Whether it’s the human connection that comes with the flash of a smile, or the influence it has on disease, the health of an individual’s mouth, teeth, and gums substantially impacts overall well-being. For older, medically vulnerable populations, the link between oral health and other physical and mental health concerns is especially acute. Simply put, poor oral health presents added risks and complications. This direct and consequential association makes clear the critical importance of routine dental care as a therapeutic intervention for overall wellness.

Common dental problems among residents

Many seniors entering skilled nursing facilities haven’t seen a dentist in a considerable amount of time. They also may face mental and physical challenges in maintaining daily oral care. Consequently, many have or quickly develop serious dental issues. Below are among the most common and significant.

• Gum Disease

When bacteria progressively collect on teeth, gum infection often follows. Severe gum disease, known as periodontitis, ensues, and the associated inflammation creates problems elsewhere in the body. About two in three adults aged 65 and older have gum disease^[1] People with severe periodontal disease have roughly 40% more chronic conditions than those without such disease.^[2]

• Diabetes

Approximately one in three Americans 65 and older have diabetes.^[3] The condition is tightly connected to the state of an individual’s mouth, teeth, and gums. The diabetes-oral health link involves a two-way dynamic. Inflammation caused by periodontal disease negatively influences our ability to use insulin. High blood sugar associated with diabetes also increases the odds of infection within the body, including the gums. Diabetes has also been shown to create nerve damage in some individuals that can alter taste and smell in ways that impact eating and mouth care.^[4] Effectively managing both sides of the diabetes-oral health equation is beneficial.

• Diet and Nutrition

The ability of residents to consume nutritious food often depends on comfort and the absence of cavities and other sources of mouth pain, such as ill-fitting dentures. Maintaining oral health helps avoid diet-related problems, including malnutrition. And it reduces the need to administer nutritional supplements.

• Medication Side Effects

Complicating the challenges to dental care are commonly prescribed medicines.^[5] Many have side effects that can increase oral health risks, even leading to dental deterioration. Hundreds of drugs for depression, Alzheimer’s and Parkinson’s, respiratory, and cardiovascular diseases, can negatively impact dental status. Given that nearly nine in ten adults 65 and older take at least one prescription drug, and more than half (54%) take at least four different medicines, routine dental care for this population is essential.^[6]

• Behavioral and Psychological Issues

A 2022 meta-analysis found that poorer oral health correlates with higher levels of loneliness and social isolation.^[7] In May 2023, U.S. Surgeon General Dr. Vivek Murthy flagged loneliness as a serious public health concern that poses health risks as deadly as smoking up to 15 cigarettes a day. Tooth loss frequently causes self-consciousness about appearance and makes talking more difficult, often resulting in withdrawal from opportunities for social interaction. Additionally, persistent oral pain can affect sleep, mood, and behavior, heightening the risk for mental health problems.

The value of onsite dental care

Onsite dental services directly address the oral health needs of patients in skilled nursing facilities and provide a host of benefits. Delivering high-quality oral care when and where residents need it offers not only convenience but also avoidance of complications that arise with transport to off-site providers. An onsite program provides access to dental professionals who understand the needs and challenges of this patient popfulation and are equipped to compassionately meet them. This is especially valuable when cognitive and behavioral issues related to memory loss are present.

Regular exposure to dental professionals at the skilled nursing facility supports comprehensive quality care in other ways as well. Critical dental problems can be accurately identified upon admission. Regular check-ups, monitoring, and preventive practices are more easily conducted. Appropriate interventions can take place in a timely manner. Importantly, signs of other medical problems revealed through dental conditions can be more readily identified. All these benefits come with the expertise of knowledgeable dental professionals who have extensive experience working in skilled nursing environments amid related regulatory requirements.

All told, oral care is about quality of life. Bringing dental services onsite fosters the kind of collaborative, compassionate, and convenient care that enriches the lives of residents.

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[1] Centers for Disease Control and Prevention, “Older Adult Oral Health.”

[2] L. Bensley, J. VanEenwyk, E.M. Ossiander, “Associations of Self-Reported Periodontal Disease With Metabolic Syndrome and Number of Self-Reported Chronic Conditions,’ Preventing Chronic Disease, May 2011.

[3] American Diabetes Association, “Statistics About Diabetes.”

[4] S. Pugnaloni, S. Alia, M. Mancini, et. al, “A Study on the Relationship between Type 2 Diabetes and Taste Function in Patients with Good Glycemic Control,” Nutrients, April 16, 2020.

[5] A. Glick, V. Sista, C. Johnson, “Oral Manifestations of Commonly Prescribed Drugs,” American Family Physician, November 2020.

[6] A. Kirzinger, T. Neuman, J. Cubanski, et al. “Data Note: Prescription Drugs and Older Adults,” KFF, August 2019.

[7] A. Hajek, B. Kretzler, H-H König, “Oral Health, Loneliness and Social Isolation. A Systematic Review and Meta-Analysis,” The Journal of Nutrition, Health & Aging, June 2022.