How a Massachusetts Dentist is Filling a Gap in Geriatric Care
Kadambari Rawal, BDS, CAGS, MSD, FASGD, FICD, FACD, a geriatric dentist and Clinical Assistant Professor at Boston University’s Henry M. Goldman School of Dental Medicine, is a 2021 DentaQuest Health Equity Hero.
Dr. Kadambari Rawal knew what she wanted to do from a young age. As a new dental student at the age of 20, Rawal entered into geriatric care—treating older patients. Selecting this particular area of dentistry was not by chance, rather a culmination of her life experiences. Rawal had seen firsthand how the lack of care can impact a person’s oral and overall health.
“During the time I was at school, my grandmother was diagnosed with Non-Hodgkin lymphoma. She was struggling with major oral health issues and having to suffer through pain because no dentist was willing, or adequately trained, to treat her in her deteriorating health,” says Rawal.
After seeing her grandmother struggle, she was determined to address the lack of care provided to older adults and long-term care patients and make a difference in their oral health. Now, Rawal is making sure patients like her grandmother are able to receive the treatment they need.
As a dentist at the Hebrew Rehabilitation Center in Dedham and Roslindale, Massachusetts, Rawal provides routine and emergency care at the nursing homes for patients ages 70 and older. Her patients often experience increased oral health problems that require specialized management, prevention and treatment—including teeth grinding, restoring broken teeth and more.
“Geriatric care is extremely important. For patients between 70 and 80 years old, their oral health is already vulnerable due to various medical complications. Oral health is a big concern and factor in the overall health and quality of life for this population.”
Poor oral health leads to poor overall health outcomes and higher health care costs, especially for those with chronic diseases, mental illness and other conditions that impact us as we age. Conditions such as obesity, heart disease and dementia are linked to gum disease. In fact, having 10 years of chronic gum disease (periodontitis) was associated with a higher risk of developing Alzheimer’s disease.
Geriatric care goes beyond general treatment. Older patients often need specialized care from dentists who have expertise with potential drug interactions and impairments. According to the American Dental Association, older patients are more likely to be using several prescription and/or over-the-counter medications, making them more vulnerable to medication and drug interactions. Patients may also experience physical, sensory and cognitive impairments—making communication between the dentist and patient difficult. With extensive training, geriatric dentists are equipped to navigate these barriers to care.
While there is an adequate number of licensed dentists in Massachusetts, and across the nation, to meet the demand for dental services, there are not enough practitioners adequately trained to provide care for the elderly. And this is a patient population that is on the rise. That’s why Rawal is training the next generation of dentists to properly treat elderly patients.
“People are living longer than ever before and are keeping their teeth longer. With disease a serious possibility for many elderly adults, current and new dentists need to be trained in how to properly care for this population.”
This passion is reflected in Rawal’s work as a professor of general dentistry at Boston University. Through her teaching, she is able to address the gap in geriatric oral health care and educate the next generation of dentists how to treat those in long-term care settings who suffer from increased oral health problems.
“The students and residents I teach are exposed to geriatric care as part of my curriculum. They work with me at long-term health centers and are exposed to older adults who are in need of treatment.”
Rawal is proud of the work she is doing to promote geriatric care, particularly among a new generation of dentists. With a movement within the profession to make geriatric dentistry a recognized specialty, she hopes that – unlike her grandmother – future generations won’t have to struggle with oral care as they age.
Kadambari Rawal is a 2021 Health Equity Hero. She is directing her award donation to the Smiles for Success Foundation and AID’s COVID Relief Fund for India.