Poor oral health in older persons described as a ‘geriatric giant’ in New Zealand

06 June 2018 Ageing population

A recent study from the University of Otago in New Zealand highlights the need for ‘urgent attention’ to be paid to frail older New Zealanders' oral health.

A lack of preparedness for ‘teeth for life’

Researchers surveyed the oral health of 987 people living in aged residential care and found those with dementia, and older men in general, have dirtier and more decayed teeth.

Prof. Murray Thomson, Head of the Department of Oral Sciences at the University of Otago and lead author of the study, describes poor oral health as one of the "geriatric giants" with the situation a "major clinical and public health problem which is going to get worse."

Older people have higher rates of cognitive and physical impairments that can adversely affect their oral self-care and complicate the provision of oral care. Of those examined in the study (representative of the more than 14,000 New Zealanders living in aged care), about half had severely impaired cognitive function, and more than a third required fillings or extractions.

Those with severely impaired cognitive function had greater numbers of teeth with decay and higher oral debris scores, reflecting poorer daily oral hygiene. Greater rates of tooth decay can result in dental and facial infections, poorer quality of life, malnutrition and difficulties in communication.

"Neither the aged care sector nor the dental profession, in most countries, is prepared. Not only do we have more and more older people every year, but more and more people are entering old age with their own teeth, rather than full dentures, as was the situation just a couple of decades ago. In some ways, dentistry has been a victim of its success – we have long emphasized the idea of 'teeth for life' without much thought to what happens towards the end of life."
Prof. Murray Thomson, Head of the Department of Oral Sciences at the University of Otago

The researchers also found that even the most cognitively impaired participants were able to be examined fairly easily; meaning that regular, routine removal of oral debris by carers should not be difficult – yet much of this remains undone. In addition, frequent exposure to sugary, over-processed meals and snacks, and poor salivary function are enabling plaque and dental caries to flourish in aged residential care populations.

"It's a very complex situation involving a lot of players – the aged care sector, the Ministry of Health, the dental profession, and the public. An encouraging sign is the inclusion of oral health in New Zealand's Healthy Ageing Strategy. That's a starting point, but there is a lot of work to be done."
Prof. Murray Thomson, Head of the Department of Oral Sciences at the University of Otago 

World Oral Health Forum on healthy ageing

FDI has been actively working on addressing Oral Health for an Ageing Population (OHAP) through its partnership with GC International AG since 2015. The partnership seeks to ensure oral health challenges are addressed in broader disease policies for ageing population.

OHAP aims to further study opportunities for improved oral disease prevention and treatment of elderly patients and actively promote awareness of research on oral health in ageing populations. Therefore, healthy ageing has been identified as the topic for discussion at the 2018 World Oral Health Forum (WOHF) in Buenos Aires.

The forum will provide an overview of the partnership, as well as panel discussions on: the surveillance and information systems for the oral health of the institutionalized elderly, the community-based approach, and the management of elderly patients. The WOHF will take place during the FDI World Dental Congress on 5 September from 14:30-17:00.

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