Teeth Extractions - Age 65+ in New York

New York

Complete tooth loss, also known as edentulism, has been called the “ultimate marker of disease burden for oral health” by researchers. The most common causes of complete tooth loss are tooth decay and gum disease, both of which become more likely with age. Having all or some permanent teeth missing is associated with increased risk of disability, mortality and reduced daily function and quality of life, as well as multiple chronic conditions, including:

• Heart disease.
• Diabetes.
• Arthritis.
• Chronic obstructive pulmonary disease (COPD).

Missing teeth or having dentures can impair one’s ability to eat and socialize and is associated with poor nutrition. Because dentures are less efficient for chewing than natural teeth, people using dentures tend to eat softer foods that are easy to chew, and consume fewer fruits and vegetables as a result. In addition, studies find that having an oral health issue that impacts daily life is associated with loneliness and isolation among older adults. 

Due to high costs and lack of Medicare coverage for routine dental visits, many older adults may have trouble getting proper care for their teeth. Annual dental expenditures in the United States increase with age and are highest among adults age 75 and older, who paid an average of $1,244 per patient in 2021.

According to America’s Health Rankings analysis, the prevalence of full-mouth teeth extractions due to tooth decay or gum disease is higher among:

• American Indian/Alaska Native and Black older adults compared with Asian, white and Hispanic older adults. 
• Older adults with less than a high school education, who have a prevalence more than eight times that of older adults with a college degree. The prevalence is lower with each increase in education level.
• Older adults with an annual household income less than $25,000, who have a prevalence nearly 10 times that of those with an income of $150,000 or more. 
• Older adults living in nonmetropolitan areas compared with those in metropolitan areas.
• Older adults who have served in the U.S. armed forces compared with those who have not served. 
• Older adults who have independent living difficulty, difficulty with self-care, difficulty seeing, difficulty with cognition or difficulty with mobility compared with those without a disability.

The percentage of older adults with full-mouth extractions has decreased in recent decades, likely due to public water fluoridation programs and reduced smoking rates. However, access to oral health care remains low, particularly among Medicaid enrollees: Only 20% of dentists in the U.S. accept Medicaid, and state cuts to Medicaid dental coverage have led to a 10% decline in oral health care use among adults with low incomes. 

Creating a separate, voluntary dental benefits program under a new part of Medicare can help strengthen oral health care for older adults. In a 2021 statement, the American Dental Association called for Medicare dental benefits efforts to prioritize low-income older adults, emphasizing that dental coverage should be delivered through a separate program tailored to the distinct nature of dental care.

Steps older adults can take to maintain good oral health include the following:

• Using fluoride toothpaste.
• Brushing and flossing teeth regularly.
• Avoiding tobacco.
• Limiting alcohol.
• Seeing a dentist annually for preventive care.

Healthy People 2030 has an objective to reduce the proportion of adults age 45 and older who have lost all of their natural teeth.

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