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Geriatric Dentistry: Before You Call 911

Course Number: 586

Geriatric Dentistry

Gerontology, often known as geriatrics or clinical gerontology, is the study of the physical and psychological changes that occur as people age. As part of an interdisciplinary team alongside other healthcare professionals14, Geriatric dentistry, also known as Gerodontology or Gerodontics, is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal aging and age-related diseases. It was originally defined as "that portion of the pre-doctoral dental curriculum that deals with special knowledge, attitudes and technical skills required in the provision of oral health care to older adults."15 It’s commonly considered to be a part of ‘Special Care Dentistry’ by the Commission on Dental Accreditation. The Special Care Dentistry Association (SCDA) formed the American Society of Geriatric Dentistry (ASGD) in 1965 and later the SCDA Council of Geriatric Dentistry in 2013.15

Facts and Figures

Geriatric dentistry is a crucial part of the health maintenance mechanism for the elderly and medically compromised individuals. In the USA, there will be 74 million persons over the age of 65 by 2030, up from 56 million in 2020. Scientific research also indicates that by 2030, over 22 million senior citizens in the United States will require expert geriatrician care.65 On average, people above the age of 65 years are expected to report one or more chronic medical conditions that require consideration before initiating any dental treatment.15 The U.S. Surgeon General’s Report stated that older adults suffer from a “silent epidemic of profound and consequential dental problems".16 As per one estimate, a typical dental practice could expect to see about four to five elderly patients on any given day of operation.17

Correspondingly, in a statement released by the US Department of Health and Human Services (DHHS), it is projected there will be a need for more than 6,000 dental practitioners with specialized training in geriatric dentistry by the year 2020.18,19

According to a 2018 American Dental Association survey, 86% of Americans believe that dental health is highly essential to their overall health. Both the American Dental Education Association (ADA) and American Dental Education Association (ADEA) have created clinical guides for oral health professionals after realizing the complex needs for dental services among geriatric populations. These clinical guides will help professionals to better evaluate and diagnose dental problems, link oral health to chronic conditions, and provide treatment to improve older adults' quality of life.64,65 All health professions must work together to develop interprofessional education on geriatric oral health.

Impact of COVID-19 on Geriatric Patients

Severe acute respiratory syndrome Coronavirus infection (COVID-19) is brought on by the RNA virus coronavirus 2 (SARS-CoV-2). The COVID-19 pandemic and its effects on society's most vulnerable groups were seen by the entire world. Since its widespread spread began in December 2019, COVID-19 has killed 6,390,401 people worldwide and caused over 572,239,451 confirmed cases, paralyzing the whole humanity.68, Because COVID-19 spreads by airborne droplets and direct human touch, it has a wide-ranging impact.

Older persons are more prone to developing nosocomial infections since they frequently have many comorbid diseases. As a result of their health, they may frequently need dental care at hospitals or special care facilities, and going to the dentist only when there is pain or discomfort exposes older people to an elevated risk of infection brought on by protracted appointments or the use of rotary tools. As a result, it's critical to take extra care to reduce the possibility of infecting them with the virus.

While it is important to stop the spread of the new coronavirus (2019nCoV), it is also vital for oral healthcare professionals to focus on the unique requirements of adult patients who are ageing, by implementing specific guidelines and effective infection control methods timely.

The problem in geriatric dentistry care nowadays is preventing older persons from getting nosocomial infections which they are susceptible to due to underlying coexisting diseases. According to the literature, dental professionals should use a few extra precautions to protect themselves from infection.

Strategies in the dental office to help older adults during COVID 19 pandemic era include:

  • To prevent the spread of COVID-19, patients might choose to get their initial dental visit via tele dentistry.

  • Pre-check triaging of the patients may be a useful screening technique.

  • By advising doctors or prescribing RT-PCR tests and chest CT scans for questionable patients, you can keep them from attending dental clinics.

  • Strict and effective infection control methods are particularly advised for dental emergency practices.

  • The dentist can treat elderly persons while adhering to all infection control protocols and measures, depending on the urgency of the case.