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Importance of Oral-Systemic Health in Older Adults

Oral health is directly related to systemic health in all individuals, but particularly in older adults. Oral health has a significant impact on the overall health and well-being of individuals across their life span. Among older adults, poor oral health is associated with pain, loss of teeth, poor nutrition, increased risk for systemic conditions, and serious morbidity and mortality in the case of oral cancer. The projected aging of the US population, coupled with the increasing number of adults retaining their teeth, is creating an unprecedented need for oral health care among older adults.

The burden of oral health problems is particularly severe in vulnerable populations. Among older adults, 70 percent of whom have no dental insurance, the burden of oral disease is most significantly borne by minorities, the poor, and immigrants. According to the 2000 Surgeon General’s Report on Oral Health, oral health is key to overall health and all health professions can play a role in reducing the burden of disease.

Importance of Oral-Systemic Health in Older Adults

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Learning Objectives

Students will:

  • Describe the importance of oral health in older adults
  • Determine oral systemic connections for older adults
  • Describe the role of the nurse when providing oral health care to older adults in the community

Learner Pre-Work

This teaching strategy incorporates the ACE.S Essential Nursing Actions: Assess Function and Expectations, Coordinate and Manage Care, and Make Situational Decisions. A number of materials that can be used to provide a complete overview of the topic are available at no cost.

1. Tell the students to become familiar with the Smiles for Life website at http://www.smilesforlifeoralhealth.org. The website has a comprehensive curriculum that can be easily implemented in an academic setting.

2. Read the full text of the following article, which offers an educational and clinical innovation designed to promote interprofessional oral health workforce capacity:

Haber, J., Hartnett, E., Allen, K., Hallas, D., Dorsen, C., Lange-Kessler, J., … Wholihan, D. (2015). Putting the mouth back in the head: HEENT to HEENOT. American Journal of Public Health, 105(3), 437-441. Retrieved from http://ajph.aphapublications.org/doi/full/10.2105/AJPH.2014.302495

Ask the students to watch the NICHE archived webinar “Oral Health: Overview for Older Adults” at https://youtu.be/0sQlX7xkPkw.

And/or

Public Health Learning Module 15, “Oral health Across the Lifespan” by the Association for Prevention Teaching and Research. (2014). Retrieved from http://www.aptrweb.org/?PHLM_15.

Suggested Learning Activities

Smiles for Life, an interprofessional oral health curriculum produced by the Society of Teachers of Family Medicine, consists of eight 45-minute models that contain the core components of oral health throughout the lifespan.

1. Included in the curriculum is a comprehensive set of educational objectives based on the Accreditation Council for Graduate Medical Education (ACGME) competencies, test questions, resources for further learning, oral health web links, an implementation guide, and detailed module outlines. CE credit is available for each module upon completion.

The modules that pertain to the aging population are:

Module #1, The Relationship of Oral to Systemic Health

Module #7, The Oral Exam

Module #8, Geriatric Oral Health

Have the students complete these modules on their own prior to class. After completing each module, ask the students to complete the appropriate SFL quiz and submit SFL Certificates of Completion for each module to the faculty member.

2. Students can also download:

  • Smiles for Life “SFL Adult Oral Health Pocket Card”
  • Smiles for Life app for mobile devices to use as a reference in the clinical area

HEENOT

3. Read: Putting the Mouth Back in the Head: HEENT to HEENOT (Haber et al., 2015)

  • As a learning activity, instruct the students to:
    • Choose an oral-systemic health problem from table below
    • Present photos of the oral – systemic problem
    • Describe how the oral manifestation is linked to the systemic disease
    • Describe an oral health preventive intervention or anticipatory guidance you would implement for the oral manifestation

 

Systemic

Oral

Diabetes

Periodontal disease

Cancer

Mucositis, xerostomia, bleeding gums

Autoimmune disease: Celiac

Enamel dysplasia

Eating disorders

Enamel erosion

HPV

Oropharyngeal cancer

HIV

Oral lesion

 

Suggested Reading

Hunt, R. (2012). Health promotion and disease and injury prevention for older adults. Introduction to Community-Based Nursing. Philadelphia, PA: Wolters Kluwer. 

Centers for Disease Control and Prevention Aging Publications
The above link provides information and statistics regarding chronic disease and wellbeing of older adults.

Older Americans 2010: Key Indicators of Well-Being (Older Americans 2010) 
provides a comprehensive picture of our older population’s health and well-being. It is the fifth chartbook prepared by the Federal Interagency Forum on Aging-Related Statistics (Forum). 

The Try This:® Series from the Hartford Institute for Geriatric Nursing (HIGN) at the NYU Rory Meyers College of Nursing contains many evidence-based assessment tools. The tool, an article about using the tool, and a video illustrating the use of the tool, are all available for your use.

Author Information

Erin Hartnett, DNP, APRN-BC, CPNP
NYU Rory Meyers College of Nursing
New York, NY