A program of Home Instead Senior Care Foundation

Gary and Mary West Senior Dental Center

San Diego, California

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Poor oral health is a growing public health crisis for vulnerable seniors in the United States. To address this critical need, the SDC was established in 2016, a one-of-a-kind, nonprofit community dental clinic embedded within a bustling senior wellness center that provides daily meals and supportive services for hundreds of low-income seniors in downtown San Diego. This innovative, integrated care model is stabilizing and restoring the oral health of a neglected population while helping to advance research, policy, and advocacy efforts to identify solutions to increase access to oral healthcare.


Despite significant advances in dentistry to prevent many oral healthcare issues, dental disease remains one of the most serious and widespread chronic health problems in America. The problem is even more severe among low-income seniors, who often lack access to care.

• Financial realities force 41% of American seniors to choose between rent and nutrition each day. In such a scenario, dental care is rarely prioritized
• And with 10,000 Americans turning 65 every day, and 70% of them having no dental insurance, a problem is rapidly turning into a crisis

In our community, the urgent need for oral healthcare intervention was identified when many seniors at a bustling San Diego senior center were unable to eat the meals provided due to missing teeth and/or oral discomfort and pain.

Seniors report that:
• 77% have fair or poor oral health
• 45% are missing teeth with no dentures/partials/implants
• The top three barriers to care are high cost, transportation, and lack of providers accepting Denti-Cal (CA state Medicaid)

Using an oral health surveillance tool to examine seniors' mouths, our Registered Dental Hygienist has found that:

• 41% of seniors must be seen right away for dental treatment
• 46% have untreated decay
• 43% need periodontal care
• 26% have severe gingival inflammation

These troubles lead to a growing care gap and a cascading list of other problems that dramatically and negatively impact every aspect of a senior's life. For, although oral health is often and mistakenly compartmentalized from the rest of the body, it is inextricably linked to overall health and quality of life.


To address these barriers and this critical unmet need, the Senior Dental Center was established, designed, staffed, and licensed as a community health clinic embedded within Serving Seniors' Gary and Mary West Senior Wellness Center, a larger community wellness hub. Our patients are screened, triaged, and their care is coordinated, all on-site. Every senior interested in services receives a comprehensive geriatric assessment and attends an oral health education workshop taught by a registered dental hygienist. Our goals in dental treatment are to provide quality oral healthcare, re-engage seniors that have gone without services for extended periods of time, and ensure that the mouth is not treated in isolation.

Through clinical treatment and teaching at the Senior Dental Center, we have been able to "reconnect" the mouth with the rest of the body and raise the profile of this vital barometer of health. By accepting Denti-Cal and using a sliding-fee scale, seniors can access affordable oral healthcare services in a dental home that is co-located in a familiar and trusted setting, creating an innovative, integrated community-based system of care for older adults.

Since opening, we have seen over 700 unique patients for nearly 6,000 visits. We have already seen the amazing impact our services have had on not only seniors' functional ability to eat, speak and smile but also their renewed self-confidence and quality of life. We've had many teary eyed moments teaching a senior how to smile again, hearing their satisfaction eating corn on the cob for the first time in many years, and learning of their newly submitted employment applications.


The Gary and Mary West Senior Dental Center's mission is to provide affordable, high-quality oral healthcare with comprehensive education, clinical, and wellness services for seniors in need, enabling them to live healthy and productive lives.
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