By Tony Edwards, DrBicuspid.com editor in chief, Theresa Pablos, DrBicuspid.com associate editor

April 18, 2018 -- The state of dental care for older Americans is mixed, according to a new report from Oral Health America (OHA) released on April 17, 2018. While 25 U.S. states received a poor overall score on key oral health performance measures, the number of people covered by community water fluoridation increased from 2016 to 2018.

Coverage needed to pay for care was critical to increasing older Americans' overall health and wellness, noted OHA President and CEO Beth Truett.

"With half of the United States receiving a 'fair' or 'poor' rating relative to meeting minimal standards for the oral health of older adults, we must identify and address the steps needed to ensure the health of our burgeoning senior population," she stated in an OHA press release.

Mixed messages

The report, "A State of Decay, Vol. IV," combines information gathered from surveys of state dental directors with data from publicly available sources. The report is issued every two years by OHA.

“We must identify and address the steps needed to ensure the health of our burgeoning senior population.”
— Beth Truett, president and CEO, Oral Health America

Key findings of the report include the following:

  • A third of older adults age 65 and older have lost six or more teeth.
  • Community water fluoridation increased from a state average of 71.9% in 2016 to 72.6% in 2018, a national increase of about 2.2 million people.
  • Fifteen U.S. states have 90% or more of their population receiving fluoridated water.

While the number of people receiving fluoridated water increased, many states do not cover basic dental treatments for older adults on Medicaid, according to the report. Extractions are covered by 42 states to some extent, but only 31 states reimburse for a periodic oral evaluation, and periodontal maintenance is only covered by 23 states (see table below).

Common dental procedures and number of U.S. states that reimburse for procedure
Code Procedure No. of states that cover procedure
D7140 - 7250  Tooth extractions 42
D0140 Limited oral evaluation, problem focused 40
D1110 Adult prophylaxis 35
D0150 Comprehensive exam 34
D2140 - 2161 Amalgam restorations 32
D2330 - 2394 Composite restorations 32
D0120 Periodic oral evaluation 31
D5510 - 5212 Dentures 31
D3220 - 3999 Endodontic treatment 24
D4910 Periodontal maintenance 23
D4341 - 4342 Scaling and root planing 23
D2930 - 2954 Crowns 21
D1206 Fluoride varnish 14

State rankings

Oral Health America also ranked each of the 50 states based on state-level data that affects the oral health of older adults. The metrics included community water fluoridation, dental visits, adult dental Medicaid coverage, severe tooth loss, and basic screening surveys.

Minnesota ranked No. 1 on OHA's list for the third time and was one of just five states rated as excellent for oral health for older adults. Wisconsin, Connecticut, Colorado, North Dakota, Rhode Island, and Michigan also made the top 10 list for the third survey in a row.

At the other end of the spectrum, Mississippi ranked last for oral health for older adults, receiving a score of 0%. Alabama, which ranked last in 2016, jumped to 21 places to No. 29 in 2018.

View the infographic below to learn how other states performed in OHA's latest oral health analysis.

Oral health and older adults

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