August 2015 Seattle Care Pathway Root Caries Aging Periodontium Apple Tree Dental JournaCALIFORNIA DENTAL ASSOCIATION DENTISTRY FOR THE AGES: Part II Susan Hyde, DDS, MPH, PhD, FACD, and Dick Gregory, DDS Times change, but our promises remain the same. The Dentists Insurance Company (TDIC) is proud to celebrate 35 years dedicated to protecting dentists. We thank you for helping us reach this milestone through your ongoing support of our company. The promises we made in 1980 are still true today: to only protect dentists, to protect them better than any other insurance company and to be there when they need us. We look forward to celebrating new milestones with you as we continue to strengthen, innovate and grow. Thank you. ® Protecting dentists. It’s all we do. 800.733.0633 | tdicsolutions.com | CA Insurance Lic. #0652783 Aug. 2015 CDA JOURNAL, VOL 43, Nº8 DEPARTMENTS 417 The Guest Editor/Collaborative Practice — Paving the Path to Success 419 Impressions 461 RM Matters/Accounting Controls Can Prevent Dishonest Behavior 467 Regulatory Compliance/Marketing and Advertising Rules 419 471 Periscope 476 Tech Trends 477 Dr. Bob/Aging Gracefully (and Other Indignities) FEATURES 426 Dentistry for the Ages: Part II An introduction to the issue. Susan Hyde, DDS, MPH, PhD, FACD 429 The Seattle Care Pathway: Defining Dental Care for Older Adults This article describes the evidence for, and the details of, the Seattle Care Pathway to ensure older adults receive optimum dental care. Iain A. Pretty, BDS, MSC, MPH, PhD, FDSRCS(ED) 439 Root Caries in Older Adults Root caries is a major cause of tooth loss in older adults and the need for improved preventive efforts and treatment strategies for this population is acute. Dick Gregory, DDS, and Susan Hyde, DDS, MPH, PhD, FACD 447 Aging Periodontium, Aging Patient: Current Concepts This paper presents the current state of knowledge and opinion on approaches to periodontal diseases and periodontal treatment in the elderly with an emphasis on consensus, conclusions and future directions for dental practitioners. Mark Ryder, DMD 453 Apple Tree Dental: An Innovative Oral Health Solution Apple Tree Dental’s Community Collaborative Practice model illustrates a sustainable, patient-centered approach to overcoming barriers to care across the lifespan. Deborah Jacobi, RDH, MA, and Michael J. Helgeson, DDS 459 National Resources A listing of websites on the oral health of older adults submitted by the authors of this issue. Compiled by Susan Hyde, DDS, MPH, PhD, FACD AUGUST 2015 415 CDA JOURNAL, VOL 43, Nº8 Volume 43, Number 8 JournaCALIFORNIA DENTAL ASSOCIATION August 2015 CDA Classifieds. Free postings. published by the Editorial Upcoming Topics Manuscript California Kerry K. Carney, DDS, CDE September/Radiology Submissions EDITOR-IN-CHIEF Priceless results. Dental Association October/The Dental Team www.editorialmanager. 1201 K St., 14th Floor [email protected] November/Pain com/jcaldentassoc Sacramento, CA 95814 Ruchi K. Sahota, DDS, CDE Management 800.232.7645 ASSOCIATE EDITOR Letters to the Editor cda.org Advertising www.editorialmanager. Brian K. Shue, DDS, CDE Doug Brown com/jcaldentassoc CDA Offi cers ASSOCIATE EDITOR ADVERTISING SALES Walter G. Weber, DDS [email protected] PRESIDENT Susan Hyde, DDS, MPH, 916.554.7312 Subscriptions [email protected] PhD, FACD Subscriptions are available Dick Gregory, DDS Tiff any Carlson only to active members of GUEST EDITORS ADVERTISING SALES Kenneth G. Wallis, DDS the Association. 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All rights reserved. 416 AUGUST 2015 GuestEditor Editor CDA JOURNAL, VOL 43, Nº8 Collaborative Practice — Paving the Path to Success Susan Hyde, DDS, MPH, PhD, FACD any Native American cultures teach that Inclusion of oral-systemic health data in risk caring for elders is a blessing path in which assessment and disease management plans the whole community have resulted in improved collaboration and Mshould participate. Like many of us with referrals between dental-primary care providers. aging parents, I have provided a lot of care to my parents, and oral health issues always arose. My experiences dealing with my father’s care-resistant behaviors dental care is one of the Leading Health health is an important population health as he battled Alzheimer’s and diffi culties Indicators for Healthy People 2020.2 issue for primary care providers.5 New in obtaining dental treatment for my Additionally, oral health disparities in York University has successfully integrated stepmother, who was paralyzed and older adults are now recognized to extend HEENOT in the comprehensive history unable to speak as the result of a stroke, beyond edentulism, as refl ected by the and physical examinations for nursing contributed greatly to my decision to new Healthy People 2020 objectives and medical student clinics and faculty specialize in geriatric dentistry. Thanks to reduce untreated coronal and root practices. Inclusion of oral-systemic to the geriatric training I received, caries in older adults, and decrease health data in risk assessment and disease when my mother moved into a long- the prevalence of moderate or severe management plans have resulted in term care facility, I immediately put her periodontal disease.3 Therefore, primary improved collaboration and referrals on a three-month schedule for home care providers must obtain training in oral between dental-primary care providers.6 visits with a dental hygienist. Similarly, health screening and referral, consider Dentists and dental hygienists also when my father-in-law’s face ballooned oral health in disease management and need to participate in the cycle of because of multiple periapical abscesses, collaborate with the dental community interprofessional collaborative practice. I was able to raise the awareness of his to develop home-based programs Healthy People 2020 objectives promote family, endocrinologist and orthopedic for older adults in order to achieve collaborative practice with two new oral surgeon that the needed dental treatment patient-centered, value-based care.1 health goals for increasing the proportion wasn’t elective but rather critical to the An article in the October 2014 issue of adults who receive tobacco cessation resolution of his poor wound-healing of the Journal of the California Dental information and who are tested or referred from a recent diabetic amputation. My Association described the National for glycemic control by a dentist or dental experiences are by no means unique. Interprofessional Initiative on Oral hygienist.3 Although previous studies Homebound and institutionalized older Health (NIIOH), established in 2008 to indicated both dentists and patients are adults