Mrs. Jones¹ was an 87 year-old retired teacher who spent her life raising her family, educating the children of her community and volunteering at the local community center. She lost her husband at age 80 and was diagnosed with mild Alzheimer’s disease at age 85. She was known in her community for her brilliant smile. Mrs. Jones’ retirement benefits didn’t cover dental care; however, her daughter, Susan, continued driving her mother to appointments with her lifetime dentist for basic cleanings and Mrs. Jones paid the bill using some of her own money as well as support she received from a public dental program. After her Alzheimer’s disease diagnosis, her dentist began directing his questions about her future oral care to Susan, even though Mrs. Jones was capable of making her own dental decisions. During one visit, the dentist reported hearing Susan say that she was “more interested in preserving her “inheritance” than her mother’s oral health.” As a result, Mrs. Jones stopped smiling.

When Mrs. Jones’ dentist started asking Susan “one too many questions” about the state of her mother’s oral health, which included gum disease, decay, broken teeth and abscesses, Susan stopped taking her mother to the dentist altogether. Weeks later Mrs. Jones was admitted to hospital for pneumonia and her oral infections were so advanced that surgical intervention was required. Mrs. Jones spent years in pain, lost the ability to chew or speak clearly and died of pneumonia, which was an entirely preventable condition caused secondarily to oral infection.

Mrs. Jones’ case is a common reality of dental elder abuse and neglect in Canada. Many dentists may think that geriatric dentistry is not something that they will practice. However, with Canada’s rapidly aging population, 1 in 5 people will be over the age of 65 by about 2030. All dentists will practice geriatric dentistry - simply because the number of older adults in our society will be so high. In Canada and in the US, many older adults pay for their own dental care, which is expensive and creates barriers to accessing services. The Canadian government provides some support through several programs. In the US, Medicare covers medically necessary dental services done in hospital settings and, in some states, community based dental services. Medicaid pays for adult care in a limited number of states and dental services for institutionalized older adults. In addition, there are some Medicare Advantage Plans that cover limited dental services; however, the coverage is not standardized across plans.

As a result of cases such as Mrs. Jones’ and others, the Dental Elder Abuse Response (D.E.A.R.) project was created by Dr. Natalie Archer and Laura Tamblyn Watts. D.E.A.R is dedicated to raising awareness about the seriousness of dental elder abuse, which happens when a person or system fails to provide the necessary dental care for an older adult (Click here for more).

“Dental elder abuse can cause pain, suffering and illness for the older person. It can even lead to cases of preventable death.” – Dr. Natalie Archer

The DEAR project fights dental elder abuse by:

• Using a peer education model to teach older adults, dentists, caregivers and families to recognize dental elder abuse and neglect issues
• Increasing awareness of the importance of oral health as we age
• Highlighting the need to create a dental advance care plan, which will help older adults manage the cost of maintaining oral health in later life
• Bringing dentists, patients and their families together across Canada through the NICE Network’s Dental Theme Team

Click here to watch a Rogers TV interview featuring Dr. Natalie Archer speaking in depth about dental health and elder abuse. Click here to download the DEAR program’s brochure, which includes facts and figures about older adults and oral health care abuse and neglect. Click here to review the educational tools and materials created through this project. (Please note that you may need to scroll down to the bottom of the page to access the tools)

DEAR is supported by a community-based grant from the New Horizons for Seniors Program – Employment and Social Development Canada and is a joint pilot project of Archer Dental, the Canadian Centre for Elder Law, and the National Initiative for Care of the Elderly.

Are you aware of other prevention work focusing on elder abuse and oral health? If so, please share in the comments below.

By Cara Kenien, LMSW, MPA, NYCEAC Social Media Manager & Allison Calcutt, Archer Dental Communications Coordinator, D.E.A.R Project Manager, & contributing authors, Natalie Archer, DDS, Archer Dental, D.E.A.R Project Lead, Laura Tamblyn Watts, LLB, SJD (in progress), D.E.A.R Project Lead, Canadian Centre for Elder Law Senior Fellow and NICE Network Law and Aging Theme Team Leader and Kavita P. Ahluwalia, DDS, MPH, Associate Professor at the College of Dental Medicine at Columbia University.

1. Mrs. Jones’ story is an example of dental elder abuse. It is not an actual case. [↩]