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ELDERLY NEED REGULAR DENTAL CHECKUPS

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QUESTION: I'm 78 and haven't been to the dentist in over 10 years. Lately, my daughter-in-law has been urging me to go, arguing that regular dental checkups are especially important in late adulthood. I believe the opposite is true: At my age, a checkup is likely to be a waste of time. Who's right?

ANSWER: Your daughter-in-law is right. Regular dental checkups are recommended at any age, but they are particularly important in the later years to reduce the risk of cavities, dry mouth, gum disease and mouth cancer.Contrary to popular belief, older adults do get cavities - about one a year, on average, according to a study by the Iowa College of Dentistry in Iowa City. Decay of older teeth often starts around the edges of fillings or next to the gum line. And many older adults are more likely to have many fillings because they grew up without the benefit of fluoridated water and other fluoridated products.

Your dentist may give you regular fluoride treatments in the dental office to help prevent tooth decay or prescribe a fluoride gel or mouth rinse for use at home.

Dry mouth, which also contributes to tooth decay, is another common problem among older adults. Dry mouth makes you feel thirsty and is caused by reduced salivary flow, a side effect of many medications and certain medical disorders. Besides cavities, dry mouth can lead to speech problems, difficulty swallowing, hoarseness and a sore throat. Ask your dentist about treatments if dry mouth is a problem for you. To increase saliva flow, drink plenty of water, suck on sugar-free candy and avoid caffeinated beverages, tobacco and alcohol.

Gum disease, the leading cause of tooth loss in adults, affects an estimated 64 percent of people over 65. Gum disease, or periodontitis, is caused by buildup of plaque, which irritates the gums if not removed daily. Over time, plaque and its byproducts cause the gums to recede. Eventually plaque accumulates along the roots of the teeth. The teeth then become loose and may fall out or have to be pulled.

The good news is that gum disease can be prevented, and in some cases reversed, with proper care. You need to brush and floss your teeth at least once a day and get regular cleanings (once every four months is best) by a dentist or dental hygienist.

Mouth cancer, which may affect any of the oral tissues including the tongue, cheeks, lips and throat, occurs most frequently in people over 45. The disease often goes undetected in its early and curable stage partly because older adults do not visit their dentists frequently enough. Symptoms include sores on the lips, gum or mouth; white scaly patches inside the mouth or on the lips; lumps on any of the oral tissues; and bleeding in the mouth. If you experience any of these symptoms, you need to be checked by a dentist as soon as possible.

QUESTION: I'm a 56-year-old, single woman who was recently laid off from a secretarial position. I am currently working part time at another company but do not qualify for health-care benefits. I've priced individual health-care policies but can't afford them at my present salary level. How do other women in similar straits find health-care coverage?

ANSWER: The sad fact is that many of them don't. According to a recent report by the Older Women's League (OWL), 13 percent of women 45 to 64 have no health insurance. Another 1.5 million women in that age group are underinsured.

According to the report, entitled "Critical Condition: Midlife and Older Women in America's Health System," "Lack of financial resources, changes in marital status and the inability to obtain decent-paying full-time work make midlife women especially vulnerable to a loss of health-insurance coverage."

Compared to their male counterparts, midlife women are less likely to have health-insurance coverage through their employers and more likely to buy individual health-insurance policies, the report said. Individual health insurance is considerably more expensive than comparable group coverage. In general, according to the report, older women pay more for individual policies than older men.

An option exercised by many older women - and one that may be available to you - is to elect continuing health-care coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA requires employers with 20 or more employees to offer continued health benefits at group rates for a limited period after a qualifying event. For termination of employment or a reduction in hours, coverage under COBRA is available for up to 18 months. In general, employees must pay the full group-rate premium plus a 2 percent administration fee, a sum that is lower than the charge for most comparable individual health-insurance policies. If you received health insurance at your previous job, contact your former employer to find out whether you can continue the coverage under COBRA.