Understanding oral health for the aging population

It’s the truth – regular trips to the dentist are just as important as regular trips to the doctor, no matter how old you are.

And thanks to researchers Debora Matthews and Mary McNally from Dalhousie’s Faculty of Dentistry, both education and awareness of oral health issues among older adults in Nova Scotia is improving.

Drs. Matthews and McNally, along with their research team, have been investigating the subject for more than ten years. They will be presenting some of their findings at a one-day workshop, “Closing the Gap Between Oral Health Research and Practice,” on Thursday, Oct. 27 at the Westin Nova Scotian in Halifax, hosted by Dalhousie and the Atlantic Health Promotion Research Centre. 

The workshop will look at the outcomes from two recent studies:

• The oral health of our aging population (TOHAP), where researchers surveyed the oral health status of Nova Scotia adults age 45 and up.
• Oral care in long-term settings (TriFacilities Oral Health Project), where researchers explored strategies to assist in daily oral care for residents in long-term care facilities.

These studies have focused on finding patterns of disease, understanding the barriers that prevent the aging population from receiving good oral health care, and proposing solutions for improvement – research that has never been done before in Atlantic Canada.

A province-wide survey

“We started our research with a large population-based survey to look at what diseases were out there and who was subject to them,” explains Dr. Matthews.

They surveyed over 1,400 people in 31 communities across Nova Scotia. Perhaps one of the biggest challenges according to researchers is that the coming generation have more of their natural teeth.

“Most of the older population today has dentures which are easier to look after,” explains Dr. Matthews. “But according to our population-based survey, the next cohort coming up has twice as many natural teeth as the current generation. This means older adults with fillings and crowns will present many more challenges for professional dental care.

“We also did an environmental scan across the province looking at accessibility, attitudes, and awareness among various groups of people who deal with seniors health.”

Some challenges they discovered were financial barriers: when older adults retire they no longer have third party coverage for professional dental care. There are also transportation barriers – older adults who move out of the city often have difficulty accessing oral health care facilities in rural areas.

More than just oral health

Oral diseases like decay and gum disease affect more than just your teeth and gums. In fact, cavities are the most common chronic condition in the world, says Dr. Matthews, more than any other health condition or chronic infectious disease.

Drs. Matthews and McNally discovered a profound lack of awareness of the implications oral health has on general health.

“For the older population, visits to the doctor are increasing but visits to the dentist are decreasing,” says Dr. McNally. “We found that across the board, there was a lack of understanding and awareness on how poor oral health translates to poor overall health.”

Furthermore, there’s evidence that confirms the link between people with poor oral health care to people with trouble managing diabetes, and to people living in residential care homes with respiratory and cardiovascular disease.

Suddenly, it’s no longer just an oral health issue, but an overall health issue, explains Dr. McNally.

“People with poor oral health—people with pain in their mouths or with teeth that don’t function properly—are not likely to eat the right foods,” she says. “And therefore, they’re at a higher risk of being undernourished.”

The aging population is even more at risk since many prescription and non-prescription drugs have damaging side effects to oral health including dry mouth and tooth erosion.

Educating future caregivers

Another arm of research that will be showcased at the workshop looks at personal care practices in long-term facilities.

“We discovered oral health awareness is not a highly prioritized aspect of long-term care,” explains Dr. McNally. “Knowing this, we’re looking to introduce mouth care programs and provide education packages and tool kits to heighten attention to mouth care.”

A relationship with the Nova Scotia Community College has also been created to capture the long-term caregivers in training.

“It’s a pretty neat collaboration,” Dr. McNally says. “We’ve developed a comprehensive oral health program for long-term caregivers and we’re going to continue working with NSCC to help bring more awareness to oral health at the training level.”