An in-depth look at oral health and healthy ageing

11 July 2018 Congress

The 2018 World Oral Health Forum (WOHF) will illustrate the strong link between oral health and healthy ageing through a series of real-life examples of elderly oral healthcare models from Asia, Europe, and South America.

Dr Sophie Dartevelle

Dr Sophie Dartevelle, Oral Health for an Ageing Population Task Team Member

Professor Kakuhiro Fukai

Prof. Kakuhiro Fukai, Oral Health for an Ageing Population Task Team Chair

What do you consider to be the most important area of research concerning oral health in ageing populations?

Portrait of Prof. Kakuhiro Fukai

The unavoidable reality of population ageing is affecting our society on a global scale. Dental and oral health are essential to sustain lifelong quality of life, and research has established that dental and oral health contribute to the maintenance and improvement of general health.

Based on these considerations, these are the most pressing areas of research regarding elderly oral health:

  1. Investigating effective measures of prevention and control of oral diseases, tooth loss and declining oral health function in elderly people.
  2. Further investigation of the linkage between oral health and general health is required. The economic effect of oral healthcare on medical care expenditure needs to be studied as well.
  3. To close the health gap and reduce barriers in access to oral healthcare, we need to study and identify the most effective ways to target the social determinants of oral health.

"[With the goal of healthy longevity in mind], it is essential to accumulate clear evidence and take specific action to ensure that dental care and oral health have a secure and established position within an effective and efficient social security system and healthcare policy."
Prof. Kakuhiro Fukai

The Roadmap for Healthy Ageing, one of the two strategic documents that has been produced this year as part of the Oral Health for an Ageing Population partnership, will be launched during the World Oral Health Forum (WOHF). Tell us about the Roadmap. What do you hope it will achieve? Why is it unique?

Portrait of Dr Sophie Dartevelle

The Roadmap is unique in several ways. First, it reminds us that population ageing is a global concern and that oral health is a fundamental right, indispensable for healthy ageing. Secondly, it highlights the urgent need to adapt health systems to respond to the needs of ageing people and improve their oral health and quality of life.

Most importantly, the Roadmap identifies all stakeholders who can, and should, become drivers of change and presents possible actions for them to take in line with 8 different pillars.

"The Roadmap can easily be used, all around the world, as a reference guide for global, national, or local actions on behalf of the elderly community."
Dr Sophie Dartevelle

How has the approach to oral care for the elderly evolved in your country throughout your professional career?

Portrait of Prof. Kakuhiro Fukai

In Japan, we have transitioned from approaching this issue purely as an internal matter within the field of dentistry to a broader effort involving collaboration between the medical field and the dental field toward the prevention and control of oral diseases.

The rapidly accumulating evidence of the link between oral health and general health has contributed to changes in our national health policy.

"[In Japan], oral health is now seen as integral to general health, so oral health policy has been integrated into general health policy more and more."
Prof. Kakuhiro Fukai

Japan has also been one of the first countries to be confronted with the challenges of a ‘super-ageing’ society and a decreasing population. Japan is currently engaged in an intensive process of making its healthcare system even more efficient, economical and prevention-oriented, with an eye to create an ageing-friendly society. To achieve this, we are also trying to forge a much higher level of communication and collaboration among healthcare professionals.

Portrait of Dr Sophie Dartevelle

In France, the French Union for Oral Health (UFSBD), a professional body responsible for health prevention and promotion, has been developing oral health prevention programmes for older people in elder care facilities for more than 15 years.

"[In France], support for oral health, and especially oral hygiene, is gradually improving but is still not adequately considered within broader healthcare protocols due to a lack of information and resources."
Dr Sophie Dartevelle

Oral health remains a low priority, even though the implementation of preventive and maintenance protocols has an obvious impact on the reduction and severity of oral care needs and, therefore, on the general health and well-being of the elderly.

Action remains critical. Life expectancy is increasing, and older people are not the same today as they were 30 years ago. Up until a few years ago, most elderly people had complete sets of dentures. Today, elderly patients often have both natural teeth and elaborate dental appliances which require special maintenance and care.

During the WOHF, you’ll discuss ‘Oralien’ - an innovative tool to monitor the oral health of the elderly in care facilities. Tell us a little bit about that. What is Oralien? How is it received within the elderly community?

Portrait of Dr Sophie Dartevelle

Oralien came to be through a partnership between the UFSBD and a French start-up called Dental Monitoring.

Oralien has developed a mobile app which allows caregivers within the elderly care facility to take mouth scans of the residents in a quick, non-intrusive way. The gathered data are made anonymous and are encrypted and uploaded on a secure server before being analyzed by an algorithm rooted in diagnostic criteria developed by the UFSBD. This analysis of oral health needs and general oral health status facilitates a practical and personalized recommendation for each patient that medical staff within the elderly care facility can consult via an online platform on the Oralien website.

Thanks this simple and secure tool, medical staff are able to evaluate the impact of personalized hygiene protocols implemented on a daily basis and easily refer the patient to a dental surgeon if additional care proves to be necessary. Each resident is entitled to two follow-up appointments every year, during which additional mouth scans can be taken in case of ‘dental emergencies’.

Oralien is very well received within the elderly care facilities by both residents and caregivers.

What is health community doing to improve global oral health, both within the elderly community and the wider population?

Portrait of Prof. Kakuhiro Fukai

Oral disease is common to all countries and all peoples, regardless of socioeconomic status, and elderly people are at a particularly high risk for oral diseases. The global burden of oral disease remains a critical and often underestimated problem.

"As ageing progresses on a global scale, the maintenance of oral health becomes a matter not only of public health, but also of fundamental human rights, as highlighted in the Tokyo Declaration."
Prof. Kakuhiro Fukai

While the need for oral healthcare provision is increasing rapidly in low-, middle- and high-income countries, there is a large gap in terms of resource availability, particularly when it comes to access to dental care professionals, facilities, and education.

[In order to] achieve and maintain global oral health, the World Health Organization and international bodies such as FDI (through its member National Dental Associations) call for monitoring the [oral health] situation in all countries and making this information accessible to all. Then, each country can refer to that information to plan and implement the most appropriate improvements to their respective oral healthcare policies, programmes and provisions. Information on these efforts and outcomes can then once again be shared globally, and the improvement cycle can continue.

 

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