A practicing dentist since 1985, Dr. Alisa Kauffman is now a leading figure in geriatric dentistry and pioneer in running a house-call practice, treating patients at home in both NYC and the Hamptons. Dr. Kauffman is an in-demand lecturer worldwide, Director of Geriatric Dental Care at three nursing homes and founder of the Dental LIFE program at the University of Pennsylvania School of Nursing.
How did you get to this point in your career?
After graduation I opened my own office on the Upper West Side on Central Park West where I treated a lot of retired teachers. Many of my patients or patients’ families would call me asking if we were wheelchair compatible as they aged and could no longer come on their own. Unfortunately, the office was small and it was difficult to manage a wheelchair in the operatory, so I offered to see them at home. At first, I wasn’t sure that this could work, but over the years I was able to figure it out. I bring extension cords and my own light, and I have adapted a suitcase and duffel bag to contain my complete office!
Doing dental work in patients’ homes is a pretty innovative concept, and pretty unusual for the uninitiated. Did you come up with this idea?
I like to think I am the pioneer in this industry since I have been doing it for 35 years!
I am also at least one of the first to do it as a full-time career. When I was teaching at UPenn, they sent me to lecture to dental students in China and Korea. They were quite amazed and hopefully have adapted to this type of niche practice as well.
What makes geriatric dentistry unique? What is done differently with elderly patients?
I carefully chose my words when I chose GeriatricHouseCallDentistry.com. I do not want to treat patients who are able to go to a traditional brick-and-mortar office. My patients tend to be frailer, some are on many medications, have physical issues, and many have Alzheimer’s disease or some form of dementia.
The most important skill one must have when treating an elderly or geriatric patient is patience. Going to homebound patients’ homes makes them feel safe and comfortable. I can take my time and no ambulette is necessary for transportation. I can treat them wherever they would like—their bed, recliner or even in a chair with their head supported. Thank goodness I have a strong back.
Why have you focused on treating the elderly? It’s a noble calling and possibly one not a lot of other dentists might choose.
The elderly are the most underserved population and the group with the most dental needs. Teeth are often neglected as you age. “They are just teeth,” but teeth and the oral cavity are the gateway to our overall health. Poor oral health can lead to many dental issues, such as cavities, gum disease, infection and pain. Maintaining good oral care throughout your life can prevent cancer, diabetes, heart disease, Alzheimer’s disease and dementia. I like to tell my patients to “only floss the teeth you want to keep!”
It’s important as a quality-of-life issue to be able to smile (socialize) with teeth or with well-fitting dentures; and eating is the most essential activity in life, isn’t it? We need our teeth to chew our food properly. No one likes eating puréed food if it can be avoided.
What are some challenges of treating those with dementia or Alzheimer’s?
It definitely takes a special skill set as a dentist to treat the dementia patient. They often refuse to cooperate, but it’s my job to get the procedure done. I can’t share all my secrets. Read my book The Tooth and Nothing But the Truth! (thetruthandnothingbutthetruth.com). It’s a complete guide to oral care for the elderly.
Are there services you can’t perform in a patient’s home?
The only dental procedures that cannot be done at home are root canals, crowns, bridges and extraction of impacted teeth.
Do you have anything to add?
I am working on a new project. CaringAndAble.com, a website addressing everyday needs of the elderly. It contains a curated list of products, services and resources designed to help caregivers manage daily living. And there are webinars to watch, so you can click on the topics you need and listen to the CEO of the company giving you valuable information straight from the primary source. We are looking for new companies, services and products to join our list. I want to be the Angie’s List for everything a caregiver needs.
I am also grateful for being honored as the chair of the CaringKind NYC Alzheimer’s Walk on October 10 in Central Park. This is the charity closest to my heart. Alzheimer’s disease will be cured in my lifetime!
Learn more at geriatrichousecalldentistry.com.