Delivering dental care to nursing home and homebound patients.

The growing life expectancy has created a number of challenges for society and for the dental profession. One of these challenges is the increasing number of people, particularly those over age 85, who are considered frail and functionally impaired, who no longer can live independently or participate in the community. If the impairment is severe enough, the older adult may become home-bound or unable to leave the home without assistive aids or, less commonly, institutionalized in a nursing home. The characteristics of the homebound and nursing home resident represent a dramatic contrast from those who are the same age and living in the community: They are older, predominantly female, and have more physical and mental disabilities. In addition, there are differences in oral health characteristics, of which dentists and other health professionals need to be aware. Although there are a number of obstacles and barriers that make providing dental care more difficult for these patients, federal mandates and a growing professional response to develop initiatives for outreach and access are beginning to have an effect. Still the challenge for providing dental care to these groups remains great, and it will take a tremendous effort from many oral health professionals before significant change is evident. There are many professional and personal rewards for providing this care, and we as dental professionals must be committed to seeing that the oral health needs are met for all underserved populations in our society.