24 February 2025

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Keeping Smiles Golden

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In the face of an impending silver tsunami where U.S. seniors will number more than 80 million, Ostrow aims to inspire the next generation of dentists to embrace geriatric dental care — not just as a specialty but as a vital part of human health care.

At 90 years old, Paul Kamachi is more than a resident of the Hollenbeck Palms Senior Living Facility — residents affectionately call him the “Mayor of Hollenbeck” as he ambles across campus, warmly greeting everyone who passes him.

“It’s such a blessing for us to be seen by USC dentists and students just steps away from where we live,” Kamachi says. “Most of us wouldn’t have any other way to see a dentist.”

Kamachi’s connection to Hollenbeck Palms began in 2007 when his wife entered hospice care there. By 2010, he had joined her, moving into the independent living building on campus. It wasn’t long thereafter that a dental emergency prompted him to make his first visit to the USC mobile dental clinic parked onsite.

“I had a tooth so loose and painful I thought I could pull it out myself,” Kamachi recalls, with a chuckle. “My doctor said, ‘No, no, no, you need to go see the USC dentists.’”

Since that visit in 2014, Kamachi has undergone various treatments — from cleanings to removable prosthodontics — and learned new ways to care for his teeth along the way.

“Before that, I hadn’t been to the dentist in over 10 years,” he admits. “It was never a priority in my life. I was busy with work and visiting my wife daily.”

What began as a necessity has evolved into a partnership that improved Kamachi’s quality of life and highlights the importance of geriatric dental care for the nation’s growing elderly population.

A Specialized Approach to Aging Smiles

For nearly 25 years, Ostrow has partnered with Hollenbeck Palms to provide on-site dental care for its residents. What began as a program focused on providing residents with removable prosthodontics has since evolved into comprehensive geriatric dental services.

Department Chair of Geriatrics, Special Needs and Behavioral Sciences Piedad Suarez Durall highlights the unique challenges of treating elderly patients.

“A lot of the patients have cognitive decline, so prevention and education are key,” she explains.

Many residents require extensive cleanings or partial removable prosthodontics, often due to years of neglected care. Others face logistical challenges, such as limited mobility or a lack of transportation, making the on-site dental services indispensable.

A Transformative Connection

Each year, fourth-year USC dental students complete a week-long rotation in the Dr. Roseann Mulligan Special Patients Clinic — which also treats, among many other types of patients, frail elderly patients — followed by one day at Hollenbeck Palms, gaining hands-on experience with elderly patients.

“These rotations allow students to apply their classroom knowledge to real-world scenarios, confronting the complexities of treating individuals with multiple health conditions,” Suarez says.

To further prepare students, Suarez and her team have developed a specialized manual that covers common conditions, treatment modifications and patient care strategies for elderly patients.

“It’s become our signature,” Suarez says. “The manual allows students to quickly reference conditions like Parkinson’s, hypertension or diabetes and understand how to adjust their treatment plans and apply modifications accordingly.”

The goal is not only to enhance clinical skills but to foster empathy.

“When students interact with these patients — who often remind them of their grandparents — it creates a connection that can be transformative.”

Meeting the Challenges of Geriatric Dentistry

Like many residents, Kamachi initially struggled with the idea of comprehensive dental care after years of neglect.

“My family was poor,” he recalls. “I didn’t go to the dentist much as a child, and when I did, it was just to pull a loose tooth.”

For Suarez and her team, overcoming these long-held attitudes is part of the challenge. Physical limitations, cognitive decline and a lack of family support also complicate treatment.

In one memorable case, Suarez encountered an elderly husband with severe arthritis who was only able to brush the teeth of his wife, who was severely affected with dementia, just once a week.

“Sometimes we have to educate the whole family for support,” Suarez says. “In this case, the husband was doing his best despite his own limitations, so we adapted and dedicated extra time for her care.”

Facing the Silver Tsunami

By 2050, the portion of the U.S. population over 65 is expected to surpass 80 million, making geriatric dental care increasingly urgent. Suarez refers to this trend as the “silver tsunami,” emphasizing the need for more specialized providers.

“If students aren’t confident treating older adults, they’ll end up referring these patients elsewhere,” she says. “But with proper training, they can better serve their communities and become the go-to providers for geriatric care.”

For Kamachi, the care he’s received from USC has been life-changing.

“They’ve taught me so much and helped relieve my pain,” he says proudly. “I tell everyone here we’re lucky to have them. We need to keep this program going strong!”