One of the questions that is routinely asked of patients during a new patient visit and then periodically afterwards focuses on their dental health. Some patients are surprised that this question is asked primarily because they have not pondered the connection between their dental health and their overall medical health.

Dental care, as we all know, can be quite expensive. I have found it surprising that many patients who have dental insurance do not use it. Many people also fear visiting the dentist. They have that old stereotypical vision of pain and discomfort. So many advances have been made in dental care that a trip to the dentist is no longer the stuff of bad dreams.

I see many patients who are aware of their dental needs, however, on many occasions the immediate need for the funds will delay a dental visit until an is-sue becomes an emergency. In an emergency situation relief of pain is the objective and unfortunately salvaging teeth may not be in the picture due to tooth decay or expense.

Medicare, which is medical care for people with disabilities and more commonly for the elderly, does not provide for dental care, so a supplement for dental care must be sought.

One of the flaws in our health system that must be worked out is a lack of dental coverage by Medicare.. A recent study published in the Journal of the American Geriatrics Society looked at dental health and malnutrition in older adults.

It is of note that North Carolina ranks third in the nation with the most elderly living below the poverty line. This leads to scarcity of food and exacerbates the already high risk of decline in function, decreased quality of life and increased mortality.

Of all the factors studied, poor dental health had the largest impact on malnutrition. More than half of the patients in the study had dental problems. Those with dental problems were three times more likely to suffer from malnutrition.

Dr. Tim Platts-Mills, senior author and director of the Division of Geriatric Emergency Medicine at the UNC School of Medicine, looked at the problem in a practical manner. He noted that we need to find adequate nutritional support for these patients. This would be far less costly than caring for the problems that arise as a result of malnutrition. He noted that food assistance programs such as Meals on Wheels were relatively inexpensive at about $6 per individual per day. He further noted that many of these pro-grams were underutilized and underfunded.

Dr. Plant-Mills suggested we need to find ways to connect at risk patients with organizations and find additional funding for programs that provide afforable dental care. It is better and cost effective to tackle the problem before malnutrition than after malnutrition.

Collin Burks, a UNC medical student and the study’s lead author said, “Improving oral health in older adults will be more challenging but also important. Medicare does not cover dental care. Fixing dental problems not only makes it easier for these individuals to eat but also can improve their self-esteem, quality of life and overall health. We need affordable methods of providing dental care for older adults.”

Dr. Veita Bland is a board certified Greensboro physician and hypertension specialist. Dr. Bland’s radio show, “It’s a Matter of Your Health,” can be heard live on Wednesdays, 5:30 p.m. on North Carolina A&T State University’s WNAA, 90.1 FM. Listeners may call in and ask questions. The show is replayed on Sirius 142 at 5 p.m. on Wednesdays. Email Dr. Bland at

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