Primarily due to improved preventive measures, US adults are retaining their teeth in increasingly large numbers. Although gains in dentate status represent an improvement in oral health and healthcare across the lifespan, tooth retention also represents a challenge - as the proportion of older adults who are retaining their teeth increases - so too does the prevalence of oral diseases.

Read more on the CDC's website

Oral diseases prevalent in older adults include dental caries, root caries, periodontal diseases and oral cancer, which is primarily seen in adults over the age of 50 in the United States. In addition to traditional risk factors for oral and dental diseases, older adults are at high risk for oral diseases due to Xerostomia secondary to diabetes and medications (link to table), and medical conditions such as diabetes, CHD and CVD which are associated with periodontal diseases. In addition, functional difficulties, arthritis and cognitive declines may impact ability to perform optimal daily oral care.

The increasing retention of teeth and prevalence of oral diseases, has in turn, increased the need for professional and preventive services, which are often limited by public payor systems. Despite the significant negative impact of oral diseases on quality of life, utilization of professional dental services by the elderly remains low. Nationally, data indicate that over half of adults 65 and older have not seen a dentist in the past year, and 25% have not been to a dentist in the past five years or longer.

A number of reasons for low levels of utilization have been suggested - insurance status, cost of care, functional and cognitive limitations, transportation problems, fear, and an untrained workforce make access to dental services difficult.

In addition to the very real challenges posed by cost and transportation, perceived need and demand for dental services is low in the elderly. Acceptance of dental dysfunction as a natural consequence of aging appears to be a predominant reason for low rates of utilization, which are highly correlated with dentate status. Edentulous elderly report lower perceived need and rates of utilization than dentate elderly, and data suggest that self-reported perceived need and objective measures of oral health are not correlated, implying the need for interventions designed to underscore signs and symptoms of oral diseases and the importance of seeking dental care.