Oral health is one of the greatest unmet healthcare needs for the elderly, according to the University of Massachusetts Medical School (UMMS), which has found that geriatric medical fellowship programs provide little oral health training for doctors who will provide care to the growing older adult population.
“Medicare has no dental benefit. We know that 70% of older adults do not visit the dentist due to lack of dental insurance coverage,” said Hugh Silk, MD, professor of family and community medicine. “Because these patients are more likely to seek care from a medical providers, the need for geriatricians in training to be familiar with oral health conditions and local dental resources is essential.”
Oral disease in older adults not only can amplify chronic and systemic health conditions, it also can impact daily life including the ability to communicate, chew, and swallow, which can result in poor nutrition, isolation, pain, and lack of sleep, among other issues, report researchers at the school.
The school’s survey of 148 geriatric fellowship program directors nationwide revealed that nearly two-thirds of respondents reported that fellows receive only one to two hours of training in oral health, while almost a quarter received none at all.
The study is one of six in a series spearheaded by the Center for Integration of Primary Care and Oral Health. One of six nationwide, the center was established by UMMS and Harvard’s medical and dental schools in July 2016 through a cooperative agreement with the United States Health Resources and Services Administration.
The researchers suggest that there are opportunities to promote greater oral health training for fellows if there is a faculty champion or leadership that supports interprofessional education. Geriatric fellowship programs also can tap into existing national and local resources such as the Smiles for Life geriatric oral health module, which Silk was instrumental in creating.
A founder and co-principal investigator for the center, Silk is a longtime advocate for the integration of dental care into primary care. He is the founder of the oral health elective at UMMS and the founder and co-chair of the Massachusetts Medical Society Committee on Oral Health, and he has held similar positions and roles with related advocacy groups.
The study, “An Assessment of Oral Health Training Among Geriatric Fellowship Programs: A National Survey,” was published by the Journal of the American Geriatrics Society.
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