Ageing Population and Geriatrics as a Dental Specialty
- The world's population is currently ageing, with the number and proportion of elderly people growing substantially.
- Life expectancy at birth has increased from 67.2 to 70.8 years between 2000-2005 and 2010-2015.
- By 2045-2050, life expectancy is projected to increase to 77 years.
- The population of people aged 60 and over is expected to more than double by 2050 globally.
- Geriatric dentistry is recognised as a specialty in Australia under the 'Special needs dentistry' category.
- Age-related problems and medication can make oral health diseases more serious and complicated to treat.
- Specialised and individualised treatment is required for geriatric patients.
- Ageing should be considered a natural and inevitable physiological process, not a disease.
- In the United Kingdom, geriatrics is not recognised as a specialty, but special care dentistry focuses on oral health conditions for people with impairments or disabilities.
The Geriatric Patient and Dental Health of Geriatric Population
- Elderly individuals can be classified into different age groups: young-old (65-74), middle-old (75-84), and oldest-old (≥ 85).
- Frail elderly patients have chronic physical, medical, and emotional problems and require assistance from others.
- Functionally dependent elderly patients are unable to maintain independence and may be homebound or institutionalised.
- Classifying geriatric patients based on their ability to seek dental care independently is more useful for diagnosis and treatment planning.
- Support services are often needed for the majority of frail elderly patients living in the community.
- The geriatric population has rapidly changing dental needs.
- In developed countries, it is predicted that more than 25% of the population will be over the age of 65 by 2020.
- The rate of edentulism (tooth loss) has decreased due to improvements in oral health.
- Geriatric patients often have high levels of plaque, calculus, and debris, leading to increased caries prevalence.
- Gingival recession and periodontal disease are common among older adults.
Medical Conditions affecting Oral Health
- Physiological changes in the geriatric population, such as decreased efficiency in gastrointestinal, renal, cardiovascular, respiratory, and immune systems, impact oral health.
- Reduced bone and muscle mass, along with conditions like osteoarthritis, can affect mobility.
- Audio and visual changes, such as cataracts, macular degeneration, and hearing loss, make communication and oral health care challenging.
- Common chronic conditions in the elderly include hypertension, arthritis, heart disease, cancers, and diabetes.
- Dementia, depression, hearing loss, cataracts, back and neck pain, and chronic obstructive pulmonary disease are also prevalent in the geriatric population.
Oral Changes and Dentures
- Tooth loss
- Dental caries
- Periodontitis
- Dry mouth
- Oral cancer
- Changes to Saliva
- Changes to the Oral Mucosa
- Changes to the Teeth
- Ageing and Periodontal Disease
- Dentures and Edentulism
Dental care in residential aged care facilities and Barriers to effective cleaning
- Elderly in residential care have poor oral health
- Dependence on staff for oral hygiene care
- Oral health requirements often overlooked
- Lack of oral health policies and education for care staff
- Need for regular onsite professional dental care
- Difficulty accessing dental care for frail and disabled elderly
- Limited mobility and cognitive impairment affect access to dental care
- Increased risk of oral health problems due to health problems or disabilities
- Cognitive impairment leads to uncooperative behavior
- Functional limitations and swallowing difficulties affect oral care
Geriatric dentistry is the delivery of dental care to older adults involving diagnosis, prevention, management and treatment of problems associated with age related diseases. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. In the elderly population poor oral health has been considered a risk factor for general health problems. Older adults are more susceptible to oral conditions or diseases due to an increase in chronic conditions and physical/mental disabilities. Thus, the elderly form a distinct group in terms of provision of care.
 An elderly woman in a residential care home receiving dental treatment | |
| Significant diseases | Dementia, arthritis, palliative care, osteoporosis, osteoarthritis, rheumatoid arthritis, Parkinson's disease, atherosclerosis, heart disease, high blood pressure, high cholesterol |
|---|---|
| Specialist | Dentist |
