scholarly journals An aging population – have we got an Oral Health Policy?

2009 ◽  
Vol 1 (1) ◽  
pp. 28-50
Author(s):  
Noel Woods ◽  
Helen Whelton ◽  
Tara Crowley ◽  
Ian Stephenson ◽  
Mary Ormbsy

This paper highlights the impact of an aging population on the oral health of the elderly and to recommend policy measures to address the oral health inequities experienced by older people. It analyses data based on examinations carried out in the National Survey of Adult Oral Health on a sample of 714 adults aged 65 and older using commonly used parameters of dental health. The survey consisted of a clinical oral examination, a detailed questionnaire to establish behaviour patterns and attitudes, and focus group discussions to establish broader health and quality of life issues. The survey found that 65 per cent of the elderly had a medical card and thus were eligible for free dental services. However, just 14 per cent availed of the service even though 79 per cent had a clinical need for treatment. Over 20 per cent never visit the dentist and only 44 percent attend the dentist regularly. Older people were not well informed of the oral health needs and tended to visit the dentist for symptomatic reasons. Barriers to care included reduced morbidity, cost of transport, and fear of the dentist. It concludes that oral health promotion is required to raise awareness of oral health and of the Dental Treatment Services Scheme (DTSS) entitlements, promotion by other healthcare professionals and carers who are in frequent contact with older people, the provision of domiciliary care for those who cannot access clinic-based services and integration between the dental profession and medical profession.

2021 ◽  
Vol 5 (1) ◽  
pp. 102-116
Author(s):  
Hasan Hekmatnia ◽  
Kamran Jafarpour Ghalehteimouri ◽  
Ali Shamsoddini

Population aging and its consequences are an extremely controversial issue in the global context. An increase in the number of older people along with a decrease in the birth rate leads to an excessive burden on the economically active part of the population. Such imbalances threaten to reduce the workforce, slow economic growth, increase social spending, increase the fiscal burden. Therefore, using the country’s own experience to solve the problem of rapid aging of the nation and take measures to improve the quality of life of older people and their social integration into society is insufficient, as changes in the age structure of the population may occur for the first time. Therefore, it is necessary to study and adapt the experience of other countries to address this social issue. The purpose of this study was to conduct a comparative analysis of the aging population in Iran and Poland, as well as to assess the impact of the nation’s aging on life expectancy, fertility and gross domestic product (GDP) in these two countries. The object of the study is Poland as a representative of European countries, which is facing an increase in the number of elderly people, and Iran as a country where the age structure of the population is just beginning to change. The study period is 1950-2020. The results of the study show that there has been an increase in the elderly population, but the share of this population compared to other countries is lower. The authors of the study proved the existence of significant differences in the aging population in Poland and Iran. A feature of the demographic situation in Iran is the declining birth rate, which leads to a decrease in the total population and an increase in the proportion of elderly people. These socio-demographic transformations in the long run can have a destructive effect on Iran’s GDP. In contrast to Iran, Poland is experiencing an increase in population aging, leading to rising spending on social security and protection, as well as falling GDP. The rapid growth of the elderly population compared to the growth of the total population of the country and the increase in the share of elderly people in the coming years emphasizes the need for further planning of control over the problems associated with this population group.


Author(s):  
Ye Seol Lee ◽  
Juyeong Kim ◽  
Yoon Soo Choy ◽  
Eunkyong Kim ◽  
Jaehyun Yoo

Background: Dental health is an important factor in daily life routines and is closely associated with maintaining a health-related quality of life. This study examined denture procedure changes after implementation of the National Health Insurance (NHI) Coverage of Dentures for the elderly. Methods: We used the “Korean Community Health Survey (KCHS)” developed by the Korea Centers for Diseases Control and Prevention. We analyzed the association between policy implementation and dental health-related outcomes using difference-in-differences (DID) analysis to compare patients aged ≥75 with those 65–74 years before and after coverage. Results: A comparison of age groups and coverage periods showed that patients aged ≥75 years had higher (OR: 1.038, 95% CI: 1.021–1.055) procedure rates after coverage. In particular, elderly patients on medical aid had significantly higher denture procedure rates, while those without oral health screening were more likely to have denture procedures. Conclusions: This study determined the impact of the NHI Coverage of Denture procedure policy for the elderly and found increased denture treatments in the elderly. This policy appeared to positively affect older patients by increasing denture procedures for low-income and medical aid beneficiaries. Hence, the government needs to increase oral health examination and dental health policies for the elderly.


2009 ◽  
Vol 22 (3) ◽  
pp. 417-425 ◽  
Author(s):  
Nitin Purandare ◽  
Eva Woods ◽  
Sue Butler ◽  
Julie Morris ◽  
Martin Vernon ◽  
...  

ABSTRACTBackground: Mental illness and cognitive impairment are risk factors for poor dental health.Methods: We conducted a cross-sectional study to compare the dental health of older patients attending out-patient clinics and day hospitals of old age psychiatry services (the psychiatry group, n = 103) with those attending general/geriatric medical services (the medical group; n = 99). Those living in care homes, and those with diagnosed mental illness (in the medical group) were excluded. A registered mental health nurse assessed mental and general health using validated and previously published instruments. A registered dentist made an independent assessment of dental health (examination to assess oral pathology, status of remaining teeth, and dentures) and made an overall judgment about whether the patient needed any dental treatment (a “normative” need).Results: The normative need for dental treatment was significantly higher among the psychiatry group compared to the medical group (85% vs 52%; p<0.001); even after taking account of the effect of age, gender, teeth status, physical comorbidity, cognition, depressive symptoms, and overall mental and social health [adjusted odds ratio, OR (95% confidence interval): 4.32 (2.09, 8.91)]. The presence of any natural remaining teeth [OR: 4.44 (2.10, 9.42)] and Barthel Index [OR: 0.96 (0.93, 0.99)] were the two other independent predictors of the need for treatment.Conclusion: Dental problems are common in community-living older people, especially those with some natural remaining teeth and those with mental illness. There is a need to develop integrated mental health and dental care services for older people with emphasis on prevention of dental problems.


Author(s):  
Ramprasad Vasthare ◽  
Anil V. Ankola ◽  
Arron Lim Yan Ran ◽  
Prateek Mansingh

Across the world, the segment of the elderly in populations is seen to be increasing at a rapid rate. There also exists a trend in which more teeth are retained as age increases due to effective dental public health measures like fluoridation. This inevitably places an increased need for dental healthcare among the geriatric populations. Since oral health greatly affects the systemic health of aged individuals, it is imperative for dentists and physicians to work together as a team to impart treatment to the best of one’s abilities for geriatric patients. It is therefore, necessary to first assess the oral health concerns surrounding the geriatric population from the perspective of public health dentistry. Relationship of the elderly with periodontal disease, dental caries, salivary hyposalivation and xerostomia, cognitive changes, and simultaneous usage of diverse medications was discussed. This paper reviewed the literature and then examined and discussed the various problems mentioned in depth and suggested recommendations for a plan of action. Knowledge about the specific oral health concerns and issues will help to better position us in developing strategies for providing better oral healthcare to the geriatric population in addition to the existing systemic healthcare. In the future, the elderly will make up a huge portion of the demographic visiting dentist regularly for a myriad of oral health problems. Dental health professionals therefore, must have adequate training and competency to deal with the predicament of this geriatric population. Preventive and treatment services can ensure healthy aging which will improve the quality of life.


2021 ◽  
Vol 105 (1) ◽  
pp. 78-81
Author(s):  
N. Zhachko ◽  
◽  
T. Nespriad’ko-Monborgne ◽  
I. Skrypnyk ◽  
M. Zhachko ◽  
...  

Summary: The search for and development of methods for determining the quality of life is an urgent problem of foreign and domestic medicine, and the state of dental health plays a very important role. An important role in human communication plays the maxillofacial area. Therefore, the most important areas and defects associated with the communication process – defects in the frontal area, smile, change of pronunciation, spitting during the conversation – all these signs accompany a number of anomalous processes. Objective: to assess the impact of dental status on the quality of life of the adult population in the presence of the disease periodontal disease in combination with musculoskeletal dysfunction in patients with dental anomalies and deformities. Materials and methods. To study this goal, a survey of 283 patients who applied was conducte with complaints of aesthetic defect of the dentition, combined with the presence of joint pain and periodontal disease of varying severity. Results. A complete analysis of factors that significantly affected the quality of life of patients with a number of diseases was obtained oral cavity. Conclusions. Deficiencies related to oral health reduce the quality of life of our patients, and the treatment significantly changes its quality depending on age, sex and method. But for the best results positive changes in the quality of life of the patient dentists can expect only by conducting a comprehensive treatment. Key words: quality of life, dental health correction.


Author(s):  
Saber Azami-Aghdash ◽  
Fatemeh Pournaghi-Azar ◽  
Ahmad Moosavi ◽  
Mohammad Mohseni ◽  
Naser Derakhshani ◽  
...  

Background: Of the most important implications and complaints in the elderly group of the population, is oral and dental health problems. This study aimed to assess oral health- related quality of life in older people. Methods: To data collection, databases were searched including PubMed, EMBASE, Scopus, SID, MagIran, Cochrane Central Register of Controlled Trials and scholar google The keywords were “older adults", “Geriatric” Elderly", "Older", “Aged”, "Ageing", "Oral health", "Oral hygiene" and "Quality of life", "QOL. For manual searching, several specialized journals of related scope as well as the finalized articles' reference list were searched. Studies from 1st Jan 2000 to 30th Jan 2017 were included. Studies were subjected to meta-analysis to calculate indexes, using CMA:2 (Comprehensive Meta-Analysis) software. Results: Totally, 3707 articles were searched that 48 of them were subjected to the oral and dental health-related quality of life in 59 groups of the elderly population with the mean age of 73.57+6.62 in the 26 countries. The obtained percentage values of dental and oral health were 80.2% (0-60), 14.8% (0-12), 16.4% (0-70), 22% (0-14 or 0-59) and 19.2% (0-196) for GOHAI with the additive method, GOHAI with Simple Count Method, OHIP14 with the additive method, OHIP-14 with Simple Count method and OHIP-49 with additive method indexes, respectively. Conclusion: The elderly group of the population had no proper oral health-related quality of life. Regarding the importance and necessity of oral and dental health and its effect on general health care in the target group, it is recommended to improve dental hygiene in the mentioned group of population.


2021 ◽  
pp. 238008442110419
Author(s):  
M. Hijryana ◽  
M. MacDougall ◽  
N. Ariani ◽  
L.S. Kusdhany ◽  
A.W.G. Walls

Introduction: The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people. Objectives: To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences. Methods: Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes. Results: Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process. Conclusions: Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences. Knowledge Transfer Statement: This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.


2005 ◽  
Vol os12 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Edith M Allen ◽  
Nick M Girdler

Introduction Anxiety and fear in relation to dentistry are long-standing problems and the incidence of dental fear does not appear to be decreasing. It can result in poor dental health and wastage of clinical time. Conscious sedation is one method of allaying anxiety in dental patients and enables such patients to accept dental treatment. Aims, Materials and Methods A questionnaire survey was undertaken among patients attending an emergency dental clinic. Its aims were to assess the levels of dental anxiety in these subjects, the impact on their attendance for dental treatment, and their knowledge of and desire to have conscious sedation, should it be available. Results The results indicated that in the 72 patients who responded, levels of anxiety regarding dental treatment were high, with 49 (68%) claiming some nervousness or worse. Thirty-one (43%) cited fear/nervousness as a reason for delaying making a dental appointment. Twenty-seven (38%) were not aware of the existence of conscious sedation for dental treatment, of whom half reported that they were in the highly anxious group. Forty (56%) respondents said they would like to have sedation if it were available. Twenty-five (35%) claimed to have received sedation for dental treatment in the past. Conclusion It was concluded that the availability of dental sedation was currently not matching the needs and demands of several patients who took part in the survey. Increased availability of dental sedation could remove a barrier to dental care for many highly anxious dental patients.


2019 ◽  
Vol 5 (2) ◽  
pp. 146-155 ◽  
Author(s):  
B.D. Meyer ◽  
R. Wang ◽  
M.J. Steiner ◽  
J.S. Preisser

Background: Despite early evidence touting the effectiveness of physician-provided oral health services (POHS), recent evidence suggests these services might have little impact on caries-related outcomes in children. General anesthesia (GA) is often used to treat early childhood caries and may be considered the most extreme utilization outcome. We sought to assess the impact of POHS utilization on dental GA utilization and expenditures. Methods: We used the Medicaid claims of a birth cohort of children born in 2008 in North Carolina ( N = 32,558) to determine the impact of POHS on dental utilization and expenditures under GA for individual children. Children were followed until their eighth birthday. We analyzed the association of the number of prior POHS visits with visit-specific outcomes of dental treatment under GA using population-averaged models fit with generalized estimating equations with exchangeable working correlation structure. Results: Children with 2 or more previous POHS visits had reduced odds of GA (odds ratio [OR] = 0.93; confidence interval [CI], 0.87–0.99; P = 0.029) and expenditures ($114; CI,−$152.61 to −$75.19; P < 0.001) compared to those without physician-provided oral health visits, adjusting for age, sex, race/ethnicity, and geographic residence. Dental expenditures did not differ between POHS and non-POHS subjects at non-GA visits. Conclusions: POHS decreased the odds of having dental GA treatment and dental expenditures at GA visits. The role of physicians in oral health care can reduce the impact on the most severe outcome—treatment under general anesthesia. Knowledge Transfer Statement: The results of this study have important financial implications for state Medicaid programs and disease management programs trying to mitigate the costs of treating early childhood caries under general anesthesia. Children who receive physician oral health care are less likely to use and more likely to save money on general anesthesia to complete dental treatment.


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