Published Report Details
Mandatory Fields
Whelton H., Woods N., Kelleher, V., Crowley T., Stephenson I., , and Ormsby M. ;
Evidence Based Options for an Oral Health Policy of Older People.
Dublin, Ireland
National Council on Ageing and Older People and Health Research Board
Optional Fields

This report recommends policy options to improve the oral health and well-being of older people. The

emergence of an ageing population dictates an urgent need to develop appropriate oral health

services for older people. National surveys reveal an increasingly dentate older population with

specific oral health service needs. Older people face particular oral health challenges as a result of

progression of dental decay, gum disease and tooth wear, accompanied by a reduction in the natural

defence offered by saliva as a side effect of many commonly prescribed medications. Many older

people also have a reduced capacity for self care as manual dexterity decreases and the ability to

maintain good oral hygiene is reduced. Furthermore, older people are at greater risk of oral cancer:

Impediments to their access to oral health care services also reduce the likelihood of opportunistic

screening and early detection. This situation of low service utilisation rates and poorer oral health

amongst older adults aged 65+ compared to younger adults is evidenced in the National Survey of

Adult Oral Health 2000-02 (Whelton
et al., 2007a).

This report examines the oral health status of older people, the factors affecting their utilisation of

services and the constraints to service provision. The recommendations aim to improve their access

to oral health services. A blend of quantitative and qualitative research methodologies was adopted,

involving survey questionnaires, focus group discussions and interviews with stakeholders, and a

secondary analysis of national survey data. The resulting primary and secondary data as well as a

comprehensive literature review provide the evidence base for this report.

The main issues identified were: older people's low uptake of dental services; the adequacy of the

DTSS in relation to older people's needs; the provision of domiciliary care for those who cannot

access clinic-based services; the accessibility of service providers to older people; and the

integration of care between the dental profession and the medical profession. The policy options

recommended are:

that a national oral health promotion campaign targeting older people be carried out to raise

their awareness of the need for dental visits (even if they have no teeth) and to inform them

of their DTSS entitlements;

that the DTSS range of services and fee levels be reviewed such that older people are

assured an equitable and acceptable level of treatment services;

that domiciliary services, particularly for older people in residential care, be given greater

priority by the HSE dental service;

that appropriate policies and actions be identified and implemented to improve the

availability and accessibility of oral health service providers (GDPs) to older people;

that stronger linkages between dental professionals and other primary care professionals be

promoted within the structure of Primary, Community and Continuing Care (PCCC) public

services as well as among private sector professionals.

Evidence Based Options for an Oral Health Policy of Older People
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