{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:18:33Z","timestamp":1785410313229,"version":"3.56.0"},"reference-count":101,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000072","name":"The Ohio State University","doi-asserted-by":"publisher","award":["5T32DE032994"],"award-info":[{"award-number":["5T32DE032994"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]},{"award":["5T32DE032994"],"award-info":[{"award-number":["5T32DE032994"]}],"id":[{"id":"https:\/\/ror.org\/00rs6vg23","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>The United States is experiencing rapid population aging, making geriatric oral health an increasingly important public health and clinical concern. Older adults bear a disproportionate burden of oral diseases, including dental caries, periodontal disease, edentulism, xerostomia, and oral cancer, many of which are closely linked to chronic systemic conditions such as diabetes, cardiovascular disease, and cognitive impairment. This narrative review synthesizes current evidence on oral disease patterns and trends among older adults in the United States, with particular attention to the bidirectional relationships between oral and systemic health. It further examines the organization of oral health care delivery and financing for this population, including the roles of Medicare and Medicaid. Persistent inequities in access to preventive and restorative dental services are highlighted, especially among low-income individuals, racial and ethnic minorities, rural residents, and older adults with functional or cognitive limitations. Workforce shortages, fragmented care models, and limited integration of oral health into primary and geriatric care further exacerbate these disparities. Finally, this review identifies future directions to improve geriatric oral health, including policy reforms to expand dental coverage, integration of oral health into medical and long-term care settings, adoption of minimally invasive approaches, and strengthened interprofessional education and research. Addressing these challenges is essential to promoting healthy aging and reducing oral health disparities among older adults in the United States.<\/jats:p>","DOI":"10.3390\/geriatrics11040084","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:51:09Z","timestamp":1783936269000},"page":"84","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Geriatric Oral Health in the United States: Current Status and Challenges"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6014-4398","authenticated-orcid":false,"given":"Sherif","family":"Ammar","sequence":"first","affiliation":[{"name":"College of Public Health, The Ohio State University, 1841 Neil Ave, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5688-2794","authenticated-orcid":false,"given":"Frederick","family":"Howard","sequence":"additional","affiliation":[{"name":"Division of Dental Public Health, College of Dentistry, The Ohio State University, 305 W 12th Ave, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2821-0726","authenticated-orcid":false,"given":"Xi","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Dental Public Health, College of Dentistry, The Ohio State University, 305 W 12th Ave, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3819-3560","authenticated-orcid":false,"given":"Duangporn","family":"Duangthip","sequence":"additional","affiliation":[{"name":"Division of Dental Public Health, College of Dentistry, The Ohio State University, 305 W 12th Ave, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, February 14). Oral Health. Available online: https:\/\/www.who.int\/health-topics\/oral-health."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Zhao, H., Wu, B., Zhou, Y., Yang, Z., Zhao, H., Tian, Z., Jiang, M., and Huang, D. (2024). Oral Frailty: A Concept Analysis. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-04376-6"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.adaj.2018.04.023","article-title":"Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009\u20132014","volume":"149","author":"Eke","year":"2018","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Johansson, A.-K., Omar, R., Sannevik, J., Mastrovito, B., Blomma, C., and Johansson, A. (2025). Xerostomia from Age 50 to 90 Years: Prediction and Prevalence in Cross-Sectional and Longitudinal Studies. Front. Oral Health, 6.","DOI":"10.3389\/froh.2025.1648038"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1253\/circrep.CR-24-0187","article-title":"Oral Health and Cardiovascular Disease\u2014A Scoping Review of Assessment Methods, Risk Factors, and Prognosis","volume":"7","author":"Ogawa","year":"2025","journal-title":"Circ. Rep."},{"key":"ref_6","unstructured":"Cleveland Clinic (2026, February 15). Oral Health Problems and Diabetes. Available online: https:\/\/my.clevelandclinic.org\/health\/diseases\/11263-oral-health-problems-and-diabetes."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.cden.2020.11.002","article-title":"Physiology of Aging of Older Adults: Systemic and Oral Health Considerations 2021 Update","volume":"65","author":"Thompson","year":"2021","journal-title":"Dent. Clin. N. Am."},{"key":"ref_8","unstructured":"US Census Bureau (2026, February 14). 2023 National Population Projections Tables: Main Series, Available online: https:\/\/www.census.gov\/data\/tables\/2023\/demo\/popproj\/2023-summary-tables.html."},{"key":"ref_9","unstructured":"Administration for Community Living (2026, February 14). 2023 Profile of Older Americans, Available online: https:\/\/acl.gov\/aging-and-disability-in-america\/data-and-research\/profile-older-americans."},{"key":"ref_10","unstructured":"Federal Interagency Forum on Aging-Related Statistics (2026, February 14). Older Americans 2004: Key Indicators of Well-Being, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/13588."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Lowenstein, A., Singh, M.L., and Papas, A.S. (2025). Addressing Disparities in Oral Health Access and Outcomes for Aging Adults in the United States. Front. Dent. Med., 6.","DOI":"10.3389\/fdmed.2025.1522892"},{"key":"ref_12","unstructured":"Centers for Disease Control and Prevention (2025, December 08). Oral Health Surveillance Report: Dental Caries, Tooth Retention, and Edentulism, United States, 2017\u2013March 2020, Available online: https:\/\/www.cdc.gov\/oral-health\/php\/2024-oral-health-surveillance-report\/index.html."},{"key":"ref_13","unstructured":"Centers for Disease Control and Prevention (2019). Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States: 1999\u20132004 to 2011\u20132016."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.adaj.2021.09.004","article-title":"Update on the Prevalence of Untreated Caries in the US Adult Population, 2017\u20132020","volume":"153","author":"Bashir","year":"2022","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_15","unstructured":"Centers for Disease Control and Prevention (2026, February 22). About Tooth Loss, Available online: https:\/\/www.cdc.gov\/oral-health\/about\/about-tooth-loss.html."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/prd.12145","article-title":"Periodontitis Prevalence in Adults \u2265 65 Years of Age, in the USA","volume":"72","author":"Eke","year":"2016","journal-title":"Periodontology 2000"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1001\/jamaoto.2023.4322","article-title":"Head and Neck Cancer Incidence in the United States Before and During the COVID-19 Pandemic","volume":"150","author":"Semprini","year":"2024","journal-title":"JAMA Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_18","unstructured":"National Institute of Dental and Craniofacial Research (2026, February 24). Oral Cancer Prevalence (Total Number of Cases) by Age|NIDCR, Available online: https:\/\/www.nidcr.nih.gov\/research\/data-statistics\/oral-cancer\/prevalence."},{"key":"ref_19","unstructured":"National Institute of Dental and Craniofacial Research (2026, February 24). Oral Cancer Incidence (New Cases) by Age, Race, and Sex|NIDCR, Available online: https:\/\/www.nidcr.nih.gov\/research\/data-statistics\/oral-cancer\/incidence."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"867","DOI":"10.14219\/jada.2014.44","article-title":"Managing Xerostomia and Salivary Gland Hypofunction: Executive Summary of a Report from the American Dental Association Council on Scientific Affairs","volume":"145","author":"Plemons","year":"2014","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_21","unstructured":"National Institute of Dental and Craniofacial Research (2026, February 24). Dry Mouth|NIDCR, Available online: https:\/\/www.nidcr.nih.gov\/health-info\/dry-mouth."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Rughwani, V., Miao Jonasson, J., Marklund, B., Mossberg, K., Almst\u00e5hl, A., Lynge Pedersen, A.M., and Cevik-Aras, H. (2025). Xerostomia in Primary Care: A Register-Based Study of Prevalence, Medication Categories, and Associated Risk Factors. Front. Oral Health, 6.","DOI":"10.3389\/froh.2025.1684568"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/jgs.15151","article-title":"Medications That Cause Dry Mouth As an Adverse Effect in Older People: A Systematic Review and Metaanalysis","volume":"66","author":"Tan","year":"2018","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"104056","DOI":"10.1016\/j.jdent.2022.104056","article-title":"Prediction of Xerostomia in a 75-Year-Old Population: A 25-Year Longitudinal Study","volume":"118","author":"Johansson","year":"2022","journal-title":"J. Dent."},{"key":"ref_25","unstructured":"American Dental Association (2026, February 24). Aging and Dental Health. Available online: https:\/\/www.ada.org\/resources\/ada-library\/oral-health-topics\/aging-and-dental-health."},{"key":"ref_26","unstructured":"American Dental Association (2026, February 11). Xerostomia (Dry Mouth). Available online: https:\/\/www.ada.org\/resources\/ada-library\/oral-health-topics\/xerostomia."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Lamster, I.B., and Northridge, M.E. (2008). Improving Oral Health for the Elderly: An Interdisciplinary Approach, Springer.","DOI":"10.1007\/978-0-387-74337-0"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.cden.2014.06.005","article-title":"Oral Health Disparities in Older Adults: Oral Bacteria, Inflammation, and Aspiration Pneumonia","volume":"58","author":"Scannapieco","year":"2014","journal-title":"Dent. Clin. N. Am."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"15S","DOI":"10.14219\/jada.archive.2007.0358","article-title":"Dry Mouth and Its Effects on the Oral Health of Elderly People","volume":"138","author":"Turner","year":"2007","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s40266-023-01017-5","article-title":"From Drugs to Dry Mouth: A Systematic Review Exploring Oral and Psychological Health Conditions Associated with Dry Mouth in Older Adults with Polypharmacy","volume":"40","author":"Cannon","year":"2023","journal-title":"Drugs Aging"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e521","DOI":"10.1016\/S2666-7568(21)00142-2","article-title":"Oral Health for Healthy Ageing","volume":"2","author":"Patel","year":"2021","journal-title":"Lancet Healthy Longev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/j.1754-4505.2008.00045.x","article-title":"Oral Health, General Health, and Quality of Life in Older People","volume":"28","author":"Kandelman","year":"2008","journal-title":"Spec. Care Dent."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1177\/0022034517693566","article-title":"Global, Regional, and National Prevalence, Incidence, and Disability Adjusted Life Years for Oral Conditions for 195 Countries, 1990\u20132015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors","volume":"96","author":"Kassebaum","year":"2017","journal-title":"J. Dent. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1902\/annals.2001.6.1.99","article-title":"Bidirectional Interrelationships between Diabetes and Periodontal Diseases: An Epidemiologic Perspective","volume":"6","author":"Taylor","year":"2001","journal-title":"Ann. Periodontol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Poudel, P., Griffiths, R., Wong, V.W., Arora, A., Flack, J.R., Khoo, C.L., and George, A. (2018). Oral Health Knowledge, Attitudes and Care Practices of People with Diabetes: A Systematic Review. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5485-7"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s00125-011-2342-y","article-title":"Periodontitis and Diabetes: A Two-Way Relationship","volume":"55","author":"Preshaw","year":"2012","journal-title":"Diabetologia"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/S2213-8587(18)30038-X","article-title":"Systemic Effects of Periodontitis Treatment in Patients with Type 2 Diabetes: A 12 Month, Single-Centre, Investigator-Masked, Randomised Trial","volume":"6","author":"Gkranias","year":"2018","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/jcpe.12808","article-title":"Scientific Evidence on the Links between Periodontal Diseases and Diabetes: Consensus Report and Guidelines of the Joint Workshop on Periodontal Diseases and Diabetes by the International Diabetes Federation and the European Federation of Periodontology","volume":"45","author":"Sanz","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1136\/pgmj.2005.043281","article-title":"Dysphagia in Stroke Patients","volume":"82","author":"Singh","year":"2006","journal-title":"Postgrad. Med. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/ageing\/afaa102","article-title":"Poor Oral Hygiene, Oral Microorganisms and Aspiration Pneumonia Risk in Older People in Residential Aged Care: A Systematic Review","volume":"50","author":"Khadka","year":"2021","journal-title":"Age Ageing"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1741-2358.2012.00637.x","article-title":"Oral Health Care and Aspiration Pneumonia in Frail Older People: A Systematic Literature Review","volume":"30","author":"Vanobbergen","year":"2013","journal-title":"Gerodontology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1001\/jama.286.18.2235","article-title":"Daily Oral Care and Risk Factors for Pneumonia among Elderly Nursing Home Patients","volume":"286","author":"Yoshino","year":"2001","journal-title":"JAMA"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1001\/jamainternmed.2023.6638","article-title":"Association Between Daily Toothbrushing and Hospital-Acquired Pneumonia: A Systematic Review and Meta-Analysis","volume":"184","author":"Ehrenzeller","year":"2024","journal-title":"JAMA Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1902\/jop.2013.1340019","article-title":"Periodontitis and Atherosclerotic Cardiovascular Disease: Consensus Report of the Joint EFP\/AAP Workshop on Periodontitis and Systemic Diseases","volume":"84","author":"Tonetti","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/jcpe.13189","article-title":"Periodontitis and Cardiovascular Diseases: Consensus Report","volume":"47","author":"Sanz","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.1161\/CIR.0b013e31825719f3","article-title":"Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association?: A Scientific Statement from the American Heart Association","volume":"125","author":"Lockhart","year":"2012","journal-title":"Circulation"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/ger.12061","article-title":"Cognitive Impairment, Oral Self-Care Function and Dental Caries Severity in Community-Dwelling Older Adults","volume":"32","author":"Chen","year":"2015","journal-title":"Gerodontology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/j.adaj.2018.07.015","article-title":"The Pathway from Cognitive Impairment to Caries in Older Adults: A Conceptual Model","volume":"149","author":"Chen","year":"2018","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/j.1741-2358.2012.00644.x","article-title":"Oral Health in Nursing Home Residents with Different Cognitive Statuses","volume":"30","author":"Chen","year":"2013","journal-title":"Gerodontology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2695","DOI":"10.1111\/jgs.17978","article-title":"Periodontal Health, Cognitive Decline, and Dementia: A Systematic Review and Meta-Analysis of Longitudinal Studies","volume":"70","author":"Asher","year":"2022","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1097\/j.pain.0000000000000095","article-title":"Pain, Agitation, and Behavioural Problems in People with Dementia Admitted to General Hospital Wards: A Longitudinal Cohort Study","volume":"156","author":"Sampson","year":"2015","journal-title":"Pain"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Niesten, D., van Mourik, K., and van der Sanden, W. (2013). The Impact of Frailty on Oral Care Behavior of Older People: A Qualitative Study. BMC Oral Health, 13.","DOI":"10.1186\/1472-6831-13-61"},{"key":"ref_53","first-page":"4","article-title":"Tooth Loss and Nutritional Status in Older Adults: A Systematic Review and Meta-Analysis","volume":"7","author":"Zelig","year":"2022","journal-title":"JDR Clin. Transl. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1093\/gerona\/glx225","article-title":"Oral Frailty as a Risk Factor for Physical Frailty and Mortality in Community-Dwelling Elderly","volume":"73","author":"Tanaka","year":"2018","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.adaj.2020.12.004","article-title":"Delivery and Financing of Oral Health Care in Long-Term Services and Supports: A Scoping Review","volume":"152","author":"Oishi","year":"2021","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"647168","DOI":"10.1155\/2011\/647168","article-title":"Elderly at Greater Risk for Root Caries: A Look at the Multifactorial Risks with Emphasis on Genetics Susceptibility","volume":"2011","author":"Gati","year":"2011","journal-title":"Int. J. Dent."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"da Mata, C., and Allen, P.F. (2023). Providing Oral Healthcare to Older Patients\u2014Do We Have What It Takes?. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20136234"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.cden.2020.12.002","article-title":"Innovations in Geriatric Oral Health Care","volume":"65","author":"Ghezzi","year":"2021","journal-title":"Dent. Clin. N. Am."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"0046958016652523","DOI":"10.1177\/0046958016652523","article-title":"Differences Among Older Adults in the Types of Dental Services Used in the United States","volume":"53","author":"Manski","year":"2016","journal-title":"Inquiry"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.adaj.2022.04.002","article-title":"Oral Health in America: Implications for Dental Practice","volume":"153","author":"Fellows","year":"2022","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_61","unstructured":"Centers for Medicare & Medicaid Services (CMS) (2025). Medicare & You, Medicare."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1377\/hlthaff.2024.01478","article-title":"Medicare Advantage Dental Benefits: Comprehensive Coverage Available in Fewer Than Half of US Counties","volume":"44","author":"Simon","year":"2025","journal-title":"Health Aff."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1177\/00220345231165011","article-title":"Integrating Oral Health into Primary Care: Perspectives for Older Adults","volume":"102","author":"Nelson","year":"2023","journal-title":"J. Dent. Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s40496-016-0093-z","article-title":"Geriatric Oral Health Care Delivery in the United States of America","volume":"3","author":"Jones","year":"2016","journal-title":"Curr. Oral Health Rep."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1377\/hlthaff.2016.0829","article-title":"Dental Care And Medicare Beneficiaries: Access Gaps, Cost Burdens, And Policy Options","volume":"35","author":"Willink","year":"2016","journal-title":"Health Aff."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e254403","DOI":"10.1001\/jamahealthforum.2025.4403","article-title":"Barriers and Facilitators of Medicaid Participation Among Dentists","volume":"6","author":"Elani","year":"2025","journal-title":"JAMA Health Forum"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.adaj.2021.03.010","article-title":"Medicaid Adult Dental Benefits and Oral Health of Low-Income Older Adults","volume":"152","author":"Singhal","year":"2021","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_68","unstructured":"HealthCare.gov (2026, April 04). Federal Poverty Level (FPL)\u2014Glossary, Available online: https:\/\/www.healthcare.gov\/glossary\/federal-poverty-level-fpl."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1007\/s11606-023-08558-w","article-title":"Did Medicaid Reimbursements Shape the Effects of Medicaid Expansion on Access to Health Care Among the Low-Income Population?","volume":"39","author":"Benitez","year":"2024","journal-title":"J. Gen. Intern. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1111\/1475-6773.13981","article-title":"Effects of a Medicaid Dental Coverage \u201cCliff\u201d on Dental Care Access among Low-income Medicare Beneficiaries","volume":"58","author":"Roberts","year":"2023","journal-title":"Health Serv. Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e70062","DOI":"10.1111\/scd.70062","article-title":"Exploring Oral Care in Long-Term Care Homes: An Institutional Ethnography","volume":"45","author":"Brodie","year":"2025","journal-title":"Spec. Care Dent."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Gupta, S., Hakim, M., Patel, D., Stow, L.C., Shin, K., Timoth\u00e9, P., and Nalliah, R.P. (2019). Reaching Vulnerable Populations through Portable and Mobile Dentistry\u2014Current and Future Opportunities. Dent. J., 7.","DOI":"10.3390\/dj7030075"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Fahim, A., Saleem, Z., Malik, K.A., Atta, K., Mahmood, R., Alam, M.K., and Sethi, A. (2022). Exploring Challenges and Mitigation Strategies towards Practicing Teledentistry. BMC Oral Health, 22.","DOI":"10.1186\/s12903-022-02685-2"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e44218","DOI":"10.2196\/44218","article-title":"Barriers and Enablers to Implementing Teledentistry From the Perspective of Dental Health Care Professionals: Protocol for a Systematic Quantitative, Qualitative, and Mixed Studies Review","volume":"12","author":"Talla","year":"2023","journal-title":"JMIR Res. Protoc."},{"key":"ref_75","first-page":"e62286","article-title":"Beyond the Chair: Exploring the Boundaries of Teledentistry","volume":"16","author":"Malpe","year":"2024","journal-title":"Cureus"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Shivakumar, A.T., Srinivas, S., Kalgeri, S.H., Kishor, M., and Avarebeel, S. (2026). A Transformative Interprofessional Model for Geriatric Oral Health Care\u2014A Proposed Working Model. Front. Dent. Med., 7.","DOI":"10.3389\/fdmed.2026.1757007"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Cohen, R., and Bottoms-McClain, L. (2024). Dental Care Among Adults Age 65 and Older: United States, 2022, NCHS Data Brief.","DOI":"10.15620\/cdc\/151928"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/ggi.12264","article-title":"Dental Care Utilization among Older Adults with Cognitive Impairment in the USA","volume":"15","author":"Lee","year":"2015","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1177\/10499091211007449","article-title":"Oral Health in Adult Patients Receiving Palliative Care: A Mixed Method Study","volume":"38","author":"Chen","year":"2021","journal-title":"Am. J. Hosp. Palliat. Care"},{"key":"ref_80","unstructured":"CareQuest Institute for Oral Health (2026, March 03). Why We Still Need to Add Dental to Medicare. Available online: https:\/\/carequest.org\/why-we-still-need-to-add-dental-to-medicare\/."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Martin, P., Santoro, M., Heaton, L., Preston, R., and Tranby, E. (2023). Still Searching Meeting Oral Health Needs in Rural Settings, CareQuest Institute for Oral Health.","DOI":"10.35565\/CQI.2023.2007"},{"key":"ref_82","unstructured":"Locklear, C. (2024). Oral Health and Aging: Improving Access to Care for Older Adults, CareQuest Institute for Oral Health."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Yu, S., Huang, S., Song, S., Lin, J., and Liu, F. (2024). Impact of Oral Health Literacy on Oral Health Behaviors and Outcomes among the Older Adults: A Scoping Review. BMC Geriatr., 24.","DOI":"10.1186\/s12877-024-05469-1"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1111\/jphd.70006","article-title":"Oral Health Literacy and Dental Caries Status in Adults","volume":"85","author":"Macek","year":"2025","journal-title":"J. Public Health Dent."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Baskaradoss, J.K. (2018). Relationship between Oral Health Literacy and Oral Health Status. BMC Oral Health, 18.","DOI":"10.1186\/s12903-018-0640-1"},{"key":"ref_86","first-page":"24","article-title":"Access to Preventive Oral Health Services for Homebound Populations: A Pilot Program","volume":"92","author":"Crete","year":"2018","journal-title":"J. Dent. Hyg."},{"key":"ref_87","unstructured":"The National Center for Health Workforce Analysis (NCHWA) (2026, March 24). Health Workforce Projections|Bureau of Health Workforce, Available online: https:\/\/bhw.hrsa.gov\/data-research\/projecting-health-workforce-supply-demand."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1001\/journalofethics.2016.18.9.pfor1-1609","article-title":"Overcoming Historical Separation between Oral and General Health Care: Interprofessional Collaboration for Promoting Health Equity","volume":"18","author":"Simon","year":"2016","journal-title":"AMA J. Ethics"},{"key":"ref_89","first-page":"33S","article-title":"All in for Integration: Oral Health in Interprofessional Education and Training","volume":"10","author":"Riedy","year":"2025","journal-title":"JDR Clin. Transl. Res."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"14931","DOI":"10.1038\/s41598-025-98718-1","article-title":"The Interconnection of Oral and Systemic Health","volume":"15","author":"Christidis","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1111\/jgs.15755","article-title":"An Assessment of Oral Health Training Among Geriatric Fellowship Programs: A National Survey","volume":"67","author":"Thompson","year":"2019","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_92","first-page":"1","article-title":"Oral Health in Nursing Homes: What We Know and What We Need to Know","volume":"6","author":"Sifuentes","year":"2020","journal-title":"J. Nurs. Home Res. Sci."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"425","DOI":"10.4338\/ACI-2015-09-LE-0124","article-title":"An EHR with Teeth","volume":"7","author":"Kalenderian","year":"2016","journal-title":"Appl. Clin. Inform."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.adaj.2019.05.020","article-title":"Knowledgeability, Attitude, and Practice Behaviors of Primary Care Providers toward Managing Patients\u2019 Oral Health Care in Medical Practice: Wisconsin Statewide Survey","volume":"150","author":"Shimpi","year":"2019","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.identj.2020.12.027","article-title":"Global Neglect of Dental Coverage in Universal Health Coverage Systems and Japan\u2019s Broad Coverage","volume":"71","author":"Aida","year":"2021","journal-title":"Int. Dent. J."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"e1078","DOI":"10.1111\/j.1741-2358.2011.00615.x","article-title":"Maximal Voluntary Tongue Pressure Is Decreased in Japanese Frail Elderly Persons","volume":"29","author":"Tsuga","year":"2012","journal-title":"Gerodontology"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/ger.12347","article-title":"Oral Hypofunction in the Older Population: Position Paper of the Japanese Society of Gerodontology in 2016","volume":"35","author":"Minakuchi","year":"2018","journal-title":"Gerodontology"},{"key":"ref_98","unstructured":"British Geriatrics Society (2026, July 03). Improving Oral Health in Older People|British Geriatrics Society. Available online: https:\/\/www.rcseng.ac.uk\/-\/media\/files\/rcs\/fds\/media-gov\/fds-improving-older-peoples-oral-health-2017.pdf."},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Duangthip, D., Ammar, S., Howard, F., and Chen, X. (2026). Oral Health Care in the United States. Dent. J., 14.","DOI":"10.3390\/dj14050265"},{"key":"ref_100","unstructured":"Centers for Disease Control and Prevention (2026, June 14). Healthy People 2030: Oral Conditions, Available online: https:\/\/www.cdc.gov\/oral-health\/php\/healthy-people-2030\/index.html."},{"key":"ref_101","unstructured":"Office of Disease Prevention and Health Promotion (2026, June 14). Social Determinants of Health, Available online: https:\/\/odphp.health.gov\/healthypeople\/priority-areas\/social-determinants-health."}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/11\/4\/84\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:16:36Z","timestamp":1783937796000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/11\/4\/84"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":101,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["geriatrics11040084"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics11040084","relation":{},"ISSN":["2308-3417"],"issn-type":[{"value":"2308-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]}}}