A recent survey of nursing homes in Kansas revealed that one-third of residents had lost all of their natural teeth, according to the Kansas Bureau of Oral Health and Oral Health Kansas.
“When a person loses all of their natural teeth, it affects their appearance and their ability to eat and speak,” the report said. “An additional 43.7 percent had lost some, but not all of their teeth. This is significantly higher than the 17.4 percent of seniors living independently in the community who have lost all of their natural teeth.”
The survey, based on a nationally recognized protocol, included 540 Kansas elders living in 20 nursing homes and consisted of a clinical oral health screening and a resident questionnaire.

Key Findings

■ Residents had significant dental care in the past, but now have untreated dental disease. More than one-third of nursing facility residents had untreated dental decay. “The screeners noted a large amount of past dental work (crowns, bridges, partial dentures) in the residents’ mouths. This indicates past access and investment in professional dental care,” the report said. “The presence of current untreated dental disease suggests that this level of care has not continued in their current life situation.”

■ Residents had poor oral hygiene. Daily brushing and flossing removes the bacteria and plaque that irritates gums and leads to inflammation (gingivitis) and periodontal disease. Twenty-six percent of surveyed residents had severe gingival inflammation, meaning that the gums were swollen, bleeding, and/or painful. Twenty-nine percent had substantial oral debris on at least two-thirds of their teeth, and 15 percent of the residents had natural teeth that were loose. Taken together, these indicators suggest that many residents are not removing the plaque and bacteria from their teeth on a regular basis.

■ Residents have limited financial resources for dental care. Medicare does not cover preventive and restorative professional dental services or dentures. Kansas Medicaid offers minimal dental benefits for adults. Sixty-six percent of the residents surveyed were on Kansas Medicaid. Professional dental care is an out-of-pocket expense for most seniors, and this is a barrier to care for many on limited incomes.
Given these findings, the report recommends that residents receive daily preventive care, improved access to oral care be created via additional mobile programs in nursing homes, and the sustainability of the programs be ensured through a reliable payment source.
“Nursing facilities must monitor residents to ensure they are receiving adequate daily oral care and to identify oral health needs that require professional attention,” the report said. “Access to dental professionals must be physically and financially feasible. All three components are necessary to see impactful and sustainable improvement in the oral health of this population.”
Source: “Elder Smiles 2012: A Survey of the Oral Health of Kansas Seniors Living in Nursing Facilities,” Kansas Bureau of Oral Health, Kansas Department of Health and Environment, Topeka, Kan.