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David Beam, a Chester dentist, volunteers monthly to provide care for patients at Lucy Corr Village. Photo by Ash Daniel
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Volunteer dentist Michael Hanley’s son, Peter, a Virginia Commonwealth University graduate who is headed to dental school, assists with a patient. Photo by Ash Daniel
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Dr. Trish Bonwell is the dental coordinator for the Lucy Corr clinic. Photo by Ash Daniel
David Beam gets great satisfaction from providing dental care to geriatric patients. He is one of seven Richmond-area dentists to volunteer his services at a free dental clinic run by Lucy Corr Village, a 240-bed assisted-living facility in Chesterfield County.
Beam is determined to give back to the community and help care for the region's growing number of seniors. During his once-a-month visits to the clinic, Beam examines patients and provides a range of dental services on a pro bono basis.
"I feel like I have 100 sets of grandparents: That's the way I describe it. The whole goal of the clinic is to provide dental services that help make their lives better. That's my reward," says Beam, the founder of David Beam Dentistry in Chester.
Richmond mirrors a major demographic shift taking place across the United States as baby boomers approach retirement, underscoring concerns about age-related illnesses that could stem from poor oral health. In Virginia, 12.5 percent of the population is 65 or older, comparable to the national average of 13 percent, according to 2010 census data. Senior citizens account for nearly 11 percent of the population in Chesterfield and the city of Richmond, 12.6 percent in Henrico County, and close to 14 percent in Hanover County.
The all-volunteer Lucy Corr Dental Clinic is funded by private grants and run by volunteers. Along with Beam, volunteers include dentists Michael Hanley, Tyson Anderson, Peter Appleby, Gordon Witcher, Leonard Jackson and Edward Jordan. They perform routine checkups, fillings, extractions and dental impressions for implants or dentures. Major upgrades have been made to the clinic in recent years, including new exam rooms, a laboratory and a conference room.
Lucy Corr also forged a partnership with the VCU School of Dentistry. As part of curriculum requirements, seniors in VCU's dental-hygiene program participate in weekly clinical rotations at the clinic. They assist dentists by preparing patients for X-rays and providing routine cleaning. Beginning in the fall, senior dental students at VCU will rotate four days of each month at Lucy Corr, getting hands-on exposure in a clinical environment under the supervision of practicing dentists.
The clinic addresses a pressing problem: adequate dental care for some of Richmond's most vulnerable residents. Making sure seniors get access to regular checkups is a quality-of-life issue, says Dr. Trish Bonwell, the clinic's dental coordinator.
"Seniors face a range of health risks as they age," Bonwell says. "We know there is a strong correlation between having bad teeth and more serious health problems."
The Lucy Corr clinic could serve as a blueprint for community-based dental services in Virginia and across the country, says Hobart Harvey, a spokesman for the Virginia Health Care Association. He notes that about 60 percent of U.S. seniors in nursing or assisted-living facilities rely on Medicare, yet the federally funded, state-mandated insurance program does not cover routine dental care. "That's why the free dental clinic at Lucy Corr is so important," he says.
Dentists for years have tied poor oral hygiene to the incidence of cancer and heart disease. The direct links are debatable, though. In a landmark study in 2012, the American Heart Association (AHA) concluded that periodontal, or gum, disease has not been proven to cause cardiovascular illness. However, a 2012 report by researchers in Sweden linked high levels of plaque with increased risk of cancer. Yale University researchers also found that poor oral health could be a factor in pneumonia among seniors.
Taking care of teeth and gums helps patients avoid the necessity of dentures or bridgework, says Dr. Michael Hanley, of Hanley Family Dentistry in Chester. "Many of the current generation of seniors expected to have dentures, because they saw their parents wearing dentures. That's not as common among baby boomers, who grew up in an era that placed a lot of emphasis on health and wellness," says Hanley, who has volunteered at Lucy Corr for 10 years.
Specialists Needed
The dental profession traditionally has given short shrift to oral care for older patients, says Dr. Karen McAndrew, the founder of the Virginia Center for Prosthodontics in western Henrico. She specializes in dental techniques to improve the structure of the teeth, gums and supporting tissue. Prosthodontics includes such things as dentures, dental implants and rebuilding oral tissue.
Just as pediatric dentists specialize in treating children and adolescents, McAndrew says a similar specialty is needed for older people. They often have complex needs that require a higher degree of attention and treatment. Some geriatric patients have limited mobility that makes brushing or flossing difficult, and they may have to depend on others for transportation. Medications used to treat other age-related illnesses, such as blood thinners for heart patients, cause dry mouth — a contributing factor to gum disease and cavities.
"Geriatric dentistry is an area that our profession really has not advanced. But as baby boomers age, we as a society are being forced to look at the needs of older patients in a different light," McAndrew says.
Indeed, senior citizens soon will account for nearly 20 percent of the U.S. population, spiraling to 72 million people by 2030, according to the Administration on Aging, part of the federal Department of Health and Human Services. That's more than double the 31 million seniors in 1990.
Geriatric dental care is gaining exposure for another reason: extended life spans. According to 2010 census data, the average American's life expectancy is 79 years, up from 75 years in 1990. The increase is due in part to an increased emphasis on healthy lifestyles and proper diet, says Dr. William Octave, an assistant professor at the VCU School of Dentistry. "The truth is, we're living longer and we have a lot more to maintain," he says. "Teeth are incredibly strong, but they aren't indestructible. All that gnawing and chewing eventually wears away our teeth."
Factor in "environmental changes" in the mouth from medications, stress and heredity, and the chance of dental-related problems increases, Octave says. But he acknowledges that getting dentists to specialize in geriatric services is a tough sell. Geriatric patients have problems that are difficult to treat and require lots of time. It's also not as lucrative as practicing general dentistry or specialties such as pediatrics.
"The focus is less on curing problems and more on managing them to best meet the patient's tolerance for treatment," Octave says. "As a dentist, you really have to have a passion for it."
Passion, meanwhile, remains the watchword for Richmond dentists like Beam, Hanley and their Lucy Corr colleagues. They say treating those who are most in need is the right thing to do, even if it means providing services for free. Says Beam: "Someday I could be sitting in their place. I'd want someone to look out for me."
