The number of Colorado residents over the age of 65 is projected to double to 1.7 million people by 2050, making the state’s aging population the second-fastest growing in the country. With an increasing number of older adults and a severe shortage of geriatric-trained healthcare providers, the Centennial State is taking action.
Geriatric dental medicine aims to prevent and manage oral health problems in older adults by understanding their unique needs with empathy, patience and knowledge. For example, many older adults take medications, and many of those medications have side effects such as dry mouth which can impact oral health.
There is no defined age to be considered a geriatric patient; everyone’s health is unique to the individual. It is essential to maintain good oral health as we age to ensure a better quality of life.
“Older adults now have access to increasingly sophisticated medical procedures including novel medications as compared to even 10 years ago,” said Sarah Dirks, DDS, associate professor and assistant director of the Advanced Clinical Training and Service (ACTS) program at the University of Colorado School of Dental Medicine (CU SDM). “This means that people are living longer despite increasingly complex medical conditions. As people continue to age, they must have confidence that their dentist is knowledgeable about these healthcare advances and how they impact oral health and overall health.”
With the passing of Senate Bill 23-031, the act will expand geriatric training opportunities for clinical graduate students and improve the health care of vulnerable older Coloradans. Dirks said, “There’s a big need here in Colorado for geriatric dental care and providers trained in this field. Standard adult treatment paths may not be appropriate for all geriatric patients.”
Dirks completed a two-year fellowship in geriatric dentistry where she found her calling. “I saw the need. I love working with older adults and it’s a niche in dentistry that I truly enjoy. Part of my decision to focus on geriatrics was also to share this legacy with the next generation of dentists.”
Dirks currently teaches geriatric concepts to dental students and supervises in the CU Dental Senior & Special Care Clinic. She is also one of the CU Dental faculty who will teach geriatric dental medicine to students and residents from 10 different healthcare disciplines from institutions across the state. CU Dental will host the dental medicine rotation of an interprofessional series of courses called GeriCare EveryWhere, managed by the CU Anschutz Multidisciplinary Center on Aging. Dirks explained, “We’re going to present synchronous and asynchronous case studies where we will teach the intersection of oral health and how that may impact their professions, which has never been done before.”
“Colorado’s statewide initiative to develop the geriatric workforce was the impetus for the creation of the CU SDM Geriatric Dental Medicine Fellowship,” said Bruce Dye, DDS, MPH. Dye is a professor and chair of the Department of Community Dentistry and Population Health, and the Delta Dental of Colorado Foundation Chair in Oral Health Equity.
The goal of the fellowship is to prepare dentists to effectively manage and treat older adults living with a broad range of disabilities and medical complexity that supports their oral health and promotes well-being.
The curriculum will have an emphasis on holistic health that includes advanced clinical geriatric and special needs dentistry; interprofessional care coordination; studies in gerontology; dental public health considerations for vulnerable older adult populations; community outreach; and a capstone project in an area of their interest related to gerontological research.
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Elena Ciobanu, DDS '22, is the first Geriatric Dental Medicine Fellow at the CU School of Dental Medicine. |
From a competitive pool of applicants, Elena Ciobanu, DDS ’22, was selected as the inaugural fellow. She is an alumna of the CU SDM Advanced Standing International Student Program and received the Special Care in Dentistry award at graduation. Dirks said Ciobanu “has an excellent foundation in clinical skills and patient care, because she’s been a dentist for years. After graduation, she was working as a dentist, providing dental care for geriatric and special needs patients. She has already embraced this focus as a profession.”
Ciobanu credits the CU Dental faculty for her eagerness to return for the fellowship. “At CU we have amazing educators who are focused on teaching students with a person-centered care model. It is a very welcoming culture. The faculty are truly there to support each and every student with an individualized approach.”
Ciobanu was exposed to geriatric dentistry during her time as a student. She was inspired by Dirks’s enthusiasm for the subject. She said, “There is a big need for well-prepared specialists who can safely provide geriatric dental services. And being able to do that is a superpower I want to train more.”
“With geriatric medicine we have to be extremely careful with overall medical history, and here at CU I am really grateful for the training we received in regard to that,” Ciobanu said. “I learned to reach out to patients’ primary care physicians for most procedures I do, to make sure they know what the dental team is planning to do and talk about any recommendations they might have for our patients. Geriatric patients’ health and healing can be unpredictable, and sometimes complications can happen even if everything was done by the book. It is very interdisciplinary work.”
As a child, Ciobanu used to spend a lot of time with her grandparents. She said it was wonderful to listen to their life stories and enjoys listening to her patients’ stories now too.
“Some inspire you to be like them when you grow up,” she said. “I had a patient who was 103 years old, and it was a pleasure to meet and be around her. She had a sharp mind and a young spirit. She started traveling the world when was she was in her sixties, after her husband passed, and saw pretty much every country. But when I asked what the best years of her life were, she said, ‘Honey, right here, right now.’ Such people inspire me.”
Next year, the School of Dental Medicine intends to support two fellows in training.
Header image: Patient speaks with student providers in the CU Dental Clinics.