Oral Health Needs Assessment for Vulnerable Older Adults in California

Although many people in the United States have access to the best oral health care in the world, millions of people cannot get even basic dental care.  Low-income persons, racial or ethnic minorities, pregnant women, older adults, people with special needs and people living in rural communities have a much harder time accessing a dental provider than do other groups of Americans.  Although tooth decay is almost completely preventable, when people do not see a dental provider, they cannot access the preventive services, early diagnosis, and interventions needed to halt or slow the progression of most dental diseases.  Untreated dental/periodontal disease not only leads to pain, infection, and tooth loss, studies now show that oral disease is related to premature death, long-term disability, and contributes to an increased risk for serious medical conditions such as diabetes, heart disease and poor birth outcomes (DHHS, 2000).

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Clearly, results from these studies have not yet been broadly distributed nor widely understood. For many people, oral health problems start when they are young and worsen over time.  One quarter of children ages 2-5 and one half of those 12-15 have tooth decay; in fact, dental caries (cavities) are the most common chronic disease of childhood affecting almost 60% of all children ages 5 to 17.  In contrast to the growing awareness about children’s oral health needs, the oral health needs of older adults in the U.S. have received relatively little attention and almost no public health or public policy interventions.  As people age they continue to be plagued by oral health problems; in fact, in the U.S. today, only 28 percent of older adults (ages 65-74) and only 17% of those ≥75 have dental coverage. This results in the following: 1 in 4 adults over 65 have lost all of their teeth, 23 percent of 65- to 74-year-olds have severe periodontal disease.

Because studies indicate that good dental care is linked to reduced overall healthcare costs, Aetna Health Insurance – the second largest private insurer in the U.S. –has integrated enhanced dental coverage as a key component of its primary care coverage plan (DMI 2006); however, Medicare has yet to cover routine dental services for Americans over the age of 65. By 2030, 1 in 5 Californians will be age 65 or older and increasingly diverse in terms of race/ethnicity, financial resources, and living conditions.  More efforts are needed in California to highlight the interrelationship between oral health and serious medical conditions such as diabetes, heart disease, arthritis, and other diseases resulting in tooth loss related co-morbidities.

Project Objectives and Goals:

To learn about each goal and objective in more detail, click on the link below.

Goal #1 - Document the Oral Health Needs of Older Adults

Produce a report on the oral health status of older adults in California

Goal #2 - Educate and Inform Policy and Decision Makers about Oral Health

Develop policy and administrative recommendations to improve the oral health for older adults.  

Goal #3 - Promote Statewide Networking and Interdisciplinary Learning

Organize a symposium dedicated to the oral health care needs of underserved older adults in California.

Support for this project generously funded by:


Dr. Sahiti Bhaskara
Director of Public Policy Research 
This email address is being protected from spambots. You need JavaScript enabled to view it.


Press Release: Center for Oral Health receives grant to conduct oral health assessment of Older Adults

Additional Resources for Older Adults and Oral Health:

CDC Fact Sheets

Oral Health America’s Tooth Wisdom Project

National Institute of Craniofacial Research

WHO Global Oral Health Programme White Paper

Upcoming Events:

White House Conference on Aging

Oral Health & Quality of Life Among Older Adults: A Multidisciplinary and Interprofessional Perspective – 2015 Symposium on October 29, 2015 in Los Angeles, California