policy$ense

Meeting the Oral Health Needs of an Aging Population

The case for changes in policy and training

An important, yet often overlooked aspect of comprehensive health care for a “graying” U.S. population is dental health. In a new commentary, Tim Wang, Mark Wolff, and Neeraj Panchal bring attention to the oral health needs of a growing geriatric population in the U.S., and suggest practical ways to prepare providers to meet the challenge of treating this unique group.

Wang and his coauthors point out two major barriers to geriatric dental care. For older adults, out-of-pocket costs for dental care can be particularly burdensome. Dental benefits through employer-sponsored insurance end with retirement, and Medicare does not cover most dental services. Second, this population tends to be more medically complex, heightening the risks associated with invasive procedures. While most predoctoral dental programs require didactic courses involving geriatric dentistry, only a little over half require clinical training, resulting in an “expertise gap” among oral health providers in managing the care of this population.

Among dental providers, the authors explain, oral and maxillofacial surgeons (OMSs) perform relatively costlier, more invasive procedures, and thus are well-positioned to kickstart a conversation about dental care for older adults. Within the dental field, the specialty can work to develop evidence-based guidelines for managing the care of older adults, which can then be used to train residents and inform practicing surgeons. Residency programs can give trainees more exposure to the geriatric population by incorporating rotations within the Veterans Affairs health system. Externally, OMSs can advocate for policy changes to meet the changing dental health needs of older adults, including adding dental benefit packages to Medicare, or increasing Medicaid reimbursement rates for certain dental procedures.

Read the full commentary here.

The Perspective, “The Graying of America: Considerations and Training Needs for Geriatric Patient Care,” was published in the Journal of Oral and Maxillofacial Surgery.

Authors:
Tim Wang is an LDI Associate Fellow, DMD candidate at Penn Dental, and MPH candidate at the Perelman School of Medicine.
Mark Wolff, DDS, PhD, is Morton Amsterdam Dean and Professor at Penn Dental.
Neeraj Panchal, DDS, MD, MA, is Assistant Professor of Oral and Maxillofacial Surgery at Penn Dental.