摘要：Societal changes, including the aging of the US population and the lack of routine dental service coverage under Medicare, have left many seniors unable to afford any dental care whatsoever, let alone the most advanced treatments.1 In 2004, the Columbia University College of Dental Medicine and its partners instituted the ElderSmile program in the largely impoverished communities of Harlem and Washington Heights/Inwood in New York City. The long-term goal of this program is to improve access to and delivery of oral health care for seniors; the short-term goal is to establish and operate a network of prevention centers surrounding a limited number of treatment centers. Preliminary results indicate substantial unmet dental needs in this largely Hispanic and Black elderly population. ORAL HEALTH IS A MATTER of public health concern because it affects a large proportion of the population and is linked with overall health status. 2 Recent findings suggest that the improvement of oral health may have a positive impact on general health and may delay mortality. 3 Not only is lower cognitive function associated with greater deterioration of oral health, 4 but complete or nearly complete tooth loss may be a predictor of dementia late in life. 5 Early intervention strategies to address oral health problems can prevent illness, diagnose serious conditions early, and maintain optimum overall health. 6 Attention to improving oral health for seniors is long overdue. 7
