Characteristics of Frail Elders with Limited Access to Dental Care

Objectives: The purpose of this descriptive study is to identify systemic and oral characteristics of frail elders attending Adult Day Health (ADH) sites who utilized a mobile dental clinic visiting these sites. These included 12 ADH sites in Seattle-King County. Methods: Demographic, medical history and medication data were obtained from ADH records and personal interviews with these elders. Following initial dental exams and after obtaining caregiver consent, dental treatment was provided at each of the ADH sites. Results: Of the 430 elders screened at twelve ADH sites, most were female (60.2%), and Caucasian (58%), with a mean age 74.9. The majority (78%) were on Medicaid. Almost a quarter (23%) used or needed partial or full dentures; 19.2% had > 6 chronic diseases and 52.1% used > 6 prescription medications. Almost 88% required some dental treatment: 59.4% required a prophylaxis; 12.8% a simple restoration; 26.7% required multiple or complex restorations, while 18% needed one or more extractions and 23% required some denture care. A small proportion (17%) were referred for more complex care or rejected any dental treatment. Conclusion: Consistent with previous epidemiological studies, the greatest dental need was for a dental prophylaxis; the majority had many natural teeth that required some treatment. The growing number of older adults who retain their natural teeth into advanced old age but experience significant declines in systemic health that require a complex medication regimen will continue to challenge dental professionals who must manage their oral health needs.