Elderly people who live in nursing homes are at greater risk for oral health problems compared to elderly people who live independently, according to a study published in the July/August 2002 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD).

Thanks in part to widespread fluoridation, more people than ever before are keeping their teeth throughout their lives. But as people age, medical complications and other factors can negatively affect oral health. Evidence shows that older Americans are at risk for greater oral health problems than other groups because of age and the inability to get to a dentist's office due to an existing medical condition or lack of transportation.

"Oral health of frail elders residing in long-term care facilities is very poor, probably because access to dental services is limited," says Francesco Chiappelli, PhD, co-author of the study. "Most of the care at nursing homes is medical care and nursing care, and sometimes the oral health needs are overlooked."

Children or other relatives should take an active role in the oral health needs of elderly people residing in nursing homes. "Assisting with brushing, flossing and looking around the mouth for canker sores and abscesses can help ensure an elderly relative maintains their oral health, which in turn helps maintains one's overall health. All oral health problems should be reported to the nursing staff for proper diagnosis and treatment," says Dr. Chiappelli.

According to the report, greater awareness among health care providers and caregivers can do much to ensure the elderly receive good oral health care, primarily through assessments of the patient's mouth.

Before choosing a nursing home for an elderly person, relatives and loved ones should inquire about the quality and consistency of dental care at the facility, according to AGD spokesperson Trey L. Petty, DDS, FAGD. Important questions include:

• Does the home have on-call dentists?
• Is nursing-home staff trained in basic mouth care?
• Is the staff trained to recognize oral problems?
• Does nursing home staff emphasize mouth care at least once a day?

"If the staff or home administrator can't say 'yes' to each of these questions, then a red flag should go up," he says.