Oral Health in Late Life: Challenges and Solutions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 414-415
Author(s):  
Xi Chen ◽  
Bei Wu ◽  
Stephen Shuman
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Dental Care ◽  
Healthy Aging ◽  
Care Delivery ◽  
Chinese Americans ◽  
Foreign Born ◽  
Treatment Needs ◽  
Unique Challenge ◽  
The Impact

Abstract Older adults face a unique challenge in maintaining their oral health due to an increased disease burden, polypharmacy, functional impairment and other reasons. The five papers in this symposium describe the oral health issues in various groups of older adults and discuss different approaches to improve oral health for older adults. Using data from the Population Study of Chinese Elderly in Chicago, the first paper examined the relationship between self-reported discrimination and oral health related quality of life and investigated how resilience mediated such a relationship among foreign-born older Chinese Americans. The second paper described the oral health concerns and related treatment needs in older adults receiving palliative care using a mixed method design. The third paper demonstrated how to use behavior change techniques to improve oral self-care skills of individuals with mild dementia and support their family caregivers. The fourth paper described a project that integrates the age-friendly health system's principles into specialty dental care to address healthy aging and oral health. This initiative helped prevent and change the false belief that aging inevitably involves deterioration in oral health. The fifth paper described the impact of COVID-19 on the management of oral health problems and access to dental care in older adults. Transformative changes in care delivery and the impact of vaccination on access to care was also explored. This symposium helps better understand the oral health needs in older adults and provides new evidence to improve oral health for these individuals.

scholarly journals Social and Behavioral Factors, Oral Health, and Dental Care Utilization

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 799-800
Author(s):  
Bei Wu ◽  
Stephen Shuman ◽  
Elisa Ghezzi
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Oral Health ◽  
Health Outcomes ◽  
Dental Care ◽  
Care Utilization ◽  
Behavioral Factors ◽  
Dental Care Utilization ◽  
The Impact ◽  
The U.S

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.

scholarly journals Immigrant Status, Resilience, and Perceived Oral Health Among Chinese Americans in Hawaii

2020 ◽  
Vol 42 (5-6) ◽  
pp. 186-195
Author(s):  
Bei Wu ◽  
Yaolin Pei ◽  
Wei Zhang ◽  
Mary Northridge
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Chinese American ◽  
Chinese Americans ◽  
Ordinary Least Squares ◽  
Health Problems ◽  
Least Squares Regression ◽  
Immigrant Status ◽  
Foreign Born ◽  
Targeted Interventions

Objectives: This study aims to examine the associations among immigrant status, resilience, and perceived oral health for Chinese American older adults in Hawaii. Method: Data derived from 430 Chinese American adults aged 55 years and older residing in Honolulu, HI. We compared the self-rated oral health and oral health problems between U.S.-born Chinese Americans and foreign-born Chinese Americans by using ordered logistic regression and ordinary least squares regression models. Results: Findings suggest that immigrant status and lower levels of resilience are associated with poorer self-rated oral health and more oral health problems for Chinese American older adults in Hawaii. Resilience is more strongly associated with self-rated oral health for U.S.-born Chinese American than for foreign-born Chinese Americans, but this pattern was not evident for oral health problems. Discussion: Older Chinese American immigrants in Hawaii are disadvantaged in terms of their oral health. Understanding their susceptibilities may lead to targeted interventions.

scholarly journals THE MODERATING ROLE OF BIRTHPLACE ON DENTAL CLEANING SERVICE AMONG CHINESE OLDER ADULTS IN HAWAII

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S607-S607
Author(s):  
Sizhe Liu ◽  
Wei Zhang ◽  
Keqing Zhang ◽  
Bei Wu
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Foreign Born ◽  
Dental Services ◽  
Chinese Older Adults ◽  
Birth Place ◽  
Logistic Regressions ◽  
The Impact ◽  
Moderating Role

Abstract Regular dental cleaning is vital to maintaining good oral health. This study aims to identify socio-demographic characteristics that are associated with the use of dental cleaning services among Chinese older adults in Honolulu, Hawai’i. In addition, we examine if birth-place moderates these associations. The data for this study were collected from 398 Chinese older adults living in Honolulu. Results from multivariate logistic regressions showed that those who were married and with higher levels of education were more likely to have their teeth cleaned within the past year compared to those who were not married or with lower levels of education. These significant associations were only found salient for the foreign-born when the moderating role of birth place was accounted for in the model. These differences may be partially due to the impact of acculturation and the knowledge of oral health and dental services.

scholarly journals Oral Health, Cognitive Function, and Mortality: Findings From National Surveys

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 206-206
Author(s):  
Bei Wu ◽  
Susie Keepper ◽  
Michèle Saunders
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Ethnic Groups ◽  
Dental Care ◽  
National Surveys ◽  
New Findings ◽  
The Impact ◽  
Racial Ethnic

Abstract Poor oral health, diabetes mellitus (DM), and cognitive impairment are common problems in older adults. Using national surveys, this symposium aims to present new findings regarding the impact of the co-occurrence of DM and poor oral health on cognitive function, cognitive decline, and mortality. This symposium will also cover the topic of dental care use among adult populations in the U.S. Using data from the Health and Retirement Study (HRS) (2006- 2018), the first study shows that adults with both DM and edentulism had the worst cognitive function, followed by those with edentulism alone, and those with DM alone. Using the same HRS data, the second study found that co-occurrence of DM and edentulism had a higher risk of more rapid cognitive decline with advancing age than the presence of each condition alone. The third study used data from the 2006-2016 HRS linked with mortality files, and revealed that the risk of diabetes and edentulism on mortality may vary across racial/ethnic groups. Using the Behavioral Risk Factor Surveillance System survey (2002-2018), the fourth study examined disparities of dental service utilization among racial/ethnic groups (Whites, Hispanics, Blacks, Asians, American Indians or Alaska Natives, and Native Hawaiian or other Pacific Islanders). Age differences in dental services were also compared between older adults and other younger and middle-aged populations. This symposium highlights the role of oral health in improving cognitive health. Policies and programs are needed to increase dental care access, a critical way to help maintain good oral health.

scholarly journals THE IMPACT OF DIABETES AND POOR ORAL HEALTH ON COGNITION: IMPLICATIONS TO IMPROVE DENTAL CARE ACCESS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S607-S607
Author(s):  
Bei Wu ◽  
Huabin Luo
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Cognitive Function ◽  
Dental Care ◽  
Tooth Loss ◽  
Interaction Effects ◽  
Negative Effects ◽  
Care Access ◽  
The Impact ◽  
The U.S

Abstract This study examined the joint effects of diabetes and poor oral health on cognitive function among older adults aged 60 years or older in the U.S. We analyzed data of 2,937 participants from the National Health and Nutrition Examination Survey (2011-2014). We investigated the interaction effects between diabetes and significant tooth loss, i.e. differences among the following four groups: 1=neither of the two conditions, 2=non-diabetic but with tooth loss, 3=diabetic but no tooth loss, and 4=both conditions. Significant interaction effects were found in our study. Having either diabetes or significant tooth loss was associated with lower cognitive function. When the two conditions were both present, the negative effects were much stronger than the total effects from either one of the two conditions. The additional loss of cognitive function resulting from multiple health conditions illustrates the importance of improving access to dental care for older adults in the U.S.

scholarly journals Perceptions of Two Older Adults Regarding the Factors and Barriers that Influence their Oral Health Care: A Case Study

2021 ◽  
Author(s):  
Dinorah Munira Hernandez-Santos ◽  
Irma Fabiola Diaz-Garcia
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Structured Interview ◽  
Oral Health Care ◽  
Current Status ◽  
Care Needs ◽  
The Impact

This paper presents the results of a case study about the perceptions of oral health care, factors that influenced current oral health, and barriers to dental attention of two older adults; the study was conducted by researchers from a hospital-school of dentistry at a public university in Mexico. Two adults aged 64 and 70 years participated in this study. First, the oral health status was clinically evaluated using the Decayed/Missing/Filled/Teeth (DMFT) Index. A semi-structured interview was then conducted to learn about the perceptions of oral health care. Thematic content analysis was used to explore the data obtained using the ATLAS.ti software 7.0 version. Four main themes and their subthemes were developed. The main finding of the case study was that oral health was directly and strongly associated with the impact that it has on a participant's life, especially in the functional field of chewing. Also, the participants recognized the importance of having good oral health and see it as a necessity for living. Aspects that influenced the current status of oral health were mainly the care received during their childhood, as well as the previous dental beliefs and treatments. Finally, some of the perceived barriers to dental care treatment were lack of time, finances, and education. These findings challenge professionals to be more sensitive to past and current experiences of older adults at the time of receiving dental care. Knowing their perceptions can support health professionals to strengthen patients’ commitment to prioritizing oral health care needs.

Acculturation and Subsequent Oral Health Problems Among Foreign-Born Older Chinese Americans: Does Neighborhood Disorder Matter?

2021 ◽  
pp. 016402752110187
Author(s):  
Weiyu Mao ◽  
Bei Wu ◽  
Iris Chi ◽  
Wei Yang ◽  
XinQi Dong
Keyword(s):  
Oral Health ◽  
Chinese Americans ◽  
Health Problems ◽  
Community Dwelling ◽  
Neighborhood Disorder ◽  
Foreign Born ◽  
Lagged Dependent Variable ◽  
Older Chinese ◽  
Older Chinese Americans

Objectives: To investigate the relationship between acculturation and subsequent oral health problems in older Chinese Americans and to further test the moderating role of neighborhood disorder in such a relationship. Methods: The working sample included 2,706 foreign-born community-dwelling older Chinese Americans aged 60 years or older who participated in the Population Study of Chinese Elderly in Chicago at baseline between 2011 and 2013 and the 2-year follow-up between 2013 and 2015. Stepwise Poisson regressions with lagged dependent variable were conducted. Results: Behavioral acculturation was protective against subsequent oral health problems, and the protective role was stronger among individuals reporting lower levels of neighborhood disorder. Residence in Chinatown was associated with an increase in the risk of subsequent oral health problems. Discussion: To reduce oral health symptoms and related burdens, it is important to consider, in practice and policy, the role of acculturation and the neighborhood on subsequent oral health outcomes.

scholarly journals A Cross-Sectional Analysis of Oral Health Spending Over the Lifespan in Commercial and Medicaid Insured Populations

2021 ◽  
Author(s):  
Eric Tranby ◽  
Julie Frantsve-Hawley ◽  
Myechia Minter-Jordan ◽  
James Thommes ◽  
Matt Jacob ◽  
...  
Keyword(s):  
Oral Health ◽  
Oral Cancer ◽  
Dental Care ◽  
Care Delivery ◽  
Health Spending ◽  
Dental Service ◽  
Fee For Service ◽  
Cross Sectional ◽  
Medical Spending ◽  
Ibm Watson

Background: Life course theory creates a better framework to understand how oral health needs and challenges align with specific phases of the lifespan, care models, social programs, and changes in policy. Methods): Data are from the 2018 IBM Watson Multi-State Medicaid Marketscan Database (31 million claims) and the 2018 IBM Watson Dental Commercial and Medicare Supplemental Claims Database (45 million claims). Analysis compares per enrollee spending fee-for-service dental claims and medical spending on dental care from ages 0 to 89. Results: Dental utilization and spending are lower during the first 4 years of life and in young adulthood than in other periods of life. Stark differences in the timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations. Conclusions: This unique lifespan analysis of the U.S. multi-payer dental care system demonstrates the complexities of the current dental service environment and a lack of equitable access to oral healthcare. Practical Implications: Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the lifespan.

Determining the Long-Term Effectiveness of a Group-Based Physical Activity Program

2018 ◽  
Vol 20 (3) ◽  
pp. 401-408
Author(s):  
Anamica Batra ◽  
Richard C. Palmer ◽  
Elena Bastida ◽  
H. Virginia McCoy ◽  
Hafiz M. R. Khan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Healthy Aging ◽  
Population Level ◽  
The United States ◽  
South Florida ◽  
Community Based ◽  
Evidence Based Programs ◽  
The Impact

Objective. In 2015, only half (48%) of older adults in the United States (≥60 years) reported engaging in any kind of physical activity. Few studies examine the impact of evidence-based programs when adopted in community-based settings. The purpose of this study is to assess the effectiveness of EnhanceFitness (EF) upto 12-months. Method. EF was offered to older adults in South Florida. A total of 222 EF classes were offered between October 2008 and December 2014. Program consisted of a 1-hour session held three times a week. Even though participation was required for 4 months, 1,295 participants continued the program for at least 1 year. Results. All participants showed significant improvement in outcome measures. A mean change of 1.5, 1.7, and 1.9 was seen in number of chair stands at 4, 8, and 12 months (p < .001), respectively. The number of arm curls performed improved from 16.8 at baseline to 18.8, 18.8, and 19.2 at 4-, 8-, and 12-months, respectively. Participants improved their up-and-go time by decreasing from 9.1 (baseline) to 8.7 (4 months) to 8.6 (12 months; p = .001). Discussion. Randomized controlled trials are commonly used to determine the efficacy of an intervention. These interventions when disseminated at the population level have the potential to benefit large masses. EF is currently offered at more than 700 locations. This tremendous success of EF brings attention to an important question of continuous monitoring of these programs to ensure program consistency and intended outcomes. The model used by the Healthy Aging Regional Collaborative could be replicated by other communities.

scholarly journals DOMICILIARY SERVICES IMPROVE ACCESS TO DENTAL CARE FOR FUNCTIONALLY DEPENDENT OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S492-S492
Author(s):  
Mathew A Lim ◽  
Gelsomina L Borromeo
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Oral Health ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Needs ◽  
Dental Services ◽  
Unique Challenge ◽  
Care Facilities ◽  
Aged Care Facilities

Abstract There is growing evidence demonstrating links between oral diseases and general health. The increased retention of teeth among functionally-dependent older adults presents a unique challenge in maintaining the oral health of these individuals from basic oral hygiene to accessing dental services. The results of our cross-sectional study demonstrate the important role domiciliary dental services play in reducing the barriers to accessing oral health care in this cohort. In our study, most individuals treated by domiciliary services lived in residential aged care facilities and were significantly older than those treated by hospital and community-based dental services dedicated to the specialized care of individuals with additional health care needs. A significantly higher number of those receiving domiciliary care were unable to self-consent for treatment compared to those managed in other settings. 27.4% of these patients had a diagnosis of dementia. More than half (56.9%) of patients treated by domiciliary services received some form of treatment with almost half (48.1%) of these requiring a dental extraction. Only two of these patients were not diagnosed with a chronic condition known to affect oral health (dementia, Parkinson’s disease, diabetes mellitus, arthritis, stroke, osteoporosis). 23.7% of domiciliary appointments were used for denture fabrication. The results depict the worrying level of unmet treatment need in residents of aged care facilities. However, they also demonstrate the potential for domiciliary dental services to play a role in developing partnerships between carers and oral health professionals to improve the oral health of functionally-dependent older adults.

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