Untreated dental issues in older adults can lead to serious illnesses
Older adults are keeping more of their natural teeth than previous generations, but they continue to face significant oral health challenges that can threaten their overall well-being. According to Frank Scannapieco, DMD, PhD, SUNY Distinguished Professor of Oral Biology at the University at Buffalo School of Dental Medicine, untreated dental issues such as tooth decay and periodontal disease are strongly linked to systemic illnesses including heart disease, pneumonia, chronic obstructive pulmonary disease (COPD), diabetes, and Alzheimer’s disease.
For more than three decades, Scannapieco has studied the connection between oral bacteria and systemic disease, particularly in people over the age of 65. His findings reveal that maintaining dental health is not just about preserving teeth—it can significantly reduce health risks and lower healthcare costs for older adults.
The link between oral health and systemic diseases
Periodontal disease is a cumulative condition that often becomes more severe with age. Gum disease can cause ulceration of gingival tissue, creating pathways for bacteria to enter the bloodstream. Once in the body, these bacteria may trigger or exacerbate chronic inflammation, a driving factor in cardiovascular disease, diabetes, and even cognitive decline.
Emerging research also suggests that oral bacteria or their byproducts may penetrate the blood-brain barrier, potentially contributing to neuroinflammation and Alzheimer’s disease. “We know that poor oral hygiene is a major problem for older adults. Yet for many reasons, it’s often ignored,” Scannapieco explains.
Research connecting oral bacteria to Alzheimer’s
Currently, Scannapieco is a co-investigator on a five-year NIH-funded study led by Irene Yang of Emory University, exploring the relationship between periodontal disease, the oral microbiome, and Alzheimer’s disease. The project examines whether bacteria from the mouth may infiltrate the brain and trigger harmful inflammation linked to cognitive decline.
Barriers to dental care in older adults
The biggest challenge seniors face is access to affordable care. When individuals retire, they often lose dental coverage provided by employers, and Medicare does not include dental benefits. As a result, many older adults must pay out of pocket, making routine care unaffordable.
Scannapieco is actively working with the Coalition for Oral Health Policy, a national advocacy group pushing for Medicare to cover preventive dental care. He argues that even minimal coverage—such as two annual cleanings, X-rays, and basic fillings—would dramatically improve seniors’ health and lower medical costs tied to systemic illnesses.
Oral health in nursing homes
The situation is particularly concerning in long-term care facilities, where dental hygiene is often neglected due to limited training and staffing. Many residents do not even receive daily tooth brushing, increasing their vulnerability to aspiration pneumonia and other serious infections.
The way forward
Preventive strategies like regular tooth brushing, professional cleanings, and early treatment of gum disease may sound simple, but they require systemic changes in healthcare policy, caregiver training, and insurance coverage. “If Medicare would pay for basic dental care, this would save money and help older people’s quality of life,” Scannapieco emphasizes.
Oral health is far more than a matter of comfort or appearance—it is a critical component of healthy aging. Addressing dental care in older adults could protect millions from preventable disease, improve quality of life, and significantly reduce the nation’s healthcare burden.
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