Dental Inspirations, Inc. - The experience to learn more !

Specializing in dental management of the renal transplant and lectures on life issues.

Quality of Life Dentistry:
The Team Approach

"Health is a state of complete physical, mental, and social well-being,
and not merely the absence of disease or infirmity."
- World Health Organization, 1948

In the dental industry, a new age is on the horizon! As the baby boomers of the United States (those born between the years 1946 and 1964) graduate to senior status, the dynamics of dentistry will greatly change. As this population continues to age, more and more specialized care will be required to treat chronic health conditions at an unparalleled rate. In 2003, the United States spent fifteen percent of the Gross Domestic Product, $1.7 trillion, on healthcare. Yet, this group has only yet begun to show its potential, as that by 2029, all of the baby boomers will be over age 65 and will account for over twice as many senior citizens as in today's society. Dental health care professionals accustomed to providing highly technical and cosmetic procedures on the "healthiest" patients will be introduced to the new consumer: the senior boomer.

Unlike their parents (those born in the depression era), baby boomers have the benefit of extended life expectancy due to advances in the prevention and control in infectious diseases, improved access to medical care, earlier detection of disease, better treatment, high-level knowledge of disease risk factors, new medications, and expanded uses for existing medications. They are the first elderly population to have benefited from fluoridated water during their youth. Furthermore, they are also the first population to grow up in the age of television and have embraced the internet as well. Baby boomers, who watched television shows such as Star Trek growing up, believe medicine has no boundaries and these perceptions are validated when they are able to access pertinent medical (and dental) information on multiple internet search engines in seconds. The senior boomer will not be satisfied with a dental treatment plan that includes tooth extraction, they believe we can repair anything and if all else fails they've read on the internet that we can now engineer tooth buds in a laboratory!

Unfortunately, acute and chronic illnesses are unavoidable occurrences of aging and by 2029 there will be an estimated 69 million senior boomers (20 percent of the population). Certainly, an older population with fewer edentulous people will pose new challenges to dental health care providers - most importantly the task of managing a high number of patients with complex medical histories.

Although our patient pools are evolving dramatically, dentistry will have to reacquaint itself with some of the practices of the past and "slow its pace", if not to avoid litigation, to remain competitive. Computers will have to bare more of the business burden (bookkeeping, appointments, insurance filing, record keeping, charting, communication, etc.) for the provider will need to devote more time toward thorough health evaluations. Undiagnosed medical conditions due to an overburdened healthcare system, is a realistic concern.

It will be critical that all members of the dental team realize their role in gathering accurate health information from the patient. As this group of medically complex patients continues to grow, it will be increasingly important for the dental team to work, as a whole, in gathering information regarding the patient's medical needs as well as their dental needs. Statements that confirm competence, and create trust and loyalty will be more productive than double booking schedules.

The expectations of the "senior boomer" will be high; however, providing quality dental care is more than clinical expertise. Critical gaps of communication between the dental health care provider and the patient (or the patient's medical provider) may result in injury or death.

One solution to this problem may already exist. In 1993, the CDC (Centers for Disease Control and Prevention) began research into the population health-related Quality of Life (HRQOL) and its effect on both physical and mental health. From this research, the CDC developed a set of validated questions called "healthy days measures." Physicians and public health professionals use these set of questions to measure the effects of numerous disorders, disabilities, and diseases in various populations. According to the CDC, tracking HRQOL in populations, such as the elderly or medically compromised, can identify subgroups with poor physical or mental health and can help gear policies that improve the patients attitude and health.

By the year 2050, the senor boomers will be over age 85. Therefore, the change that dentistry will be forced to make will not be short-term. Because of multiple complex medical histories, dentistry could benefit from Quality of Life questions as is or in a modified form. These questions can be used as tools to improve patient/provider communication, as well as acceptance of treatment plan proposals. In addition to the four standard "healthy days" questions, additional questions are also available from the CDC and are beneficial for patient care. Understanding the current physical and mental health, especially in the elderly, will increase patient satisfaction as well as practice productivity. When a quantifiable measure of a patient's health (both physical and mental) is applied and when the entire dental staff is held accountable for collecting medical history data, not only will treatment plans be successfully executed, the staff (as well as the patient) will find the experience positive and rewarding, but most importantly, successful.

For more information visit: http://www.cdc.gov/hrqol/index.htm

CDC uses a set of questions called the "Healthy Days Measures." These questions include the following:

Would you say that in general your health is
a. Excellent
b. Very good
c. Good
d. Fair or
e. Poor
Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?