Taking care of your teeth is important at every age. But it’s perhaps especially true for those getting older.
Poor dental care can mean tooth loss and gum disease. It can mean avoiding pain by avoiding fresh fruits and vegetables. It can mean difficulty speaking or bad breath or, simply, feelings of embarrassment and low self-esteem.
According to the Centers for Disease Control, the number of U.S. adults 65 or older is expected to reach 98 million — 24% of the total population — by 2060. The American Dental Association expects the older adult demographic to become “an increasingly large part of dental practice in the coming years.”
Creighton University is preparing a new generation of dentists to meet the needs of these patients head-on.
Since starting at Creighton, Teryn Sedillo, DDS’14, resident assistant professor in the School of Dentistry who completed a residency in geriatrics and special care, has been working to incorporate more clinical work and classroom material on caring for older patients into the dental school curriculum.
“I’m an alumna of the dental school, and I had noticed particular gaps in my education,” says Sedillo. “Now, we’re incorporating different experiences in geriatrics and special care for all four years of dental school.”
The material is peppered throughout the dental school curriculum. Senior students, Sedillo says, will take a class that specifically trains them in special-care best practices.
Through partnerships with community organizations, Creighton’s dental students are now able to receive hands-on training in treating these targeted demographics while also providing dental care to those who need it, Sedillo says. Most recently, the dental school has partnered with the Douglas County Health Center’s long-term care facility, and all seniors will rotate through working at the facility in a clinical capacity.
The partnerships are sustained by grants, private support and contracts, so the University can provide dental care without billing the patients, Sedillo says.
“In that way, we can act as a pipeline for these other outside organizations to send their vulnerable populations into the dental school,” she says. “It’s Creighton’s way of giving back to the community.”
Such partnerships give Creighton dental students the opportunity to learn to treat the unique oral health challenges facing older adults. About 1 in 5 older adults suffer from untreated tooth decay, according to the CDC. About 68% of those 65 or older have gum disease. And the risk of partial or complete tooth loss increases with age, which can cause a decline in nutrition and overall health.
In addition, many older people take over-the-counter medications that can lead to chronic dry mouth, exacerbating the risk of cavities and oral disease.
In some cases, Sedillo says, common oral health conditions can lead to more serious medical problems. Experts have found a link between gum disease and heart disease, for example. Another concern, particularly for older adults living in institutions or long-term care facilities, is aspiration pneumonia, caused by inhaling plaque or other bacteria-laden debris into the lungs.
All of this means that Creighton’s dental students need to be keenly aware of the special circumstances surrounding older patients, including their baseline health, what kind of medications they’re taking, and living environment, Sedillo says.
“They need to know how to handle the social complexities of aging,” she says. “They need to know how to handle medical emergencies. They need to know what the risk is of rapid oral health decline. They need to know safe and appropriate accommodations, how to communicate with caregivers, changes in health policy as well as (issues surrounding) consent for treatment in cases of cognitive decline.”
Sedillo also emphasizes the importance of dental students working collaboratively with other health care providers, such as primary care physicians.
“That is something the students are going to need to rely on more heavily with this change in population demographic,” she says. “The interprofessional approach is going to be the best way to maximize patient benefit for successful aging.”