To the Editor: Untreated dental disease can lead to poor quality of life and potentially life-threatening infections in the growing population of vulnerable elderly adults. National data from the U.S. Centers for Disease Control and Prevention (CDC) indicate that 7% of individuals aged 65 and older report having had tooth pain at least twice during the last 6 months and that one-third have untreated dental disease.1 Impaired mobility, poor dexterity, cognitive dysfunction, and lack of insurance coverage impede older adults' access to dental care. This is a report of a case of an independent nonagenarian hospitalized for management of a potentially preventable dental infection. This case highlights the dramatic implications of neglecting oral care on overall health and well-being of an older adult. A man in his early 90s, previously independent in all of his activities of daily living (ADLs) presented to the emergency department (ED) with a 2-week history of right facial swelling and pain, fever (103.4°F, white blood cell count 15,500/μL) and poor oral intake. His past medical history included diabetes mellitus (glycosylated hemoglobin (HbA1c) 8.0%), hypertension, benign prostatic hypertrophy, hypothyroidism, and hyperlipidemia. He had previously been seen in an outpatient clinic and was given a prescription for penicillin. In the ED, computerized tomography of his head and neck revealed a multiloculated area of gas and fluid throughout the right side of the neck (3.4 × 4.8 × 4.5 cm). An extraoral incision and drainage (I&D) was completed, and he was admitted to the surgical intensive care unit (SICU) for airway monitoring and intravenous antibiotic treatment. After 3 days, he was transitioned to oral antibiotics and transferred to the general medical floor, although he subsequently reported feeling worse, with more pain and facial swelling, and a second I&D was completed. An oral surgeon then saw him after oral imaging revealed a periapical abscess related to an odontogenic infection. The teeth involved were extracted, and the patient was returned to the floor. However, his right cheek swelling still did not improve, so he was taken to the operating room for transcervical drainage and returned to the SICU for mechanical ventilation and monitoring. He gradually improved, and on hospital Day 19 was admitted to long-term care for rehabilitation. His treatment included physical and occupational therapy, nutritional counseling (albumin 2.6 g/dL upon admission), and follow-up dental services. Further examination and imaging revealed poor remaining dentition and a second periapical abscess. His remaining teeth were extracted because of poor prognosis and risk of further infection. After extraction of the remaining teeth, he had an uneventful recovery. His strength and oral intake increased, and he was discharged home after 22 days in the long-term care setting. Follow-up at 6 months revealed an unremarkable head, ears, eyes, nose, and throat examination with improved diabetes control (HbA1c 6.8%) and a return to baseline functional status. Oral health is an important component of healthy aging.2 Poor oral health in vulnerable elderly adults can lead to compromised nutritional intake, pain, and possibly life-threatening infections. Oral disease can also affect an individual's general health and result in acute illness with prolonged recovery. The number of decayed teeth has been significantly related to the incidence of aspiration pneumonia.3 A 5-year retrospective study of individuals admitted for odontogenic maxillofacial infection reported a positive correlation between length of admission and age of the individual.4 As in the case presented, a longer hospital stay reflects a more-complicated course and treatment, such as the need for repeated I&D. Untreated dental disease in elderly adults can result in acute illness, which may result in prolonged recovery and affect quality of life. Several opportunities exist for improving oral care and reducing resultant morbidity in older adults. Improving access to dental care and stressing the importance of daily oral care to elderly adults and their caregivers should improve overall health and could even reduce the number and complexity of hospitalizations. Because aging comes with comorbid illness resulting in greater likelihood of seeing a physician rather than a dentist, further education of primary care physicians and geriatricians on common oral conditions is an important potential prevention strategy.5 This case demonstrates the effect of poor oral health in older adults on quality of life and healthcare use and the urgent need for new solutions to this growing problem. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Author Contributions: Hamid Afshari: Assistance in the dental management and treatment. Eleanor McConnell and Lauren Patton: Revision of manuscript. Mitchell Heflin: Revision of manuscript and approval of final version. Sponsor's Role: None.