Mrs. Jones 1 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.

4 Responses to An Innovative Canadian Program Prevents Dental Elder Abuse

  1. Steve says:

    I am glad to see this awareness because it is very much a problem in the United States as well. In Arizona, Medicaid Recipients over 21 years of age lost their dental benefits in October of 2010. Since then Department of Health hospital data shows ER treat and release visits for oral health diagnosis increased 29% between 2009 and 2011, and charges for those visits increased 69% during that same timeframe.

    Many of the 15,900 nursing home residents in Arizona suffer with both chronic, intense pain and often an inability to eat due to deteriorating oral health.

    Meanwhile, Arizona is tied for the THIRD worse state for senior oral care programs. Not a fact thrown about when trying to encourage seniors to retire in our state. If I could attach some pictures of conditions that exist here many of you would lose your lunch. It is a crime what is going on!

  2. Cara Kenien says:

    Hi Steve – so sorry for such a delayed response to your comment. Thanks so much for what you said and for raising awareness of this very serious issue. Sounds like you’re quite familiar with the statistics… do you work in aging services? Thank you again and looking forward to continuing the conversation.

    • Steve says:

      Hi Cara, now it is I who have to apologize for a late response. I only saw your reply because I visited the site again.

      I have worked in the elder care field for over 8 years in Phoenix. Working through hospice, home healthcare, and audiology. In 2010, I created Desired Resources for using on making care available in the home for those unable to get to appointments. Mobile dentistry is a service I have worked with for 5 years.

      Because of what the practices were seeing, I started advocating, joining committees, and leaning about the state inspection process in our state. I have learned that our whole system is inadequate to comply with the federal and state mandates. Possibly that is why they are ignored. It will be a very ugly situation when the concerned Power of Attorneys become aware of what is, and is not, being provided. Many caregivers admit that they don’t even try to brush teeth. Very sad!

  3. […] not receive the dental care they need, it can lead to much more severe problems. In this blog, An Innovative Canadian Program Prevents Dental Elder Abuse, a case describing a scenario of dental elder abuse is discussed to provide readers with an […]

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