Dentists Go Mobile for Senior Living

Between heart issues, diabetes, Alzheimer’s and more, there are plenty of health-related ailments to manage when it comes to residents in senior living. In such a crowded playing field, seniors’ oral hygiene can fall to the wayside.

Transportation to and from dentist offices, for one, proves problematic for senior living residents, as the task typically falls on their adult children. And costs can deter the receipt of such services, as well, since Medicaid’s dental coverage varies greatly by state and Medicare doesn’t cover most routine dental care or procedures. In fact, one out of every five people over age 75 haven’t seen a dentist in the past five years, according to the American Dental Association.

Some organizations claim to have found an innovative solution to the problem: Bringing dentists to the seniors rather than the other way around.

Treating an Aging Population

There are currently about 7,000 geriatricians practicing in the United States today, the New York Times reported, and the American Geriatrics Society estimates that medical schools will need to cultivate at least 6,250 additional geriatricians between now and 2030 to meet the demands of a rapidly aging population. Stats are perhaps even more dire for dentists trained in geriatrics, according to a 2013 study.

“Many dentists believe that their dental education did not adequately prepare them to treat an older adult population,” the abstract states. “Dental schools should work to incorporate clinical experience into geriatric education to prevent widening an existing gap in older adult oral health care.”

The School of Dental Medicine at Case Western Reserve University in Cleveland, Ohio had been looking to add a geriatric component with hands-on experience to its curriculum for a few years, both as a way of providing dental care to older adults without access to it and educating students on the complexities of treating this subset of the population. After much preparation and planning, the state of Ohio donated a 38-foot RV, the school provided dental chairs, and a mobile dentistry program rolled out in July.

“We had this vision of trying to get out to the elderly, because they can’t get to us,” says Dr. Suparna Mahalaha, co-director of the university’s geriatric dental program.

Students take the van out between two and four times each week to two different McGregor PACE (Programs of All-Inclusive Care for the Elderly) facilities, which provide community-based services for older adults. In addition to the PACE centers currently served by the mobile dentist service, McGregor operates a continuing care retirement community (CCRC) spanning 32 acres in the Cleveland area.

The mobile dentistry program accepts Medicaid if the patients have it; otherwise, they’re charged a reduced rate for any dental services provided.

Aside from the visits, students spend a lot of time learning how to manage these patients, discussing different medications and exploring various courses of action, Mahalaha says.

“Treating seniors requires a lot more patience and compassion, and you have to navigate a patient’s medical history and their conditions,” she says. “How do you consider that when putting together a treatment plan?”

Seniors at McGregor PACE appreciate the visits, says Joy Stokes, the organization’s medical secretary, and there’s a lengthy waiting list to be seen by a dentist.

“It’s a little more convenient, because they come to us, which is where they spend the most of their time,” she says.

Dental Care on the Go

Senior Mobile Dental takes a different approach to providing oral health care for seniors.

“We don’t travel with a van or motorhome,” says Michelle Vacha, founder and executive director of Senior Mobile Dental, based in Colorado Springs, Colorado. “We have portable equipment that we bring directly into the location.”

Every state has different laws governing dental providers, Vacha says, and in Colorado, hygienists can work independently from dentists. So hygienists serve as the first point of contact for the seniors served, administering cleanings and general hygiene assessments.* After collaborating with dentists and if follow-up care is necessary, Senior Mobile Dental arranges appointments and makes sure that seniors get there.

Senior Mobile Dental 5

To date, Vacha estimates that the nonprofit has seen about 600 seniors since services began in 2007. The Colorado organization now works with seven skilled nursing and long-term care facilities, and a chapter has started up in Minnesota, where they have more than 100 contracts with various communities.

“We’ve been able to grow successfully as the attention to the needs of seniors’ oral health care has grown,” Vacha says. “[Senior Mobile Dental] was developed for replication.”

For facilities that work with Senior Mobile Dental, like CCRC Medalion Retirement Community in Colorado Springs, the response has been profound, and the services address a largely unmet demand.

“It was an answer to a prayer,” says Jan Hall, a former medical social worker at Medallion who established the community’s relationship with Senior Mobile Dental. “They brought it right to the facility, had recommendations for what kind of follow-up care they would need and took care of cleanings.”

And overall, the goal with Senior Mobile Dental is to integrate care, with medical and dental professionals looking at patients collaboratively.

“It goes back and forth,” Vacha says. “If someone is in poor physical health, they have poor oral health, and vice versa. My philosophy is, these people have maintained their oral health their entire lives, so why should their standard of care change just because they’re living in a long-term care facility?”

Written by Kourtney Liepelt

*The story has been corrected from a previous version, which stated that hygienists conducted general checkups. Rather, they administer initial assessments and later collaborate with dentists on next steps.