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  • Writer's pictureThe San Juan Daily Star

Many older adults in island nursing homes suffer from untreated dental conditions

Dental Surgeons Association of Puerto Rico President Raúl Dámaso Ortiz Escalera

By The Star Staff

A study from the Dental Surgeons Association of Puerto Rico (CCDPR by its Spanish initials) has found that older adults living in nursing homes have poor oral and dental hygiene and their conditions often go undetected.

The study found that these older adults suffered from oral diseases of a serious nature without being detected or treated, showing the need to educate caregivers in this area.

CCDPR President Raúl Dámaso Ortiz Escalera said nearly 50 members of the association voluntarily carried out an education and evaluation session focused on studying oral health conditions in people over 55 years of age to propose solutions. The initiative began in March and will end this month. The members visited the towns of Fajardo, Trujillo Alto, Río Piedras in San Juan, Vega Baja, Caguas, Aguas Buenas, Arecibo, Mayagüez and Ponce.

The effort is being undertaken within the framework of Oral Health Month and, Ortiz Escalera said, the CCDPR will focus its efforts on education and prevention to protect the elderly population and create awareness and training among family members and caregivers.

Ortiz Escalera noted that the dentists participating in the initiative evaluated 332 older adults in some 11 care centers and at two health fairs. Of those, 19 were diagnosed with potential oral cancer lesions, while another 13 were referred for various treatments. This equates to a rate of near 10%. As the study is still ongoing, doctors estimate that the percentage could rise.

The initiative’s director and CCDPR vice president of community service, Ivette Rodríguez Vicens, said the most serious condition among patients is oral cavity cancer, detected by the most advanced oral examination device, the Velscope, purchased by the CCDPR. In addition, dentists frequently encounter older adults who have been wearing partial or complete dentures for months and years without having removed them for daily cleaning, as is directed. This leads to the accumulation of bacterial plaque, inflammation of the gums, oral infections and tooth decay.

Among the findings of the study, which will end in August, they identified the need to increase the training and education of caregivers in the field of oral care, particularly in centers that house older adults.

“We find cases of older adults who hide, even from their relatives, the use of dentures out of modesty,” Rodríguez Vicens said. “Consequently, we see patients diagnosed with dementia or Alzheimer’s who arrive at a care center without being evaluated by a dentist, and remain with their dentures without anyone around them being able to identify and attend to their oral hygiene and prevent serious conditions.”

“Older adults are currently the fastest-growing population in Puerto Rico. But at the same time it is a vulnerable and disadvantaged group, due to the mental and physical conditions many suffer from,” Ortiz Escalera said. “The personnel of the entities in charge are unaware of the conditions and whether they have prostheses, partial dentures, or removable teeth. Also, family members or guardians are often unaware of the treatments the people in their custody have received or should receive, or assume that they are being treated.”

“We have to stop normalizing the lack of teeth in our older adults, as if it were a condition of this stage of a person’s life,” he added. “There is no need to lose dental pieces if we establish a prevention routine and take care of our oral health as we do with other components of our body.”

Ortiz Escalera added that the final findings of the study will be presented in a report to the CCDPR membership during the peak activity of Oral Health Month, on Aug. 25, Dentist Day.

Rodríguez Vicens stated that as a result of the evaluations, the CCDPR has concluded that legislation is needed to address the situations that contribute to poor oral health among the elderly.

“For this reason, the association will recommend that the problem be addressed by law on multiple fronts, from individual caregivers and care centers to the elderly themselves and their relatives or guardians,” said Miguel Alvarado López, president-elect of the CCDPR.

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