Dental Care Guide for Seniors

Your teeth do much more than chew food. They provide structural support for your mouth and cheeks, help you speak clearly and make it possible to form a variety of facial expressions.  Healthy gums and teeth are also critical to your overall wellbeing. Poor oral hygiene has been linked to an increased risk of endocarditis, respiratory infections and pneumonia and oral issues can lead to complications for those with other diseases, such as making blood sugar harder to regulate for those with diabetes. Significant tooth loss in seniors may even result in reduced life expectancy.

Unfortunately, changes associated with aging make seniors more susceptible to oral health problems. Making things even worse, seniors on a fixed income may be unable to afford the dental care needed to prevent or address these problems. Data collected in 2019 revealed that almost half of all seniors had no dental insurance, indicating many seniors put off treatment because they lack a form of financial assistance. Further, a significant number of seniors admit that cost continues to be a barrier, whether or not they have insurance. One in five seniors, regardless of insurance status, revealed they delayed visiting a dentist for up to two years to avoid the resulting costs.

This guide aims to help seniors avoid serious dental problems by providing tips on maintaining good oral hygiene and explaining the risk factors that make certain dental issues more common in older adults. It also includes an extensive list of resources to help seniors access free or low-cost dental care before minor dental problems become serious ones.

Why Do Seniors Have an Increased Risk of Dental Problems?

While it’s true that you can develop dental problems at any age, seniors have some unique risk factors that make them more likely to lose some of their teeth or develop severe gum disease as they age. These are some of the most relevant risk factors:

• Insurance issues: Many seniors find that their health insurance doesn’t cover most dental problems. Medicare will cover minimal types of dental care, such as care received in the hospital, and a majority of state Medicaid programs fail to include comprehensive dental services among their benefits. As a consequence, many seniors have to buy separate dental insurance or pay in full for any dental services they receive. This can be a barrier for seniors who can’t afford another monthly expense.
• Poor dental hygiene: The longer you go without proper brushing, flossing and professional dental care, the more likely you are to develop tooth decay, gum disease and other dental problems. Unfortunately, as many as 20% of Americans are afraid to visit the dentist due to worries about treatments they will need, embarrassment over the state of their mouth and teeth, and other concerns.
• Cost of care: For some seniors, cost is a major barrier to getting regular dental care. Without insurance, a simple cleaning may cost anywhere between $75 and $200. If you have a dental problem requiring treatment, the cost of care may increase substantially. The University of Illinois at Chicago College of Dentistry reports that the cost of treating gum disease ranges from $500 to $10,000, for example.
• Lack of transportation: If you don’t drive and don’t have access to reliable public transportation, it can be difficult to get to the dentist when needed. It can also be difficult to get to the dentist if you’re homebound and don’t have a friend or family member who can drive you. In 2020, about 13% of older Americans were considered homebound, making this a somewhat common problem. If you can’t get routine dental care, you may develop cavities, gum disease or other oral health problems.
• Medication usage: Seniors are more likely to take prescription medications, some of which cause dry mouth, such as medications for Parkinson’s, Alzheimer’s and blood pressure problems. A lack of saliva also contributes to cavities and other dental problems. More than 40% of older adults take five or more prescriptions each day, increasing the risk.
• Chronic medical conditions: Certain health conditions increase the risk for oral health problems. Some of these conditions are more common in older adults than in younger people. For example, uncontrolled diabetes is a risk factor for gum disease.

The Most Common Oral Health Conditions in Seniors

Over time, a lack of preventive care — combined with financial difficulties, chronic medical conditions and/or the use of certain prescription medications — may lead to the development of serious oral health problems. The table below describes some of the most common conditions and explains how they can impact you.

Signs and Symptoms of Oral Health Conditions in Older Adults

Oral health conditions cause a variety of signs and symptoms. If you notice any of the following, schedule an appointment with a dentist as soon as possible.

Tips to Help Seniors Maintain Good Oral Hygiene

When Should You See a Dentist?

Most people don’t look forward to visiting the dentist, but there are some dental symptoms you really shouldn’t ignore. If you experience any of the following, schedule an appointment with a dental professional.

• Chipped or cracked tooth: If you chip or crack a tooth, you may experience pain any time you chew something. Without treatment, the damaged tooth may become infected.
• Bleeding gums: Healthy gums don’t bleed when you brush or floss. If you see blood on your toothbrush or in the sink, it may be a sign of gum disease.
• Persistent bad breath: It’s normal to have bad breath after eating a garlicky meal or drinking coffee, but if your breath remains bad after you brush and use mouthwash, you may have gum disease, cavities or another dental problem.
• Chronic dry mouth: You need plenty of saliva to wash away the bacteria that causes plaque and bad breath. If you always have a dry mouth, consult a dentist before you start to develop cavities.
• Tooth pain: Depending on how severe it is, tooth pain can make it difficult to chew, talk or even get a good night’s sleep. See your dentist to find out what’s causing the pain and address the problem.

Resources to Help Seniors Pay for Dental Care

If you can’t afford to pay full price for dental care, several programs are available to defray your out-of-pocket costs.

Medicaid

Medicaid is a government insurance program for applicants with limited income and assets. Almost all states offer categorical eligibility for older adults, meaning you may be eligible even if your financial resources exceed the regular limits. Although Medicaid plans aren’t required to include dental coverage for adults, many states cover at least emergency dental services. However, the Medicaid plans for more than half of states lack comprehensive dental care coverage.

Eligibility Guidelines

You may be eligible if you meet the following requirements:

• You reside in the state where you plan to receive Medicaid benefits.
• You’re a U.S. citizen or belong to an eligible immigrant category.
• You meet your state’s financial eligibility requirements.

How to Apply for Medicaid

Visit the Medicaid website to find the contact details for your state. You can call the telephone number listed or click the state website link for more information.

Medicare

Medicare provides health coverage for seniors and some younger people with disabilities. Although Original Medicare doesn’t cover most dental care or procedures, many Medicare Advantage providers cover routine cleanings, dental x-rays, dentures and other dental services.  If you want dental coverage, compare plans carefully to find one that covers the services you need.

Eligibility Guidelines

To enroll in Medicare Advantage, you must meet the following requirements:

• Eligible for and enrolled in Medicare Part A and Medicare Part B
• U.S. citizenship or lawful resident status
• Reside within the region covered by your selected Medicare Advantage Plan

How to Apply for Medicare

If you’re eligible for Medicare, apply online through the Social Security Administration website. Once you sign up for Medicare, you can shop for Medicare Advantage Plans and enroll in the one that has the best combination of coverage and affordability. Medicare.gov has a tool that allows you to compare multiple Medicare Advantage Plans and find out how much you can expect to pay for certain services with each plan offered in your area. An alternative way to apply is through SHIP, a free counseling service for recipients of Medicare.

Student-Run Dental Clinics

Many dental schools run dental clinics staffed by students and faculty members. These clinics give students an opportunity to practice their new skills. In turn, patients have access to high-quality dental care at a reduced cost.

Eligibility Guidelines

Each clinic has its own eligibility guidelines and operating schedule. To find out if you qualify, contact the clinic nearest you for information on becoming a new patient.

How to Access Care at Dental Clinics

Use the table below to find a dental school in your area.

Veterans Benefits

Overview

If you served in the Armed Forces, you may qualify for dental care through the U.S. Department of Veterans Affairs. Dental services are provided in VA facilities all over the country.

Eligibility Guidelines

The amount of coverage provided depends on your service history. Full coverage is available if you have a 100% disability rating for a service-connected disability, you receive compensation for a dental condition that’s classified as service-connected or you were a prisoner of war. One-time dental care is available to veterans who served for 90 days or more during the Persian Gulf War era and veterans who are enrolled in the Homeless Veterans Dental Program. Veterans with service-connected dental conditions that don’t qualify for disability payments, have a different condition made worse or harder to treat by a dental condition, or who are enrolled in the Readiness and Employment program may also qualify for certain VA dental benefits.

How to Apply

Visit the Department of Veterans affairs website to fill out the application form. You’ll need to sign in to your VA account before proceeding.

Free Dental Care for Seniors With Limited Financial Resources

With prices rising quickly and many other necessities competing for limited financial resources, some seniors can’t afford to pay anything out of pocket for dental care. If this applies to you, one of the organizations below may be able to help. These organizations provide free dental care to those in need.

Dental Lifeline Network

Dental Lifeline Network offers no-cost dental care to seniors over 65, those with permanent disabilities and/or those who need dental care that’s medically necessary. Some states also have veteran-specific programs. Contact a program representative in your state to find out more about the eligibility requirements.

* Delaware, New Hampshire, New Jersey and Wyoming don’t have any free clinics other than Dental Lifeline Network. The clinics listed set their fees based on a sliding scale, meaning they adjust their fees based on your income. Residents in states without additional free clinics can also check if there is an upcoming pop-up clinic coming to their area. Remote Area Medical Volunteer Corps operates clinics that take place across the United States and has an upcoming clinic schedule posted on its website.