Addressing the Challenge of Shifting Patient Demographics


An entrepreneur sees opportunity in the aging patient population. He’s working to fight deterioration of oral health in seniors, a fight he believes we can win.

The population is aging, that’s a fact.

According to figures from the US Census Bureau, by 2050, the population aged 65 and over is projected to double in size from 2012 levels. In numbers, that means increasing from 43.1 million to 83.7 million.

An aging population—in effect, a shifting of patient demographics—will, and already is, placing added challenges on dentists.

“People are living longer, as we all know,” says Paulo Malo, president of Malo Clinic Health and Wellness. “And, living longer, there’s no way you’re going to keep your teeth. But of course, losing the teeth is not the only issue here. The issue here is that you lose teeth and you lose available bone, and you lose quality of the bone. So, we have a triple problem to solve with the aging population.”

Information Problem

Malo does not believe that accessibility will be an issue for an aging population. Instead, he feels the problem will be one of information. Or more specifically, inaccurate information. That’s because many patients have been told throughout their lives that there isn’t enough bone available, or the bone is too weak, or that they’re too old to have dental implants.

Malo is the creator of the All-On-4 Dental Implant Procedures, which stands for all teeth only four dental implants. He developed the implants nearly 20 years ago to provide almost any patient with failing or missing teeth a new, non-removable bridge which is supported by only four strategically placed dental implants.

“The problem is information,” Malo says. “They need to know that we can do these types of procedures on any patient, regardless of age.”

But who performs the procedure is critical as well. Malo says that while dentists do need to address the changing demographics of their patient population, they also need to recognize that the work he and his colleagues perform is akin to full mouth reconstruction, not just placing an implant.

“This is work for specialists,” Malo says. “And it’s really sad to say that 40% of the work we do is to correct situations. And this is not acceptable.”

Teamwork Is Key

Malo and his clinical team have continued to innovate and develop new products related to All-On-4 ever since its inception. In 2010, the specialists at Malo Smiles teamed up with Dr. Malo, along with his research and development and educational teams at Malo Clinics headquarters in Lisbon, to bring these life-changing techniques to the greater New York area and elsewhere.

Malo says that the information problem still exists not only with the public, but also with dental professionals. He says that seminars are critical in getting information out to dentists. And that dentists need to understand they have the opportunity to identify and refer patients to centers that perform this level of specialty work to a high success rate.

“You would not expect a dentist to do this type of work, especially not small groups,” he says. “It’s actually teamwork, and this is a specialty on our end. We have 60-plus centers in 18 countries, and you will soon see more centers like ours around the world.”

Insurance and Price

Malo says that the tendency for the dental industry is to follow the medical industry. Currently, he projects that between 90 and 95% of all medical services are paid for by some type of insurance. In contrast, much of the dental work being done worldwide is paid for out-of-pocket. He expects that to change.

“These elderly patients, most of them are retired as well,” Malo says. “They do not have access to a lot of money. Therefore, they need help, financial help. So I believe that this shift of demographics, besides bringing new types of products and services which are more expensive to build and more expensive to teach, will also bring an opportunity for the insurance companies and the like, because it is obvious that we need to make an effort to lower the prices.”

But at what cost? Malo says that lowering the price should never occur by way of lowering the quality.

“Lowering the price should always be done by increasing the efficiency of the teams that do these cases,” he says. “Teams need to be highly trained so that we can perform these treatments faster with less failure.”

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