摘要：Racial/ethnic and socioeconomic disparities regarding untreated oral disease exist for older adults, and poor oral health diminishes quality of life. The ElderSmile program integrated screening for diabetes and hypertension into its community-based oral health activities at senior centers in northern Manhattan. The program found a willingness among minority seniors (aged ≥ 50 years) to be screened for primary care sensitive conditions by dental professionals and a high level of unrecognized disease (7.8% and 24.6% of ElderSmile participants had positive screening results for previously undiagnosed diabetes and hypertension, respectively). Dental professionals may screen for primary care–sensitive conditions and refer patients to health care providers for definitive diagnosis and treatment. The ElderSmile program is a replicable model for community-based oral and general health screening. KEY FINDINGS ▪ ElderSmile, a comprehensive community-based program offering oral health prevention, education, screening, and treatment services to minority elders in northern Manhattan, successfully incorporated education, screening, and referral for diabetes and hypertension into its service delivery offerings. ▪ Among ElderSmile participants with no previous diagnosis by a physician of diabetes or hypertension, 7.8% and 42.2% had hemoglobin A1c (HbA1c) levels in the diabetes range and prediabetes range and 24.6% and 37.7% had blood pressure readings in the hypertension range and prehypertension range, respectively. ▪ Among ElderSmile participants with a previous diagnosis by a physician of diabetes or hypertension, 38.3% had HbA1c levels in the out-of-control range, and 37.8% and 39.8% had blood pressure levels in the hypertension range and prehypertension range, respectively. ▪ In subgroups of ElderSmile participants aged 50 years and older with self-reported information on periodontal disease, 126 of 496 (25.4%) reported that their teeth had become loose on their own, and 86 of 421 participants (20.4%) reported that a dental professional had told them they had lost bone around their teeth (data available upon request). ▪ Linking primary care and oral health screening in senior centers may usefully assess disease burden and identify minority seniors in need of medical and dental services. DEMOGRAPHIC SHIFTS , including an aging and more racially/ethnically diverse population and ongoing changes in the health care policy environment, are creating opportunities for the dental profession to become more involved in providing integrated oral and general health care. 1 Challenges include providing more comprehensive care for patients with complicated medical and social needs while improving access to care for underserved populations. It has been proposed that in the future, the practice of dentistry might include monitoring and screening for chronic diseases, such as diabetes and hypertension, to achieve successful patient management of complex dental problems, such as tooth loss, dental caries, and periodontal disease. Meanwhile, the public’s expectations for dentistry will require the field to develop strategies to manage the oral health of groups not now receiving adequate care, including older adults.
