Bulletin of Dental Education Article

As the population of older adults continues to surge, experts and health organizations are sounding the alarm. Oral health is not just about a bright smile, but a critical pillar of overall well-being, demanding urgent attention and systemic reforms.

With one in five Americans projected to be age 65 or older by 2030 and nearly 10,000 individuals reaching this age daily, the health care system faces unprecedented demands, particularly at the intersection of oral and general health. Oral health is closely connected to a person’s general health at every stage of life, with particular vigilance required for the elderly.

Poor oral hygiene in older adults may lead to a cascade of potential complications, exacerbating existing medical conditions and creating new ones. Patrick Coll, M.D., lead author of a review article in the Journal of the American Geriatrics Society, emphasizes that all health care professionals should promote good oral hygiene for older patients, including oral examinations during annual wellness visits, especially for those not receiving regular dental care.

Issues of concern include:

• Cardiovascular disease and diabetes: Periodontitis, a severe gum infection prevalent in up to 64% of older adults, is directly associated with cardiovascular disease and diabetes.
  
• Malnutrition: Tooth loss and severe oral pain may impair a person’s ability to chew, limiting dietary choices and potentially leading to malnutrition. Studies show a strong link between poor oral health and nutritional status, with well-nourished individuals having more functional teeth.
  
• Cognitive decline: Adults with fewer teeth face a higher likelihood of developing memory loss, Alzheimer’s disease and greater overall disability. Oral health issues are more prevalent among older adults with cognitive impairments, impacting their quality of life and potentially altering behavior.
  
• Cancer and other conditions: Poor oral health is also linked to an increased risk of oral, breast and prostate cancers as well as pneumonia. Certain medications commonly prescribed for chronic conditions in older adults may cause dry mouth (xerostomia), which further increases the risk of cavities and soft tissue problems.
  
• High prevalence of oral disease: Over 96% of adults aged 65 and older have had a cavity, and it is estimated that two out of three (68%) suffer from gum disease.
  
• Patient misconceptions and fear: Many older adults mistakenly believe that tooth loss and bleeding gums are normal aspects of aging or that care is only necessary when pain is present.
  
• Fear and anxiety related to dental procedures deter many from seeking care.
  
• Fragmented health care systems: The historical separation of medical and dental education and practice has resulted in siloed health care systems, making it complex for older adults to navigate and for providers to offer coordinated care.
  

Experts and organizations are advocating for comprehensive strategies to address these challenges, emphasizing a collaborative, integrated approach.

Students at A.T. Still University Missouri School of Dentistry & Oral Health are helping lead the way in educating and increasing the importance and understanding of health literacy.

Ultimately, achieving optimal oral health for older adults requires a concerted, collaborative effort across policy, health care systems, and community and individual education. By prioritizing oral health, we can ensure that the growing older adult population can age with dignity, enjoy an improved quality of life and experience better overall health outcomes.

Story references are available upon request.

Courtesy of Shaista Rashid, B.D.S., M.S., M.P.H., Assistant Dean and Director of the Comprehensive Care Unit, A.T. Still University Missouri School of Dentistry & Oral Health

Published on October 8, 2025