Dental Advocacy: Bridging the Oral Health Crisis for Seniors

Oral health is a vital but often overlooked component of overall well-being—particularly for seniors. As adults age, they face a higher risk of tooth decay, gum disease, oral infections, and tooth loss, all of which can severely impact their quality of life and lead to complications in other areas of health.

CDC statistics reveal a grim reality:

• Nearly 70% of adults aged 65 and older have some form of periodontal disease.
• One in five seniors has untreated tooth decay.
• Oral infections have been linked to an increased risk of heart disease, stroke, and Alzheimer’s disease.
• Seniors with severe gum disease are more likely to suffer from complications related to diabetes.
• Nearly 1 in 10 adults aged 65 to 74 and 1 in 5 adults aged 75 and older have lost all of their natural teeth due to untreated dental conditions.

Despite these alarming numbers, oral health is often sidelined in primary care settings, especially in long-term care facilities where systemic oversight and coordination are already stretched thin.

Oral-Systemic Health: The Mouth-Body Connection

Poor oral health doesn't exist in a vacuum—it has far-reaching effects throughout the body. Studies have shown clear associations between oral infections and serious chronic conditions such as:

• Cardiovascular disease: Oral bacteria can enter the bloodstream, triggering inflammation that contributes to heart disease and stroke.
• Diabetes: Periodontal disease can make blood sugar harder to control, while elevated glucose levels make the mouth more susceptible to infection.
• Respiratory illness: Seniors are at higher risk of aspirating oral bacteria, which can lead to pneumonia.
• Cognitive decline: Emerging research links gum disease and tooth loss with an increased risk of dementia, including Alzheimer’s disease.

The implications are serious. Yet, dental care is rarely integrated into broader conversations around aging, public health, or chronic disease management. This lack of integration leaves many seniors vulnerable—not just to toothaches, but to preventable medical complications and diminished dignity.

Why Seniors Fall Through the Cracks

Seniors living in assisted living or nursing facilities often rely on others to advocate for their healthcare needs. Unfortunately, dental care is frequently overlooked until it becomes a crisis. Family members may live far away, caregivers may not be trained to recognize dental issues, and many facilities don’t have protocols in place for routine oral assessments.

On top of that, Medicare does not cover routine dental care, and many older adults live on fixed incomes that make out-of-pocket treatment unaffordable. For those on Medicaid, adult dental coverage varies dramatically by state—and proposed funding cuts threaten to further restrict access to critical services. Without clear policies and proactive care, many seniors suffer in silence until the pain becomes unbearable.

The Role of Dental Advocacy

This is where advocacy becomes crucial. Dental patient advocacy focuses on empowering older adults to receive the care they deserve by:

• Helping patients and families understand their treatment options and insurance coverage
• Supporting communication between patients, caregivers, providers, and insurers
• Ensuring dental concerns are taken seriously within larger healthcare discussions
• Identifying barriers to care such as transportation, cost, or provider availability—and finding solutions

Advocates act as connectors, educators, and watchdogs, ensuring no one is left behind due to a lack of information or access. When integrated into care teams, advocates can identify oral health needs early, support care coordination, and help prevent long-term complications.

Why the BCPA Credential Matters 

Board-Certified Patient Advocates (BCPAs) bring a unique and much-needed skill set to the dental field. While traditionally associated with medical case management, the BCPA credential is increasingly recognized in other contexts like dental, especially for vulnerable populations such as seniors and individuals with disabilities.

In a dental setting, BCPAs help:

• Decode treatment plans and billing terminology
• Assist with denials and insurance appeals
• Monitor continuity of care across dental and medical providers
• Support informed decision-making and protect patient autonomy

Given the complex nature of dental coverage, especially when medical cross-coding is involved (e.g., for sleep apnea, jaw disorders, or medically necessary extractions), having a trained advocate who understands both the insurance system and patient rights is invaluable.

A Call to Action

The oral health crisis among older adults is a public health issue—one that requires awareness, policy reform, and interdisciplinary collaboration. Healthcare professionals, caregivers, and advocates must work together to elevate dental care to its rightful place within the continuum of aging services. This means advocating for policy changes that expand coverage, pushing for better dental protocols in long-term care, and empowering patients to seek care before it becomes an emergency.

Above all, we must recognize oral health as an essential part of aging with dignity. Every smile matters.

About the Author:
Shelbey Arevalo is a Board-Certified Patient Advocate (BCPA) and founder of the National Dental Advocacy Program (NDAP), a nonprofit organization dedicated to bridging the gap between patients and providers through education, care coordination, and systemic advocacy. She is passionate about ensuring that dental health receives the recognition it deserves in senior healthcare policy. Learn more at nationaldentaladvocacy.org or contact info@nationaldentaladvocacy.org.

Here more from Shelbey on our podcast@!

Key Resources

• CDC – Oral Health for Older Adults
• NIH – Oral Health and Aging: nia.nih.gov
• Mayo Clinic – Gum Disease and Heart Health: mayoclinic.org
• PACB – What is a BCPA?: pacboard.org
• CareQuest – The Threat of Medicaid Dental Cuts: carequest.org