By 2060, according to the US Census, the number of US adults aged 65 years or older is expected to reach 98 million, 24% of the overall population.¹ Older Americans with the poorest oral health tend to be those who are economically disadvantaged, lack insurance, and are members of racial and ethnic minorities. Being disabled, homebound, or institutionalized (e.g., seniors who live in nursing homes) also increases the risk of poor oral health. Many older Americans do not have dental insurance because they lost their benefits upon retirement and the federal Medicare program does not cover routine dental care.²

Oral health problems in older adults include the following:

• Untreated tooth decay. Nearly all adults (96%) aged 65 years or older have had a cavity; 1 in 5 have untreated tooth decay.³
• Gum disease. A high percentage of older adults have gum disease. About 2 in 3 (68%) adults aged 65 years or older have gum disease.⁴
• Tooth loss. Nearly 1 in 5 of adults aged 65 or older have lost all of their teeth. Complete tooth loss is twice as prevalent among adults aged 75 and older (26%) compared with adults aged 65-74 (13%).³  Having missing teeth or wearing dentures can affect nutrition, because people without teeth or with dentures often prefer soft, easily chewed foods instead of foods such as fresh fruits and vegetables.
• Oral cancer. Cancers of the mouth (oral and pharyngeal cancers) are primarily diagnosed in older adults; median age at diagnosis is 62 years.⁵
• Chronic disease. Most older Americans take both prescription and over-the-counter drugs; many of these medications can cause dry mouth. Reduced saliva flow increases the risk of cavities.⁶

References

1. Colby SL, Ortman JM. Projections of the size and composition of the US Population: 2014 to 2060. Current Population Reports, P25-1143. Washington DC: US Census Bureau; 2014.
2. Griffin SO, Jones JA, Brunson D, Griffin PM, Bailey WD. Burden of oral disease among older adults and implications for public health priorities. Am J Public Health. 2012:102(3):411-418.
3. Dye BA, Thornton-Evans G, Xianfen L, Iafolla TJ. Dental Caries and Tooth Loss in Adults in the United States, 2011-2012. NCHS Data Brief, no 197. Hyattsville, MD: National Center for Health Statistics; 2015.
4. Eke PI, Dye BA, Wei L, et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J of Periodontology. 2015;86(5):611-622.
5. National Cancer Institute. Surveillance, Epidemiology, and End Results (SEER) Program. (N.D.) SEER Stat Fact Sheets: Oral Cavity and Pharynx Cancer website.  http://seer.cancer.gov/statfacts/html/oralcav.htmlexternal icon. Accessed July 5, 2016.
6. National Institute of Dental and Craniofacial Research. National Institutes of Health. Fact Sheet: Dry Mouth (Xerostomia) website. http://www.nidcr.nih.gov/OralHealth/Topics/DryMouth/external icon. Accessed July 5, 2016.