KDA Today

KDA Today

For Immediate Release

Date: Sep 12th, 2016
Contact: Dr. Beverly A. Largent
Phone: 800-292-1855
Email: info@kyda.org

Bonus Points May Not Be Enough

My only professional interest in aging involves looking forward to a child aging out of a difficult stage, to a time in his or her life when communication is achievable, and the maternal attachment moves from a 10 to a 9.5. I cannot even begin to imagine the difficulties in managing a frail, health compromised individual who may or may not have the capacity to understand the ramifications of my recommendations. On the whole, my patients improve. The elderly decline, and as the State of Aging Report recognizes, there are multiple problems associated with aging. Chronic diseases and the proportion of Kentuckians aging will soon put us as the number one state in the nation with a population needing long term care and support services.


My view is always as a pediatric dentist. During the month of June, I began to realize some of the answers to the complex issues with the aging dental patient as I contemplated the opinion piece for this issue. It should not have come as a shock, or an epiphany, but that is how I view it in retrospect. My little patient is two-years-old. She is a small fragile blond child who is not happy with her world, or how her world collides with mine. Her parents bring her to the dentist, still in diapers, because she is in pain. Try as they may, they have no other choice, the problem is not going away. Her pain is obvious. Along with abscesses of the upper and lower anterior teeth, she has advanced decay on eight other teeth. (No mistake, all baby teeth were badly decayed.) She will lose eight front teeth which are beyond repair. On the day of the exam her tongue was blue, the bright blue of Gatorade, which was a part, perhaps the only part of her breakfast. She had spent many nights with the beloved Gatorade in a sippy cup to help her through the night. Any adult in her situation would have demanded drugs far more potent. She could only cry. As the child wriggled in her mother’s lap, I began to gain some insight.


Mom, at age 35, is completely edentulous. She is severely overweight, and appeared to be 20 to 30 years older, and had difficulty speaking. The main food staple in the house must be sugar. The only protein I can readily think of that could be consumed without teeth is tofu, and that is not a staple in Western Kentucky. Uncooked green vegetables are out of the question. That leaves sugar and starch. Mom is feeding the child only the things she can eat, which is the same thing all moms do. No amount of nutritional counseling will change this family’s diet. The treatment plan to remove the offending teeth fit nicely into mom’s experiences, so her expectations that her child will lose her teeth just as she has, will be met. This is a vicious cycle. This delicate little child will only learn the speech patterns of her edentulous mother, and could not make proper sounds if she could hear them due to the loss of all her anterior teeth. At two she is a dental cripple, and lives in a nutritional deficiency. She will never learn oral hygiene from her mom.


And what about mom? Does she choose to look old beyond her years? What choices did she make to place her in this situation? I feel certain that the focus in our society on youth and beauty have an impact on her as well as the rest of us. What about her self-esteem? For certain, this mom is doomed to a chronic disease. Diabetes, colon cancer, heart disease—simply choose one. In 30 years this mom will absolutely be a part of the aging problem in Kentucky, if she lives another 30 years. Without a doubt she will be debilitated and require, at minimum, support care. What a difference having a natural dentition could make for this woman and her quality of life, and possibly the length of her life. Not only her health, but that of her family could be positively impacted.


Ageing, they say, is not for the faint of heart. Body parts wear out, including teeth. The prospect of becoming frail, needing assistance, and losing independence is intimidating, not only for the senior, but for those challenged to care for them. Poor oral health is not just one more issue faced by the elderly. Poor oral health has a compounding effect on how we age, and our health at the end of our lives. Poor oral health then becomes a drain on our economy. Governor Bevin has introduced his HEALTH plan to revamp Medicaid. In this plan which emphasizes healthy lifestyles, and taking more responsibilities for health insurance coverage offers points to earn dental and vision coverage. Given the long term impact of poor dental health on overall health, and the impact on the state’s finances, bonus points may not be enough.

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