Dental care for seniors involves unique considerations. Seniors are more likely to suffer from a host of oral health issues resulting from the natural aging process. Proper oral health care is critical, yet, coverage is not provided by Medicare. If your senior loved one is a low income senior, options are available.

Beware of such diseases and oral problems such as:

  • root caries
  • attrition, such as grinding of teeth causing the wearing of tooth enamel
  • gum or Periodontal disease
  • missing teeth because of earlier neglect; or having few or no teeth in the mouth which is the final marker of disease burden (edentulism)
  • poor quality of alveolar ridges
  • ill-fitting dentures
  • mucosal lesions
  • oral ulceration or dry mouth (xerostomia), oral cancers, and rampant caries happen, especially when taking certain medications

Services

Be aware that denture wearers need as much care as anyone else who has their own teeth. A dentist can perform an oral cancer screening for  your loved one and may find other diseases that you wouldn’t think would stem from the oral cavity.

Good oral hygiene improves quality of living which permits successful aging to occur. When the elderly already have heart disease, diabetes, and other vascular diseases, they are at a higher risk for gum disease.

Preparation

  • Know your parents prior dental history.
  • Its helpful to have possession of their dental records.
  • When was the last dental visit, and the reason for the visit?
  • Will you be the person responsible for signing for consent of services?
  • If other financial options need to be considered, contact the Dental Society in your County/State or the National Council on Aging.

Evaluation

  • Is the dentist accepting new patients?
  • Does the dentist treat patients with special conditions? (Alzheimer’s/Dementia)
  • Does the dentist offer the latest in dental technology?
  • Is the office wheel chair accessible?
  • Please provide references.
  • Does the dentist have a specialization in treating seniors?

Dental Care Radio Show Segments

  • How Oral Health Impacts Overall Health

    As we age, sometimes we forget about a very important aspect of our health: our oral health. Once we get in our fifties and sixties, some of us think, it is what it is. It’s expensive; senior on fixed incomes put tooth care last. But as we age, our teeth need more attention. Dr. Shawn Weiss joins Suzanne to talk about how oral health factors into overall health.

    Dr. Shawn says, “Your mouth has its own kind of ecosystem and it really does affect your overall health. It’s kind of the start of the whole gut canal, and there’s a lot of indicators for that. People might be grossed out by this, but your mouth has over 800 types of bacteria, viruses, parasites, things like that. Some of them are beneficial, and you want to eliminate the ones  that shouldn’t be there.

    “When you’re looking at gut health, there’s such a connection with gut health and oral health. Be mindful of that, outside of regular dentistry. When you get your teeth cleaned, you’re trying to prevent gum disease and some people might have dentures as they get older, and you’re trying to prevent tooth decay. But there’s so much more to it. There’s a lot of indicators that we can study in your mouth that are predictive of your overall health.”

    Learn more

    Check out our affiliate podcast Alzheimer’s Speaks.

  • Focus on Preventative Measures: Dental

    On behalf of Humana, gold sponsor of the Vitality Revolution Podcast Series, Lori Hutson joins Suzanne. Lori is owner of LJ Hutson Insurance LLC in Washington state.

    Vitality Revolution Podcast Series

    This segment addresses dental health benefits available through Medicare Advantage programs. Dental health impacts our overall health and becomes more important as we age. Unaddressed oral infections can progress into your bloodstream and throughout your body to become something more serious. If you have to be treated for some condition, it’s possible doctors will put off treating that if you have a dental problem, and have that treated first.

    Lori says, “If you have original Medicare, you do have some coverage for a medical appointment, very limited. If you have something like a tumor in your mouth, or mouth cancer, things like that, that will be covered under original Medicare. I had an example, a member I was working with, she fell and she broke off all of her bottom teeth. Well, getting the teeth removed, that was a medical appointment, so that was covered under her medical, but the restoration wasn’t covered. Then she needed a bridge, or implants, and that was not covered. So the Medicare Advantage plans, they will add in benefits, and dental is a huge issue right now, almost all of them now cover the basics. So they’re gonna get cleanings, exams, X-rays, a couple of fillings. That’s pretty standard, but then some of the plans — depending on your eligibility, depending on where you live, what’s available for you — they will cover root canals, crowns, those types of things as well.”

    Contact Lori through her website LJ Hutson Insurance LLC.

  • Sound Dental Care: Geriatric Dental Health, Part 4

    Sarah Luetke, founder and CEO Sound Dental Care, joins Suzanne to talk about breakthroughs in geriatric dental health. In this segment, Sarah talks about her mission and where future breakthroughs will take us.

    Mobile dental hygiene brings equipment to each facility to deliver the best possible care and comfort to patients. They have state-of-the-art mobile equipment that includes a portable dental chair and other dental equipment that you would see in a traditional dental office. They offer many of the same preventative procedures that you would find in a dental office including patient screenings, dental cleanings, fluoride varnish applications & silver diamine applications. Her goal is about serving others, helping family members, and trying something different. We’re all aging, and we’re all going to go through this process – seniors should be able to live out their lives feeling like they’re being advocated and cared for.

    Learn more about geriatric dental health options for people on fixed incomes or who live in senior living communities. Visit Sound Dental Care‘s website or call 206-745-3808 to learn more.

    Transcript

    Welcome back, everyone, to the Answers for Elders Radio Network, and we are here with Sarah Luetke, who’s the founder and CEO of Sound Dental Care. And this hour we have been talking about geriatric dental health, dental treatments, new breakthroughs, all kinds of things. And Sarah I, you are such a joy to talk to. I am so inspired by you know who you are. And I want to spend the last bit of the story of about your mission and and I know you touched on it a little bit, but let’s I really want to dig into you know, what happens in the future. Where are we going with all of this amazing thing, um, breakthrough stuff that you’re working on.

    – Well, this is this is the question I asked myself every day. And my goal is the same goal. I would say, our whole team at Sound General Care hats and it is serving others. And um, we are not a Christian company, but I am a Christian and many of our team members are, and Philippians to three to five always rings out to me, and it’s do nothing out of selfish ambition or being conceit, rather in humility, value others above yourself, not looking for your out for your own interests, but each of you to the interest of others. And I would say that is what we are about. Our team is about serving others, and we are about doing something different. And all of us have worked in private practice dental offices throughout our lifetime and we’ve all found ourselves has come to this and it’s the happiest years of our career. And as you know, we’re all aging, we’re all going on at the same point at some place in our life. And I’ve seen my family members now that I’m getting older, start to go through this process. And I want to see seniors live their lives out in a humane way that they feel taken care of and they feel advocated for. Because when we walk into one of our nursing home buildings and the stories that our team we’re all over the states, so we share our stories and emails at the end of our work days. And last week I got an email from one of our hygienists and she said, you know, I love this job. Thank you for providing this opportunity. And she said I had a lady today that pulled up my heart strings and she was just sitting there and she didn’t want to open her mouth, and then she finally allowed me to clean her teeth. And at the end of the appointment she said to Rachel, you know what, you really made me feel like a person again. You’re really easy to talk to and I feel like someone still cares about me.” And I’ve had another team member email me at the end of a day and say, you know, “I got a hairbrush thrown at me, I got screened at, I got my finger bit. But all in all, the sweet gentleman let me clean his teeth and by the end of the appointment he asked me if I would marry him”. So at least…

    – I love this!

    – Our goal is to continue to be a solution for families. We are about serving our geriatric patients dental care needs and helping families. I get calls from family members crying. “I don’t know what to do. There’s this expense, I can’t get them out. What do I do?” And we’re just doing everything we can to help. The silver diamine that I have spoken about in our previous segments. It was FDA approved in the United States in 2015, and so I am doing a lot of research and work with a few dentists, one in Oregon, one in Wisconsin, and actually, our whole team is headed to Bolivia in November to do a research project on silver diamine. And I’m all about pushing it into the public and telling people “Ask, ask your dentist.” You mentioned before, Suzanne, that most people don’t know about this, and they don’t you ask your dentist. And if dentists are are open to talking to their patients and giving their patients choices, they should be talking about silver diamine. They should be talking about fillings. They should be talking about…

    – Especially, I mean people that are on fixed income. There needs to be some sort of a plan for seniors that may not be the you know, I mean, seriously, not everybody has to have, you know, a $10,000 dental bill.

    – Yes. I have a dentist in Wisconsin that I’m friends with, and he two and a half years ago he closed his private practice dentist that he – dental office – that he had had for years, and he opened a new dental office called Victorious Dental. And he has not had a drill in his building for two and a half years.
    – My goodness.
    – And he serves all ages.

    – And you know, there’s so many people out there that have fear of the dentist, just because of the drill, and at least and they don’t want to be drilled on period. They can’t handle it, and their only option might be what you know, you can help them with. And a lot of what you can do is help prevent a decay to happen as well. And that’s one of the things I think that is so important that we do take, you know, be a little bit more mindful as a society, be sensitive to those fears and be sensitive to the fact that, you know a lot of times people have had traumatic incidents in a dentist office. I know somebody that I talked to not too long ago, they’re they’re terrified of the dentist and the main reason is the child, the dentist that they went to was was probably drunk that he figures that he was probably drunk and he was drilling and he just went way too far and complete ruined the tooth. You know, we couldn’t focus. It was like crazy. So he’s got this horrible fear. And you know, I in this this guy was like he was in his teens when it happened, you know. But again we’re talking the 60s. This was back in the 60s, a very different time. But those fears will last, you know, that’s PTSD that can last forever. Right. So the idea to have somebody like you that gives a good option is so amazing. And I love that you’ve taken, you know, and and the good news, you know, for all of us, it’s our gain. But you know, you’ve also chosen not to sell out and go for the big bucks, you know, because a lot of times, you know, that’s really where what it’s about. People get into dentistry because they want to be multimillionaires, you know, and and that’s you know, obviously you’re not doing that when somebody’s only paying like $149 or $189 dollars, right, So it’s a difference.

    – The other thing I really want to stress here is at Sound Dental Care. From day one, we said we are going to accept all patients, and this means Medicaid patients, patients that are lower-paying state insurance, and, you will find programs in our state that there are Medicaid providers, but they tend to serve mostly children and then also they do serve some adult patients as well. But when there’s so few and far between Medicaid dentists out there, they’re booking out months and months and months, and it’s hard to run a brick and mortar dental practice and see Medicaid patients. And we set up our practice on being viable on Medicaid reimbursements as well. And so most of our patients have met CADE and we never say no to them. Now, I when I try to find a dentist to refer these patients out to when they need care beyond what we can do at Sound Dental Care, I can find a dentist that will take the private pain and the insurance ones any day, But finding a Medicaid dentist for this population is near impossible, and it puts the facilities, me, everyone, in a very tough place. And so my goal is that we continue to do the silver diamine treatment. We continue to see these patients every three to six months for dental cleanings, and we don’t let them get to a point where their mouth is in such a bad place that we don’t we don’t know what to do. And so my goal is really medical dental integration. And in the nursing homes, the dentist tend to not be going in there. And so every nursing home that we serve, mostly the skilled nursing homes, have a medical doctor or a primary care provider. We work hand in hand with them, and they know those patients better than anyone because they see their med history every day.

    – Right right, Well, Sarah, I am telling you right now, you are such a I am so thrilled that you’ve come on our program, and I pledge to you, I will do whatever I can to get you into anywhere that needs to because my whole goal is to make sure that we have some real um, positive um experiences with our seniors that they can get the care that they need. And you know, just to think about if there’s so many boomers right now turning out there that have probably neglected their teeth a little bit, but it’s only going to get worse as they get older. There’s there’s some certain days obviously that I would love to be able to see how we could help, and I don’t know how we can do that yet, but UM, you know, I want to let you know that we would love to do what we can, because again, my whole goal is to help our older adults for sure. If somebody has a loved one in a skilled nursing healthcare facility or community, how do you reach out? How do we reach you?

    – You can look up Sound Dental Care online. You can go to www.SoundDentalCare.com, or you can call us at 206-745-3808.

    – And you know, here’s the thing that I think is really important with all of this is that let’s figure out a way if you know, if you have a loved one that you want to get UM services and you service pretty much throughout the state of Washington. You said, what areas are so you do and what is usually the waiting period for something like that to get get in to see you, not not too long. Within a month or two we’re in there to see that’s perfect, so perfect, So again, just um think about it. And the number of that Sarah has given us is two oh six seven four or five three, eight zero eight. If you want to get your loved one seen or go to sound Dental Care dot com and you can learn a lot more about it. And Sarah, thank you so much for being with us today. Thank you so very much. So I am excited to see what happens in the future with you. I have a feeling you’re going to be doing some really amazing things. Thank you and for each and every one of you this week. This has been an amazing interview and we’re looking forward to seeing how you can help your loved one think about dental health in a whole new way. Until next week, be good to each other.

  • Sound Dental Care: Geriatric Dental Health, Part 3

    Sarah Luetke, founder and CEO of Sound Dental Care, joins Suzanne to talk about breakthroughs in geriatric dental care.

    Sarah shares a story: “I saw a husband and wife for years at a private practice. I was their hygienist, and both had excellent teeth, lots of crowns in their mouth. Anytime they needed work done, they paid for it,  they just had beautiful, healthy mouths. Then I hadn’t seen his wife in a few years, and the next time the husband came in, he said, ‘I haven’t brought her in because she now lives in a nursing home, and I’m really worried about her. She has 10 to 15 teeth that have broken off to the gum line since you saw her last.’

    “So the dentist said, ‘Sarah, you’re starting your your mobile company, why don’t you go to the nursing home and see her?’ I saw her, and I sent photos to the dentist, and he said, ‘There is no way I’m extracting all those teeth.’ For an Alzheimer’s patient they would need general sedation, and that’s not in her best interest. He said, ‘why don’t you go do that thing you do?’ And what I do is a palliative care or an alternative treatment with silver diamine fluoride, an antimicrobial prescription topical. You apply it with a Q-tip, you apply it to a cavity, you can apply it to root tips. I’ve applied it to abscesses where a patient isn’t healthy enough for an extraction.

    “So this is what I did for my patient. Those teeth did turn black, as it arrested the cavities. If that’s a concern to the patient or the family, you can always have tooth-colored fillings put on top of them. But you don’t have to. Her husband said, ‘No, just leave it.’ She had quit eating a lot of her favorite foods before, but she started eating bacon again. She lived for five more years.

    “And the cost was so much less than a filling. As a matter of fact, in our practice, we charge no extra for our private pay patients. And if we bill insurance and they don’t pay for it, we write it off because we feel that it is the best thing, better than a cleaning. It’s the best thing we can do for a patient.”

    Learn more about geriatric dental care options for people on fixed incomes or who live in senior living communities. Visit Sound Dental Care‘s website or call 206-745-3808 to learn more.

    Transcript

    Welcome back, everyone, to Answers for Elders Radio Network, and I am here with Sarah Luetke, who is the founder and CEO of Sound Dental Care. And Sarah, I’m so glad we’ve been talking about seniors and dental health, all different types of situations where um, we may be neglecting ourselves and and certainly being in a situation where we’re concerned about a loved one. You shared with me, Sarah, a story that I would love to have you repeat to start off this first segment about the gentleman that used to be clients of yours and then you treated his wife. Would you kind of reiterate that story to start off the segment with our listeners.

    – Yes. I saw a couple – husband and wife’s spouse – for years at the private practice. I was their hygienist at the dental office, and both had excellent teeth, lots of crowns in their mouth. Anytime they needed work done, they financially did it, they could afford it, they believed in it, and they just had beautiful mouths, healthy mouths. And the husband came in one day and I haven’t seen his wife in a few years, and sometimes you just don’t know if it’s appropriate to ask. And so he mentioned her and it brought up the topic, and he said, I haven’t had her in because she now lives in a nursing home, and I’m really worried about her, Sarah.” And he got tears in his eyes and he said, she has 10 to 15 teeth that have broken off to the gum line since you guys saw her last. And her mouth was immaculate when I last saw her. So the dentist came in and we told him this story, and he said, Sarah, you’re starting your your mobile company, why don’t you go to the nursing home and see her? And I said, okay. So I went to the nursing home and saw her, and I took photos and I sent them to my dentist that I was working for, and he said, this patient has Alzheimer’s now, And he said, there is no way I’m extracting all those teeth on her, and you would have a different opinion from a different dentist. Some dentists may extract all of those, but he said, on an Alzheimer’s patient they would need general sedation – and he said, it’s not in her best interest. He said, “why don’t you go do that thing you do?” And that thing the thing I do is silver diamine fluoride and that is a palliative care or an alternative treatment. Silver diamine is an antimicrobial, a prescription topical, and you apply it with a Q-tip, you apply it to a cavity, you can apply it to root tips. I’ve applied it to abscesses where a patient where the medical doctor at a nursing almost say this patient isn’t healthy enough for an extraction, and I said, well, we can’t do nothing. What can we do? And the medical doctor will put the patient on a systemic antibiotic and I will treat it with silver diamine from a clinical point, and together we will try to do everything we can to keep the patient healthy. So this is what I did for my patient, and I continued to care for her for five years. She had quit eating a lot of her favorite foods before the silver treatment. Those teeth did turn black, as it arrested the cavities. If that’s a concern to the patient or the family, you can always have tooth-colored fillings put on top of them. But you don’t have to. Her husband said, no, just leave it. She started eating bacon again. She she lived for five more years, and I cared for her for three months. And the cost, the cost is so much less than doing a filling. And, as a matter of fact, in our practice, we charge no extra for our private pay patients. And if we bill insurance and they don’t pay for it, we write it off because we feel that it is the best thing, better than a cleaning. It’s the best thing we can do for a patient.

    – Sure, sure, And you know that’s the thing that a lot of us don’t realize that there are alternatives. And we go to a dentist and we’re fearful of what we’ll find when we get in there. And I know the last time I went to a dentist to get my teeth clean and they took X-rays of my mouth. They told me that it was going to be $3,000 just to get me to ground zero. Well, most of us don’t have $3,000 laying around to do stuff like that. Some don’t have income to even be able to finance something like that. So having alternatives when you’re a senior, and if you’re in a situation where you’re in assisted living, this might be a wonderful opportunity.
    – So you work primarily through assisted living, senior living communities, senior centers, or community centers, is that correct?

    – Yes, and disability homes, adult family homes.

    – Okay, okay, So you could go into an adult family home and do everything, do everyone together. And so I want to talk a little bit about when you talked last time about the lady with dementia. Dementia is a huge issue because you don’t necessarily know if someone’s in their right mind to be able to lay there and be still. How do you handle that?

    – Great question. My practice began because my grandfather had a stroke and was in a nursing home. Then my mother-in-law, she has had Alzheimer’s since she was 52 years old. Bless her heart, she’s still alive 21 years Alzheimer’s.

    – That is amazing.

    – We pray every day that that she gets to go to Heaven soon, because it’s just a very challenging thing. And then I had an uncle, and also my grandmother, and they’ve both passed. They both had Alzheimer’s as well. And what I saw is: all four of my family members had lifetime dental care and had traditional dental care every three to six months and really took care of their mouths. They all went into nursing homes, and all of a sudden, the care just fell off. It is not because the nursing homes are trying to neglect it. It’s that nursing homes have so much on their plate. They are not trained in the mouth. Just like I’m not trained to shower someone.
    – I’m part of the American Mobile & Teledentistry Alliance. There’s a lot of independent practitioners like myself, and our goal is that every single nursing home has a dental hygienist in their building at some point. It does not have to be a staff member, but they need to be there. And state auditors are starting to look at this in facilities, and so facilities are loving that our company is willing to come in and see their patients. Our approach is to meet each patient where they are. If they are in their bed. and they can’t get out and it’s a wire lift, and the facility says it’s just not possible. then we see them in be,d and I’ll do everything I can for them. It may not be the same exact cleaning they would get at a dental office, but I’m doing something.

    – Absolutely. Alzheimer’s patients, do they allow it?

    – I’ve had so many family members and guardians over the years say we’re going to sign them up, but I just don’t think it’s going to be successful. And you see someone in their own home study. You approach them in a way that we make it happen. And we rarely, rarely have a patient we do nothing for.

    – And that’s the most important thing. It’s like we all do the best we can with what we’ve got, as we always say. But you know, the idea is obviously is to find ways of you know, comfort. Like we talked about, you used a very important term called palliative care. A lot of people don’t know necessarily what palliative care is, but it is a way to to keep the patient or the individuals as comfortable as possible. And mouth pain can be debilitating and it can can also you know, affect their overall health and you know, certainly having the ability to do that is really important and I’m just so grateful that you’re on and here. So obviously you serve primarily through senior centers and community centers and senior living is your main you know, goal, or nursing homes, If you have a loved one in a nursing home, and how I guess the question is how do you find out if they if they don’t work with you, Can you go to the center and ask them to reach out? Do you reach out to them? How does that happen?

    – Great question. So we serve almost 200 nursing facilities throughout the state of Washington at this time, and we started with zero in 2016, so you can see the need out there. And so, family members, if you’re hearing about us on this podcast, you can reach out to us at Sound Dental Care. We – if it’s a facility that we do not serve and we have a provider in that location, we love introductions to the facilities. We reach out all the time to facilities and make calls. They have so many demands on them that oftentimes we don’t hear back or maybe in the future we do have that need. However, we have a family member pull us in.

    – We want to make sure that our families out there who have senior loved ones to get the care that they need. And so we’re gonna talk a little bit in our next segment about your vision, your mission, and the future. I also want to talk a little bit about overall tele-dentistry. For those that don’t live in the Puget Sound region, how can they get a similar type of a treatment. Sarah and I will be right back right after this.

  • Sound Dental Care: Geriatric Dental Health, Part 2

    Sarah Luetke, founder and CEO of Sound Dental Care, joins Suzanne to talk about breakthroughs in geriatric dental care and services. The pandemic evolved mobile dentistry. Many providers — dentists, hygienists, dental therapists, denturists — are now starting to offer mobile services. Tele-dentistry allows an offsite dentist to supervise a hygienist or diagnose a problem and give permission for treatments.

    If you have a loved one in a senior living community or who visits a community center, services are available to bring dental care to those who have difficulty getting to the dentist’s office. Washington state law allows hygienists to operate independently in certain settings, allowing Sound Dental Care to treat patients 65 and older at nursing homes and senior centers. Sarah’s mobile company has less overhead than a traditional dental practice, and can be more mindful of seniors on fixed incomes.

    When Sound Dental Care opened in 2016, they brought a dental chair with them into the senior living community, but the pandemic restricted many seniors to their rooms. Sound Dental Care works with patients who need assistance moving about, and they’re higher-risk patients, so they are cared for better if they stay indoors where staff can help should any troubles arise, for instance with a dementia patient who might have a panic attack.

    Sound Dental Care provides many preventative geriatric dental care treatments, including alternative palliative care with silver diamine fluoride. This treatment was once used in the United States but fell out of practice when anesthetics, drilling, and filling advanced, and as patients started thinking more cosmetically about their teeth. It is a liquid antimicrobial containing silver and fluoride, and silver ions, and it halts decay in a cavity or a tooth that’s broken off.

    In our next segment, Sarah and Suzanne talk more about advances in geriatric dental health. Visit Sound Dental Care‘s website or call 206-745-3808 to learn more.

    Transcript

    Welcome, everyone, back to Answers for Alders Radio Network. And I am here with Sarah Luetke, who’s the founder and CEO of Sound Dental Care. And they are an organization that are in Washington State in Greater Puget Sound, but they’re connected to a national organization that does similar types of programs and teledentistry and different things like that. And we’re really talking about the breakthroughs in geriatric dental care and what goes on with seniors and if you have a senior loved one that’s in a senior living community or you know, goes to a community center or any thing like that, there are services available for preventative dental care as well as sometimes to help with maybe some gums, you know issues and things like that that. Hygienists can help without having to pay exorbitant costs. And so, this is here for our listeners today, and Sarah Luetke, welcome back to Answers for Elders. We’re so glad you’re here on our second segment today.
    – Thank you, Suzanne.
    – So Sarah, we talked a little bit about the industry. It’s very interesting how, you know, the dental industry as a whole, in my perspective, is kind of not done anything to help seniors. And I it’s kind of strange to me because I think I think there’s just been this you know, old practice of well, when when the seniors teeth rot out, then we give them dentures, right, and it’s just this this process of you know, sometimes I know my mom used to feel like she was like herded through like a like cattle, you know, because she had dentures and they you know, pulled all of her teeth and they told her what to do, and it was just kind of a mess. And she ended up in her later years because she had dementia, she wouldn’t even put her dentiers in, you know, and that was kind of her, you know, her practice, and then it was like downhill from that. And I think there’s a lot of younger seniors that don’t want to be in that position. They want to make sure that they keep their teeth um healthy. But then there’s that fear of going to the dentist and then all of a sudden you get laid out with this plan that’s going to cost thousands and thousands of dollars, and if you’re on a fixed income, you don’t necessarily have those options available. And so Sarah, thank you for being here, and we’re very excited to learn a little bit about what goes on in the dental industry and what’s new.

    – Yes, I’m excited to share this this with you because COVID changed a lot of things for a lot of people, and tele-dentistry and mobile dentistry was just kind of being spoken about prior to the pandemic, and the pandemic really sped things up with mobile dentistry. And if you start to Google mobile dentistry, there are many many people – providers, whether it be dentists, hygienists, dental therapists, denturists – all different people in the dental field as well as the medical field – starting to be mobile and everything in our country, and not just our country, throughout the world, we want Amazon to deliver to us. We want things to be your access and so thinking outside of the box of traditional dentistry is really opening up doors and, for myself as a hygienist, there are limitations put on us as hygienists as far as what we can do without the supervision of a dentist, and tele-dentistry is changing that as well, because we can have an offsite dentist supervise us or diagnose something and give us permission to treat a patient in a different way. it’s called asynchronous and synchronous. One of them is a live video chat, just like this with you’re the dentist, I’m the hygienist and the patient’s right here, and or there’s the asynchronous where it’s recorded and the dentist goes to it at their own time, and so there’s those options now. The other thing that people are starting to think about is running – me being a previous employee at a dental practice and now owning my own practice, I operate under a small segment of a Washington law that allows hygienists to operate independently and in certain settings only, so I can only see patients 65 and older at nursing homes and senior centers, or I can see disabled patients, or you can see under-privileged, privileged- school aged children and Headstart programs. So there’s a few sections there that were allowed to see.

    – So you are basically kind of that that person that can kind of do things for people that may necessarily not be able to make it into a dental office.

    – Yes, yes, And that is exactly why I created Sound Dental Care because seniors. You started out by saying seniors tend to be more on a fixed income, and that’s ALL seniors. That’s not just our nurse. That’s all seniors, that’s anyone that is no longer has an active paycheck coming in, and so we have to think about people’s budgets in a different way. And often times people no longer have dental insurance once they are no longer with their employer dental insurance. Patients have this mindset that dental insurance pays for their whole dental appointments. It never has and it never will. It tends to pay portions of it, and then the patients are responsible for portions of it. But I have a whole new understanding of the cost of running a practice now that I run a practice and I’m not just an employee, and so I think what dentistry has found as well as medicine is being mobile. You don’t have the overhead as much as you do with a brick and mortar and, so even though I’m a hygienist doing more of an alternative setting, I think over time you will see more and more providers, dentists and just everyone being able to go and serve all different seniors. That’s their understanding.

    – So Sarah, do you have like a van, how do you operate? I mean, do you come in with a van and a dental chair or how do you operate?

    – That’s a great question. For our nursing homes, once again, COVID the pandemic changed everything because we started our practice in 2016, and we did bring a dental chair into every facility. we go into, and we have, you know, a patient chair, dental chair, and an operator chair, and we have the whole ultrasonic and the suction and everything like you would have at the office. But due to the pandemic, a lot of these facilities could not buy state mandates let patients out of their room. So we’ve really had to roll and just every day was different, and it’s still different because they’re still dealing with closures and nursing homes because of the pandemic. But for my hygiene practice, I per for to take everything in and all of our providers take everything into the building. Now I’m also a denturist, so I have a mobile denture van, so it’s set up that I have everything out in the van. The patient is still in the building, but if I need to go do something with their dentures, I can go out to my mobile denture van and that’s awesome like a lab. There are other providers that do have patients come into their van or their motor home for services, but we prefer with our setting because we work with patients that need assistance in transferring and everything, and they’re higher-risk patients that we are in the building. And that makes sense too because staff is there too, which which also you know, you never know, especially if if a senior has dementia or something like that, they can also flip out, have a panic attack anything like that. There’s a lot of memories of the dentists and you just don’t necessarily know what you’re dealing with, so that is a good thing. So you bring an actual dental care dental chair in with you, Yes, I prefer there’s a company just the other side of the water over in Seattle. It’s called Aseptico and they are one of the leading companies and mobile dentistry, and they make all of the field equipment for the military.

    – So incredible.

    -And so their chairs can hold a 300 pound sailor. And I’ve gone over and toured their plant and I’m a huge advocate for Aceptico. I’m not sponsored by them at all, but I really believe in their equipment. They have the rolling suitcases that I can unpack and it’s just like everything you would have at a dental office.

    – That’s amazing. That is amazing. So, obviously, when somebody goes to a dentist, like for example, they’re gonna go in and they’re gonna get this plan to get their teeth clean. That’s kind of the standard thing. They take X rays or whatever. If they can’t afford it, you provide a different option, do you not do?

    – Yes.

    – So we have about five minutes left. I know we’re going to go right into it in our next segment. But could you the point I think that I really want to bring out more so here is is that most of what you do is is preventative type treatment, but there can be some things you can do to help on the other side, to help me think better. And and could you explain kind of the difference for us?

    – Yes, so this is my soapbox… and it’s a product called silver diamine fluoride, and many many people have not heard of it. Silver diamine fluoride has been around for over a hundred years. However, in America we quit using it. We had it here in our country, and we quit using that when local anesthetic became available, and when drilling and filling became an option, and when patients started thinking cosmetics, and so it just kind of went away. In Japan and in South America, silver diamine is used a lot. And so what it is is that as a prescription, it has to be applied by a dental provider and it is a liquid antimicrobial, it contains silver and fluoride, and the silver ions, so if you put it on a cavity or a tooth that’s broken off at the gumline or I’m in my 40s, I paint all of my crown margins with it because I do not want decay around my crowns, I’m going to it as the preventative before i even have decay. But if you do have decay, as long as you have access to the lesion – the cavity – it will arrest it. The silver gets within the tooth and it terms that area of the tooth black. So it’s not aesthetically pleasing, but it won’t turn your home off black. I painted it on my front tooth to show people. It doesn’t turn it black, but it will turn a cavity black, and it’s hard. It’s now arrested and mineralized. And um, this is an option. It can be a solution. That’s not to say sometimes you won’t still have an abscess form or need to filling down the road. Um, that can still happen, but with traditional dentistry that can still happen as well.

    – Well. We’re going to talk about this in our next segment, and so we’re gonna talk about all kinds of things and prevention and Sarah and I will be right back right after this.

  • Sound Dental Care: Geriatric Dental Health, Part 1

    Sarah Luetke, founder and CEO of Sound Dental Care, joins Suzanne to talk about geriatric dental health. Sarah has worked in dentistry for over 20 years, for some time in Bainbridge Island, Washington, a very affluent community, as a dental hygienist at a group practice. Patients had the ability to pay for dental care and could keep up on their dental health. She has also had the opportunity to work in farm communities in Montana, Wisconsin, and Minnesota, where some people didn’t have the finances to do everything to restore their teeth. She saw patients being offered amazing dental care services. And in America, we are aging people with teeth. Previous generations had teeth pulled and perhaps had dentures. Today we have much better technology, but it can be expensive.

    If you’re having tooth pain and you can’t afford traditional dentistry, or you can’t get into the dental office even if you have the money, it’s a big problem. So, as a hygienist, Sarah’s goal has been advocating for health and educating her patients.

    Seniors may not necessarily do as good a job with their dental care. They’re perhaps not eating as many crunchy items, things that can help break down things, and instead eating softer foods. For Alzheimer’s patients, the action of chewing and masticating food actually helps the brain and function.

    In our next segment, Sarah and Suzanne talk about advances in geriatric dental health. Learn more at Sound Dental Care or call 206-745-3808.

    Transcript
    Welcome, everyone, to Answers for Elders Radio Network. And we are very excited today to have a lovely lady by the name of Sarah Luetke. And Sarah, you are the founder and amazing creator of Sound Dental Care, and we are so excited here because would you believe in the hundreds of podcasts that we have out there, I don’t think we have ever done I could be wrong because my memories not a hundred percent, but I don’t think we’ve ever done anything on geriatric dental health and on senior dental health. And it’s always been a concern of mine, how many of us that are over the age of sixty five that are on fixed incomes. We may have a situation in our lives that we’ve been putting something off because it’s just the cost is overwhelming. And it also seems like to me anyway, that the dental world never changes it’s always the same. And Sarah today, I am so excited to have you on because you’re about in this hour for those of us that are listening, um, you’re going to share with this all kinds of new things that you may never not know about, including not having to drill, which is really exciting. And the other thing that I’m really excited to learn, Sarah, is all about sound dental solutions, what you do and how you work. So Sarah, thank you, and welcome to the program.
    – Thank you so very much, Susan for having me.
    – Well, I’m very glad because, um, you are kind of a trailblazer and I love the fact that you’ve come forward and to talk a little bit about what you do. But before we get into that, I would love to have you kind of give us the three hundred and sixty degree, you know, fifty thousand foot high overview of seniors and their dental practices, what goes on out there, great questions.
    – So I have worked in dentistry for over twenty years now and I worked in Bainbridge, very affluent community as a dental hygienist for a group practice dentist. We had five hygienists, two dentists, and just an amazing practice, and patients came in that had ability to pay for dental care that could keep up on their dental health. It was an affluent community. And I’ve also had the opportunity to work in farm communities in Montana and Wisconsin and Minnesota throughout my career, where maybe people don’t have the finances to do everything to restore their teeth in their mouth. What I’ve seen in all these different areas that I’ve worked throughout my career, and especially since I got the opportunity to be in the same dental practice for fifteen years on Bainbridge, I saw we offered our patients amazing dental care services. And in America, we are aging people with teeth. Prior generations, we did not have the ability to do all of the anesthetics and the fillings and implants and all of this dentistry that kept people having teeth their whole lifetime. So as people aged in previous generations, they would loose teeth, pull teeth, maybe have dentures. Um dentures everyone says aren’t great, which they aren’t. However, a denture can come in and out your teeth if you’re having tooth pain and you can’t afford traditional dentistry, or you can’t get into the dental office even if you have the money. It’s a big problem when two concerns aren’t addressed. And so the practice I was in on Bainbridge patients I personally cared for for that many years in a preventative hygiene way, along with the dentist doing the restorative work that needed. All of a sudden, I wouldn’t see the husband or wife for a while, and then it would be for a few years, and then the spouse would come in and say, “I feel so terrible. My spouse hasn’t been in because they’re in a nursing home now.” And my first case that I will not forget ever was a patient that came in and it’s before I started sound I don’t care on my own, and the husband came in and said to me and the dentist, my wife sat a nursing home down the road and she probably has about ten or fifteen teeth that have broken off in the last two years because I haven’t gotten her in here. And they had money, They had money, and they always came in and so the dentist and I looked at each other and he said, Sarah, you’re kind of starting up sound dental care. You need to go and take care of her. And unless your heart, I took care of her until the end of the life and it was five years. So it’s pretty amazing.
    – Yeah. Well, you know, and I know for so many people in my realm, it’s like it’s expensive. It’s outrageously expensive to go forward. Especially as you get older, is when your teeth start to deteriorate, right and um, and you know how many of us have, you know, have habits that we may not necessarily floss regularly. That there’s all kinds of dental good practices, best practices in maintaining your teeth and gums. You know, for me, I’ve always been an avid flosser, and you know, I look at my my mouth and I go, you know, I’m really lucky compared to my friends because I have taken care of my teeth. Now, I’ve also done some things like I’ve whitened, had him whitened a couple of times, and things like that. So it’s not like I’m not doing some things. But there’s still that the normal process of aging that happens. And I think a lot of us are fearful to go to the dentist, you know that are over the age of 65, because they’re afraid of what their dentist is going to find. And so we tend to put it off, or we tend to think, oh, even if they diagnose something, I wouldn’t be able to pay for it anyway. And I’m sure I would guess, Sarah, are there a lot of people out there that just they get a diagnosis from a dentist and then you never see him again. You give them this big, you know, whopping $10,000 bill it’s going to take to fix your mouth, and then they turn around and they can’t afford it.
    – I would say yes, hygienists and dentists work together traditionally, However, our perspective is always prevention, preventing disease and gum disease, restoring the mouth to health. Dentists also are about that in a different way. We are the gung-ho people and the all hygiene and talking about habits at home, where the dentists tend to be the part of the practice that restores things when there’s problems, and supports the rest of the team. So as a hygienist, my goal has always been and I would say this is true for almost all hygienists, we’re about advocating for health and we don’t want problems to happen. And so I’ve always chosen to educate my patients and not shame my patients. If someone’s not flossing, I’m going to let them know the harm and not doing these things, and I’m not going to shame them. I’m going to try to find ways to encourage them. And as you said, um, as we age, we are more likely to get decay and periodontitis, and as we age, we’re on more medications due to co-morbidities and different diagnoses, and so medications lead to dry mouth. Dry mouth leads to decay. So as a hygienist, when the patient comes into have their teeth clean, I’m going to try to give them every tool they can to help with their dry mouth. So they’re home and sucking on sugar candies and coming in with the mouth full. And that’s another thing that we tent to want to do is eat more sweets. So obviously that goes. So so as you know, I’m thinking this through and when you’re talking about dry mouth and you know, so obviously hydration is huge. There’s all kinds of things that seniors may not necessarily do as much as they should. Um, the foods they’re eating, they’re probably not eating things that are that are crunchy or you know, or things that can help breakdown things, rather than they’re eating soft foods like soft ice cream and things like that, which obviously can’t be as good. I would imagine two. Because you’re not using your gums. And I’ve noticed too with a lot of people that there’s gum disease that happens if you’re not flossing or not brushing appropriately. Is there not?
    -This is true and as we age, the health conditions come. So even if you were someone that’s lost at one point in your life, but now you have paralysis on one side or good point, maybe there’s some depression that has come up as you’ve aged and you’ve just lost your ability to do yourself care as you once did. There are many co factors that go into why oral health is failing as we age. However, keeping people in a routine habit of seeing their hygienist, having a dental care visit, regardless of their age and where they are in life, whether at home or at a nursing home, it is so important.
    – I actually finished my schooling last year to become a licensed denturist as well, which is making prosthetic teeth for patients that have no teeth. And I had to do a research paper and one thing I found which I was just flabbergasted that for Alzheimer’s patients, the action of chewing and masticating food actually helps the brain and function.
    – I believe that.
    – Yeah, when one loses that ability to chew, whether you go on a special diet because of a stroke or something like that, or because you’re missing a lot of teeth because you can’t afford for them to be restored, that that affects our brains. You know, Sarah, this is really good information. And you know, as we’ve talked about this, whole issue. It’s like, I’m really interested in our next segment for us to talk about the dental industry as a whole um, what’s going on right now, how our seniors quote unquote being served, and you know, how can we make it better? And how do you make it better? Sarah and I will be right back.

     

  • Financing at The Smile Store

    Stephen DePiro is vice president and clinical director of The Smile Store, which helps seniors with dental care.

    They provide dentures, partials, implant alternatives, and manufacture their own products and have clinics to support them. They provide a very needed service in Puget Sound. Many times, financing is more competitive than anywhere else. In many cases, for about a cup of coffee you can afford good oral care to minimize out of pocket expenses. Insurance will usually cover 50-80% of the therapy.

  • Dental Care at The Smile Store

    Stephen DePiro is vice president and clinical director of The Smile Store, which helps seniors with dental care. They provide dentures, partials, implant alternatives, and manufacture their own products and have clinics to support them. Dentures and implants have come a long way and are more affordable. Lots of patients worry about prices, but their prices are posted online. They also have specials for veterans. Offer finances, take all insurance plans, it’s worth coming in for a consult.

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