Oral Health of Seniors ‑ A Nova Scotia Project

The Silent Epidemic of Oral Disease:
Evaluating Continuity of Care and Policies for the Oral Health of Seniors

Purpose: The purpose of the research was to determine the key components of a health services model, based on continuity of care that will improve the oral health of seniors, using Nova Scotia as the geographic focus. To examine the continuity of care in the delivery of oral health service for seniors in Nova Scotia. To explore the kinds of strategies used to enhance the effectiveness of oral health delivery systems for seniors. To develop action plan strategies for addressing seniors' oral health issues in Nova Scotia. To communicate and disseminate the project findings and recommendations.


Project Objectives

  • Health Services Evaluation:
    To evaluate oral health services for seniors from the perspective of recipients of care (seniors 65+), direct and indirect care-providers.

  • Promising Practices Scan:
    To determine barriers and facilitators to the use of oral health services for seniors by critical analysis of experiences and lessons learned in existing systems in Canada and elsewhere.

  • Forum:
    To develop strategies for financial, organizational, and policy interventions that will clarify roles and relationships and improve private-public sector provision of oral health services.

  • Communication/Dissemination:
    To develop strategies for financial, organizational, and policy interventions that will clarify roles and relationships and improve private-public sector provision of oral health services.


Background

Oral health has a substantive impact on health and well-being; however, it has been peripheral to general health and public healthcare delivery systems. The private nature of oral health care service in Canada contributes to profound disparities among many underserved segments of the population, including older adults. A lack of centralized, integrated decisionmaking about oral healthcare delivery makes it extremely difficult to improve oral health policy for seniors. A growing need for action on this important issue brought the partners in this project together.


Methododology

The research design included two research components (a health services evaluation and promising practices scan) and two knowledge translation components (a knowledge translation forum and a dissemination strategy).

Health Services Evaluation: conducted to examine the present state of the oral health care delivery system for seniors in Nova Scotia. The perspectives of seniors and direct care providers were gathered using focus groups convened in six locations throughout Nova Scotia. Key informant interviews were held with indirect care providers. These analyses provided detailed information about the current status of dental services available to seniors, barriers to accessing care and their determinants, and recommendations for improvements. The results of the Health Services Evaluation was presented using a storytelling format. This innovative presentation approach used a fictional rural town in Nova Scotia, Smileyville, very similar to many of the towns where focus groups were conducted.

Promising Practice Scan: carried out to determine barriers and facilitators in the use of oral health services for seniors by critical analysis of evidence and lessons learned from leading oral health systems in Canada and other countries. The review included a comprehensive search of academic and non-academic literature; internet searches and direct consultation with national and international dental professionals, service providers and program administrators under the following five themes: oral health care delivery programs, oral health policies, dental insurance plans (public and private), geriatric dental education and strategies for oral health prevention and promotion.

Two-day Oral Health Policy Forum: held to engage in an evidence-based oral health strategic planning process, based on the research that had been gathered. The Forum involved over 80 participants, including representatives of Nova Scotia seniors' organizations, dental professions, nursing care workers, 3 levels of government, long-term care, funding agencies, health professionals, and health associations. Formal presentations of project findings, informal networking and small group activities were carried out to clarify results, to prioritize areas for action and to identify roles of stakeholders in the implementation of an action plan to address the oral health care needs of seniors. Seven working groups resulted from the Forum.

Project dissemination activities: includes formal reports, media news releases, power point presentations, story-telling and animation. Information about this project and key messages about senior's oral health have also been disseminated through printed articles and publications. Additional strategies include news releases, and continuing professional education sessions.


Publications


Reports

Title Author | Date
Oral Health of Seniors - A Nova Scotia Project
The Silent Epidemic of Oral Disease: Evaluating Continuity of Care and Policies for the Oral Health Care of Seniors

28 pages

View the report » (PDF, 264 KB)
Renée Lyons and Mary McNally

October 2004. © Atlantic Health Promotion Research Centre
 
Working Together to Improve the Oral Health of Seniors: Developing an Action Plan for Nova Scotia
46 pages

View the forum proceedings » (PDF, 582 KB)
View the summary » (PDF, 149 KB)
Oral Health of Seniors Research Team

November 5 & 6, 2003. Halifax, NS © Atlantic Health Promotion Research Centre
 
The Oral Health of Seniors in Nova Scotia Policy Scan and Analysis: Synthesis Report
44 pages

View the sythesis report » (PDF, 340 KB)
Seniors Oral Health Collaboration

© Dalhousie University 2006
Smileyville: An Overview of the Seniors' Oral Health Services Evaluation
16 pages

View the health services evaluation »
(PDF, 462 KB)
Oral Health of Seniors Research Team

November 5 & 6, 2003. Halifax, NS © Atlantic Health Promotion Research Centre
 


Bibliographies

Title Author | Date
Oral Health of Seniors Reference Database

View the bibliography - Alphabetical »
(PDF, 131 KB | 30 pages)

View the bibliography - by Topic »
(PDF, 193 KB | 32 pages)
Oral Health of Seniors Research Team

Halifax, NS © Atlantic Health Promotion Research Centre
 


Presentations

Year/Location Title and Presenter
October 2004
Montreal, PQ
Research to Policy: Working Together to Improve the Oral Health of Seniors - Toward a New Perspective: From Ageing to Ageing Well (PDF, 571 KB)

Presented by Mary McNally
August 2004,
Calgary, AB
Working Together to Improve the Oral Health of Seniors: A Nova Scotia Project - Special Care Dentistry (PDF, 913 KB)

Presented by Mary McNally
June 2004
St. John's, NF
Taking Action to Improve the Oral Health of Nova Scotia Seniors - Canadian Public Health Association (CPHA) (PDF, 497 KB)

Presented by Sandra Crowell
June 2004
Moncton, NB
Oral Health Care of Nova Scotia Seniors, Let's Talk Policy - Atlantic Health Promotion Research Centre (AHPRC) Atlantic Conference (PDF, 453 KB)

Presented by Terry Mitchell
May 2004
Toronto, ON
Access to Care Forum

Presented by Valerie White
March 2004
Halifax, NS
Dalhousie's Collaboration of Oral Health Researchers (COHR) Forum

Presented by Mary McNally
November 2003
Halifax, NS
Working Together to Improve the Oral Health of Seniors: Developing anAction Plan for Nova Scotia - Oral Health of Seniors Forum (PDF, 2.4 MB)

Presented by Project Team
June 2003
Halifax, NS
The OHS Journey - Oral Health of Seniors Annual General Meeting (PDF, 3.2 MB)

Presented by Project Team
June 2003
Charlottetown, PE
An Innovative Approach to Program Assesment and Model Development - Canadian Association of Public Health Dentistry (CAPHD) (PDF, 300 KB)

Presented by Mary McNally
September 2002
Various locations throughout NS
Oral Health of Seniors Project - An Overview (PDF, 453 KB)

Presented by Elizabeth Tait


Team List

Investigators:

  • Mary McNally
    Faculty of Dentistry, Dalhousie University

  • Renée Lyons
    Atlantic Health Promotion Research Centre, Dalhousie University

Collaborators:

  • Gail Brown
    Nova Scotia Dental Hygenist Association

  • Paul Cameron
    Practicing Dentist

  • Gerard Ferguson
    Manulife Financial

  • Herenia Lawrence
    Faculty of Dentistry, University of Toronto

  • James Leake
    Faculty of Dentistry, University of Toronto

  • Robert MacDonald
    Faculty of Dentistry, Dalhousie University

  • William MacInnis
    Faculty of Dentistry, Dalhousie University

  • Scott MacLean
    Practicing Dentist

  • Debora Matthews
    Faculty of Dentistry, Dalhousie University

Collaborators:

  • Aileen McCormick
    Senior Representative

  • Terry Mitchell
    Faculty of Dental Hygiene, Dalhousie University

  • Joseph Murphy
    Faculty of Dentistry, Dalhousie University

  • Murray Nixon
    Nova Scotia Department of Health

  • Gael Page
    Northwoodcare Inc.

  • Don Pamenter
    Nova Scotia Dental Association

  • Valerie White
    Nova Scotia Senior Citizens' Secretariat

  • Patricia Williams
    Atlantic Health Promotion Research Centre

Associates:

  • Sandra Crowell
    Atlantic Health Promotion Research Centre, Dalhousie University

  • Pam Magee
    Researcher, Oral Health of Seniors Project

  • Elizabeth Tait
    Project Coordinator, Oral Health of Seniors Project