Pallas Care CEO Jennifer Dawson recently sat down with Dr. Lisa Hou to talk about dentistry and periodontal health for older adults. Dr. Hou is a triple Trojan, having earned a Bachelor’s degree from USC’s Leonard Davis School of Gerontology and a Master’s and Doctoral degree from the Herman Ostrow School of Dentistry. In addition to her private practice at Happy Family Dentistry in Alhambra, Dr. Hou currently serves as the director of the USC Dental Mobile Van at Hollenbeck Palms Retirement Community and as Clinical Assistant Professor at Herman Ostrow School of Dentistry of USC. She is the Secretary of the board of the Geriatric Council of Special Care Dentistry Association and Vice President of the local dental society.
Pallas Care (PC): Thank you so much for chatting with me! Tell me a bit about how you grew up. Did you always want to be a dentist?
Dr. Lisa Hou (LH): Oh my gosh, no, I did not always think I was going to be a dentist! I knew I was going to be something in the healthcare field. I was born and raised in Taiwan, and then when I was 10, my parents sent me and my older sister to live with our grandparents in Arcadia, San Gabriel Valley. And that’s kind of how this got started. Because living with them was very different–they only spoke Taiwanese; they didn’t even speak Mandarin. And being in a majority-English area, I saw how difficult it was for them to get access to care. So that’s why I did Gerontology as an undergrad major.
I ultimately chose dentistry because it’s more fun to work with your hands all day!
PC: How long have you been working with older adults and what inspired you?
LH: It was really my experience living with my Ah-Mah (grandmother) and Ah-Gong (grandfather). They both had health problems, my grandfather had a stroke, my grandmother was hard of hearing, and they both had partial dentures. Ah-Mah did all the cooking, and it was always soups and purees and things like that. I remember not understanding as a kid why the rice was always porridge consistency, but it was probably because it was easier for them to eat soft foods. They couldn’t enjoy the foods they loved–and as someone who loves to eat, I know how hard that is!
Even when my parents moved here, we still lived close to our grandparents and saw them frequently. My Ah-Gong passed away when I was a freshman at USC, and my Ah-Mah a few years later. She had a real immigrant mentality, still kept working until she passed away. That’s inspired my work ethic and why I want to work with older adults and immigrants, too.
PC: Now I want to talk about dental health. What are some of the most common age-related dental complications?
LH: Well, there’s a lot of things that we think of when we think about getting older, like Alzheimer’s and cancer. And those can certainly make things more complicated when it comes to dental health and care! I did my rotation working with medically complex patients, and at the Ostrow Clinic at USC we work a lot with geriatric and medically complex patients. I did a one-year residency post-dental school at Rancho Los Amigos Rehabilitation Center working with medically complex patients, and then went back and got a Master’s in Geriatric Dentistry.
Medically complex could mean anything from hypertension to diabetes all the way to people on dialysis and waiting for an organ transplant. And with something like dementia, usually that means the patient is going to be uncooperative because they may not understand what’s going on. Or there could be a condition like a stroke that makes it difficult to open their mouth fully. We have special tools that are really helpful for specific situations like these.
We do see a lot of cavities, especially root cavities. Older restorations that need repairs. Really, the whole dental landscape has changed. We know so much more now about how to take care of your teeth. There have been so many advances in dentistry. So it really depends on the patient, what their history of care has been, what their habits are, etc.
But normal, healthy aging: your teeth should be perfectly fine. Any conditions we see are usually a result of lifetime accumulation, which is why we always stress that you need to see your dentist every six months, brush twice a day, floss every day. Once a periodontal condition like gum disease sets in, it’s not like you can grow new teeth. This isn’t Shark Week! If we did grow new teeth, I’d be out of a job. So we need to try to maintain your teeth and gum health as soon as we can.
And just to get on my little soapbox: there’s your mouth, and then there’s a whole body connected to that mouth. People are used to the silo system, where we go to a different doctor for different ailments. But gum and dental health are very connected to overall health. Studies have found that it connects to cardiovascular health, dementia, and other conditions as well: cancer, rheumatoid arthritis. If you think about it, there’s bacteria in your mouth and that can then get into your bloodstream and cross the blood/brain barrier. Wild stuff!
PC: Ok then, let’s talk about prevention. What are you doing in an ideal world to keep your mouth healthy and happy? And personally, I’d love to hear your thoughts on electric vs. manual toothbrushes.
LH: A regular checkup with your dentist, I cannot stress that enough. Every six months. We’ll do an initial assessment, full mouth x-ray, and then every other appointment do just the bite-wing x-ray. We want to check in between the teeth and make sure decay hasn’t set in. We’ll also do a full cleaning. Some people might need less time in between appointments: for example, patients with mild dementia tend to forget to brush, so we see them every 3-4 months.
The good news is, you only have to brush the teeth you want to keep! I like to use an electric toothbrush because I’m lazy and it does most of the work for you. If you’re a very detail-oriented brusher, you may want to stick to old-school manual style. And if you have a small mouth, an electric can help too because the brush head is smaller and can reach into corners. Flossing is key to good periodontal health; at least once a day. You can use a water flosser but make sure you are getting in there with actual floss, too.
Another reason to come to the dentist is that as you get older, you’re more prone to oral cancer and stuff like that. You want to make sure that your dentist is doing cancer screening, checking for lumps and bumps. And if you feel anything is off or hurts, make an appointment as soon as possible. Especially if it doesn’t resolve within 2 weeks. It’s always better to get it checked out–don’t wait until the last minute!
PC: Tell me more about the Dental Clinic at the Herman Ostrow School.
LH: Well, it’s more competitive price-wise. It’s going to be less expensive than private practice. We do take dental insurance: Denti-Cal and Delta Dental PPO. You have students working on you, so it’s going to take longer, around 4 hours for a regular appointment and cleaning. We also have specialty clinics for different types of care, different needs.
PC: What about people who are home-bound? What options do they have?
LH: For my private practice, we can come out to the house. I just got a portable compressor! But it’s going to be limited in the beginning, because we still need to screen, do the assessment, treatment plan. There may be other services that do that too, but generally they are hygienists, not dentists, so they can only do the cleaning.
PC: Final question: What do you want for yourself and your life as you age? What are your plans for the future?
LH: I want to live to 100! Netflix has a new series I’ve been watching that’s called Live to 100: Secrets of the Blue Zones. We were just talking about it at lunch today; it’s all about healthy aging. I want to still be active, maybe even still practicing dentistry. And surrounded by my great-great-great-great-great-great-grandchildren. I think every 100 years is about 3 generations, so maybe just one or two greats.
Resources:
Dr. Lisa Hou, DDS
Happy Family Dentists
1212 S. Garfield Ave
Alhambra, CA
626-556-3619
Herman Ostrow School of Dentistry
Student Clinic (open to the community)
925 W 34th St
Los Angeles, CA 90089-0641
(213) 740-2805
(213) 740-2800