Increasing Access to Oral Health Care for the Elderly

dentist

Oral health, which includes adequate care for teeth, gums, and mouths and screening for oral diseases, is an important contributor to health and well-being. Access to oral health services is necessary for oral health maintenance, but varies across the globe, as well as across age segments within the population. Globally, an increase in the aging population calls for a need to consider oral health among the elderly, an often-overlooked component of physical health. Among the concerns associated with poor oral health for adults are constrained food choice, weight loss, reduced chewing ability, diminished communication ability, low self-esteem, and decreases in self-reported quality of life. The World Health Organization (WHO) has called for a greater public health response to the oral health needs of the elderly. Included within this call to action are improved public health policies that target oral health, improved access to oral health services for older adults, and increased efforts to improve dental hygiene among older adults.

Poor oral health among the elderly typically manifests as high levels of tooth loss, dental caries, periodontal disease, xerostomia, and oral cancer. According to the global World Health Survey, approximately 30% of adults aged 65-74 years across the globe are impacted by complete tooth loss. When considering prevalence of tooth loss by demographic characteristics, this problem is particularly pronounced among individuals in the lowest economic strata living in low- and middle-income countries. In Latin American and Caribbean countries, it has been noted that the adult population is aging at “unprecedented rates”. It is estimated that the elderly population will increase by about 300% by 2050 in developing countries, particularly those in Latin America. While access to oral health services are high in developed countries, utilization among the elderly remains low. In developing countries, where access to care is diminished, elderly people report higher levels of oral health problems.

In the U.S., the Centers for Disease Control and Prevention (CDC) states that many oral diseases are common for older Americans who did not grow up with fluoridation, a process that has been shown to improve oral hygiene and health. Decreased access to dental insurance, low income, increased use of prescription drugs, and being disabled, home bound, or institutionalized are also contributing factors for diminished oral health among older Americans. It has been noted by the CDC that about 25% of adults 60 and older in the U.S. “no longer have natural teeth”, a phenomenon that varies state to state. To improve the quality of life of the elderly across the globe, oral health should be included in physical health assessments. Increased access to oral health care should also be advocated. Improvements to the oral health of older adults can contribute to improved quality of life and improved management of additional health concerns that are associated with aging.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

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