Aging Virginians need dental care

Published 9:39 pm Friday, July 25, 2014

By Dr. Ted Sherwin

It’s no secret that a healthy body starts with a healthy mouth.

That is abundantly clear when you look at the teeth and gums of many nursing home residents in Virginia, the vast majority of whom receive no dental care, because Medicaid does not pay for it. As a result, many of these individuals develop infections and other conditions that must be treated in hospitals, at much greater expense to Virginia taxpayers.


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This is not just a problem in the Old Dominion, which has 29,000 nursing home residents, 60 percent of whom are on Medicaid. Dr. Sarah J. Dirks, a dentist who treats nursing home residents in San Antonio, told the New York Times in 2013 that the lack of daily oral care in nursing facilities is “an epidemic that’s almost universally overlooked.”

The fact is that losing teeth is not necessarily an inevitable result of age.

The number of people who have lost most or all of their teeth (edentulism) has decreased steadily over the years. Without regular dental care as we age, however, the teeth and gums are increasingly vulnerable to disease. And the overall health consequences of poor oral care can be life-threatening.
There may be a solution that will help relieve pain and discomfort for nursing home residents, while reducing hospital stays. A Virginia Dental Association task force on this issue recently developed a pilot program that would place oral health coordinators in nursing homes, provided grants can be secured.

These auxiliary dental workers would identify patients at risk and coordinate care with community providers before there is a need for emergent treatment. Prevention is the key.

Seniors deserve a chance to live their lives free of pain, dental disease and other serious problems that can arise when oral health is neglected. We believe this project will also show policymakers that disease prevention is less costly than disease treatment.

To gather the data to support this expenditure, the VDA, along with the Virginia Dental Hygienists’ Association and the Virginia Health Care Association, which represents the state’s nursing homes, conducted a pilot project recently in Richmond.

On a single day in June, volunteer dentists and hygienists screened patients throughout the Envoy of Westover Hills nursing home. I was there, and it was heartbreaking to see seniors in need of extensive dental care.

We found loose teeth, poorly fitting dentures, cavities and infected gums, which make life so difficult and painful that some residents stop socializing and even eating, leading to malnourishment and assorted ensuing debilitating health problems. The fact that some patients have dementia contributes to the challenge, because many resist oral care, clenching their mouths and trying to hit aides.

Trained practitioners can manage that problem if there is a will to help aging citizens have a high quality of life in their final years.

In addition to providing dental care to those in need, the pilot program also could help save taxpayer dollars through reduced Medicaid expenditures on hospital visits resulting from lack of regular dental care.

Virginia now spends $4.1-billion per year, or about 20 percent of its general fund, on Medicaid, and that figure is growing at 8 percent a year. Saving money should be a priority for lawmakers across the state. We agree, and the way to reduce the cost on the back end is to invest in more prevention on the front.

It starts in the mouths of Virginia’s seniors.

Dr. Ted Sherwin is president of the Virginia Dental Association. Email him at