ADA News

Donna E. Shelley, M.D.

New York—Some 300 seniors in New York City and 50 or so dental, dental hygiene and nursing students at New York University are working together to focus more attention on the importance of oral health care for older adults and to break through access to care barriers.

Through a one-year pilot program funded by the United Hospital Fund, older adults who attend senior centers or live in neighboring building complexes with high concentrations of seniors will receive dental education, screening and oral health care services.

The program also enables students and faculty from the NYU colleges of Dentistry and Nursing to have hands-on opportunities to provide the outreach to New York City seniors.

The end goal is to develop a seamless collaborative health care referral model that will provide underserved seniors in New York City with better access to dental care, said Donna E. Shelley, M.D., M.P.H., clinical associate professor of Cariology and Comprehensive Care and director of Interdisciplinary Research Practice at the NYU College of Dentistry.

"This pilot program fills a need for oral health education and referral services among older adults who may not have access to dental care. We will start by piloting the project in four of our partnering senior centers," said Dr. Shelley. "These centers have active education programs in place but say there is an urgent need to add oral health education. Many older adults don't know how to care for their oral health and how to deal with common problems they face like dry mouth, which is often related to taking multiple medications, what to do about dentures that don't fit and other concerns. Older adults are less likely to think they need to still see a dentist regularly compared to younger adults. They may not know that, in New York state, Medicaid covers many oral health services or they may have dental insurance and not realize it. These are issues that can affect their access to dental care and their overall health and well-being."

Seniors will receive screenings, oral health education information and referrals to local dentists or the NYU College of Dentistry Clinics as well as help with securing transportation for dental visits and answering insurance questions. Students and faculty will also gather data about patients' oral health problems and needs in order to better address barriers to oral health care and to develop a referral model that could eventually be used citywide.

The program also gives students in the health professions more exposure to the oral health issues older adults face and some hands-on experience in working with seniors.

"The program offers a great opportunity through outreach to enhance students' skills in a multidisciplinary program," Dr. Shelley said. "Nursing students already work in a geriatric outreach program, but it was missing an oral health education component, so this program will piggyback nicely with it. Nursing students will gain experience with how to recognize and address common oral health issues, and dental and dental hygiene students who participate will gain experience in working with older adults. We can leverage NYU's interdisciplinary opportunities and offer benefits for students, older adults and the community."

But more importantly, she added, participating patients will have a seamless link between their community centers and dental care. Staff at the senior centers will also receive education on common oral health problems faced by seniors and solutions they might suggest.

Dr. Shelley also created a Medicaid oral health coverage fact sheet to help patients, social services and senior center, nursing home and retirement home staff better understand what oral health care related services Medicaid patients are entitled to.

"We will be following up with patients to see how the program helps them and how we can continue to improve it," said Dr. Shelley. "We will collaborate with the New York State Dental Association to develop a referral list that includes dentists willing to treat Medicaid patients as well as patients who have private dental insurance coverage. We are also looking into solutions for those who do not have dental insurance coverage."