Evidence based options for an oral health policy for older people

Hdl Handle:
http://hdl.handle.net/10147/119009
Title:
Evidence based options for an oral health policy for older people
Authors:
Whelton, Helen; Kelleher, Virginia; Crowley, Tara; Woods, Noel; Stephenson, Ian; Ormsby, Mary
Issue Date:
10-Jan-2011
URI:
http://hdl.handle.net/10147/119009
Item Type:
Report
Language:
en
Description:
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.
Keywords:
ORAL HEALTH; POLICY FORMULATION; OLDER PEOPLE
Sponsors:
Project jointly sponsored by: National Council on Ageing and Older People and Health Research Board. Project conducted at: Oral Health Services Research Centre University Dental School and Hospital, Cork.

Full metadata record

DC FieldValue Language
dc.contributor.authorWhelton, Helenen
dc.contributor.authorKelleher, Virginiaen
dc.contributor.authorCrowley, Taraen
dc.contributor.authorWoods, Noelen
dc.contributor.authorStephenson, Ianen
dc.contributor.authorOrmsby, Maryen
dc.date.accessioned2011-01-10T09:37:02Z-
dc.date.available2011-01-10T09:37:02Z-
dc.date.issued2011-01-10T09:37:02Z-
dc.identifier.urihttp://hdl.handle.net/10147/119009-
dc.descriptionThis 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.en
dc.description.sponsorshipProject jointly sponsored by: National Council on Ageing and Older People and Health Research Board. Project conducted at: Oral Health Services Research Centre University Dental School and Hospital, Cork.en
dc.language.isoenen
dc.subjectORAL HEALTHen
dc.subjectPOLICY FORMULATIONen
dc.subjectOLDER PEOPLEen
dc.titleEvidence based options for an oral health policy for older peopleen
dc.typeReporten
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