According to the Centers for Disease Control and Prevention, by the year 2030, the number of Americans age 65 years and older will reach 71 million, approximately 20% of the U.S. population. This demographic transition will bring the oral health of older adults to the forefront, mainly due to the impact of oral health on general health status. Oral health problems such as inflammatory diseases and tooth decay are linked to cardiovascular disease, type 2 diabetes, respiratory disease, and cancer.
According to the National Health and Nutrition Examination Survey (NHANES) 1999 –2002, the prevalence of tooth decay in the permanent teeth of dentate adults 60 years of age and older was 93%; root decay was 32% and untreated decay was 19%. Prior to the initiation of the New Hampshire Statewide Senior Oral Health Survey there are no data on the prevalence of adult tooth decay experience, untreated decay and periodontal disease among older adults in New Hampshire. This constituted a major gap in New Hampshire’s oral health surveillance system.
To begin to address this gap, New Hampshire conducted a self-administered survey among older adults in six centers in 2009 to assess perceptions related to oral health and access to oral health services. In 2012, New Hampshire received NACDD funding to conduct a small scale surveillance project in which the Association of State and Territorial Dental Directors' Basic Screening Survey (BSS) tool for Older Adults was used to collect additional oral health data from older adults in the same six senior centers. In 2013, the New Hampshire Department of Health and Human Services, Oral Health Program reported the results of the oral health pilot project and received additional funding from NACDD to assess the oral health of older adults in 25 randomly selected senior centers and congregate meal sites statewide.
Nine dental hygienists were trained to use the BSS for Older Adults tool and to uniformly evaluate the older adults’ oral health status. During a brief visual screening, the hygienist assessed denture use, presence of tooth decay, untreated decay, gingivitis, root fragments, suspicious soft tissue lesions, teeth mobility, and need for dental treatment. Survey participants completed a short self-administered questionnaire related to their background, dental care, dental insurance, smoking, and whether they participated in the Commodity Supplemental Food Program (CSFP). Any survey participant that was identified as needing urgent dental care or presenting with a suspicious soft tissue lesion was referred to one of the collaborating dentists for treatment.
Altogether, 610 adults 60 years old and older attending 25 senior centers and congregate meal sites participated. Sixteen percent were edentulous (without teeth) and 42 percent reported having a removable upper or lower denture. Among edentulous adults, 5 percent had no dentures at all. Among 513 dentate participants, 22 percent had untreated tooth decay, 14 percent had root fragments, 9 percent had gingivitis, and 7 percent presented with obviously mobile teeth. Overall, 19 percent required early or urgent dental care. Differences were detected by sex, age group, urban versus rural location of the site, and by the participation in a federal nutritional program for older adults.
Date gathered during this project provide baseline information about oral health needs of older adults in New Hampshire that will be addressed through the collaboration of public and private partners.