For many elderly African-Americans, it is not all smiles when it comes to making a trip to the dentist.

According to a new study by Ann Slaughter, assistant professor in the School of Dental Medicine, dentists’ chair-side manner is one reason why elderly African-Americans are staying away from the dentist in greater numbers compared to the general population. Misperception about the state of their oral health is another.

While fear of the dentist and the costs associated with dental procedures are issues faced by the elderly population in general, these two barriers do not explain why black seniors suffer more than other elderly people from oral diseases.

Through focus group studies, which included older African-Americans who attend senior centers in West Philadelphia, Slaughter learned that when dentists are more sensitive and understanding, this trend can be partially reversed.

“If the dentist’s reactions to them were communicative, listening to what they had to say, then this helped to decrease their fear and anxiety,” said Slaughter.

Furthermore, Slaughter found that the race of the provider had no effect on how often patients saw the dentist. “This is saying right now within the profession [that] there are things we can do to pay more attention to and to better accommodate our patients, and it’s not race dependent,” she said.

Slaughter said some solutions come even before patients hop into the dentist’s chair. Setting up waiting rooms so that they are more comfortable for seniors and ensuring that the office staff is polite can go a long way. “I had an elder say, ‘I walked into that office and that environment was cold, [so] I walked right back out.’”

Dentists can earn the trust of their patients by looking them in the eyes when talking to them and by offering treatment options that take into account not only the clinical issues but the lifestyle issues as well. Sometimes the “Cadillac treatment plan,” or the spare-no-cost approach, is not best for everyone.

Chair-side manners aside, other factors play a big role in why elderly blacks suffer more from oral cancer and have fewer natural teeth remaining than their counterparts.

Slaughter also learned that when patients realized the connection between oral hygiene and general health, it was a motivating factor for using dental services.

From these findings, Slaughter is creating health promotion interventions that are community based and population sensitive. She said that heightening awareness will increase patients’ sense of self-efficacy and consequently their decision-making ability. Slaughter also hopes to apply her intervention program to other ethnic groups with disproportionate oral health problems.