healthy communities
Seniors’ oral health:
planning for the future
Author: Jackie Smorang, BA, Dip DH, MSEd
Presented by
Dr. Luke Shwart
Manager, Community Oral Health Services
www.calgaryhealthregion.ca/hecomm/oral/oral.htm
APHA Conference • 2003 Nov 17
health promotion & disease prevention
community oral health
healthy communities
Overview
A. What is oral health
B. Seniors demographics
C. Best practices review
D. Status quo in Calgary
E. Recommendations/Action Plan
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Persons age 65+ y
Calgary Health Region
200,000
150,000
127,300
100,000
50,000
154,700
89,200
0
2002
2012
2016
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Seniors: a continuum
independent ------ need help ------ dependent
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
% edentulous
Independent-living adults:
% edentulous (1991 Ontario)
45
40
35
30
25
20
15
10
5
0
40.8%
30.2%
16.8%
50-64
65-74
75+
Age (y)
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Edentulism: age or cohort?
Older adults:
• inferior access to care over lifetime
• less sophisticated dental treatment
• determinants of health
– disadvantaged
– low income
– uninsured
– less educated
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
%
Service usage by nursing home
residents (2000 US)
100
90
80
70
60
50
40
30
20
10
0
88%
69%
64%
25%
medical
nutritional
social
physical
therapy
17%
dental
Services
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Seniors’ self assessment vs.
professional assessment (1995 Winnipeg)
Self-rated oral health:
good or average
100%
80%
Professional assessment:
need care
100%
94%
80%
100%
89%
60%
60%
40%
40%
20%
20%
0%
0%
dentate
edentulous
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Barriers to Dental Care
• lack of perceived need
• financial constraints
• transportation and access
difficulties
• poor health
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Best practices
• Literature review
• Working examples
• Evaluation
• Educational institutions
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Problem: lack of evaluation
• Measurement of changes in
oral health status of elderly is
complex
• No universally accepted index
• More research needed
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Integrated Oral Health Care Model
Resident & Family
Care staff
1999 B.C.
Karen Moore
Community
professionals
Dental hygienist as coordinator
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Recommendations Summary
• Education and information (oral health
linkage to general health) needed for
seniors, health professionals, caregivers and
policy-makers.
• Include oral health in Seniors’ Programs
assessments.
• Oral care standards for residents in regional
care facilities.
• Targeted dental treatment program for atrisk low-income seniors.
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Action Plan — 5 parts
1. Initiate accord across all Regional programs
2. Use health promotion strategies to generate
awareness and action
3. Identify gaps and priorities
4. Generate innovative strategies
5. Advocate for change
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
1. Initiate accord across all
Regional programs
a. Oral care is an essential element of primary
care and integral to the general health and
well-being of older adults
b. Include oral health in seniors’ general health
assessments
c. Collect oral health information.
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
2. Use health promotion strategies
to generate awareness and action
a. Raise awareness among
seniors, professionals, policymakers, health care personnel,
the public
b. Improve knowledge among
Regional health care providers
c. Develop partnerships in the
seniors’ community to generate
and leverage oral health
promotion
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
3. Identify gaps and priorities
a. Review current Regional programs
b. Review knowledge, attitudes and practices by
care facility staff
c. Develop standards/outcomes for care facilities
d. Develop a continuing education plan for Regional
dental staff re: oral care needs of the elderly
e. Identify seniors’ oral health needs and priorities
– seniors’ focus groups
– dental health professionals
f. Report (for future program planning)
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
4. Generate innovative strategies
a. Develop innovative pilot project(s)
b. Improve communication and
cooperation between individuals
and agencies (re: seniors’ oral
health)
c. Evaluate projects and initiatives
– impact on seniors’ oral health
– assist in resource allocation
d. Share information about ways to
improve seniors’ oral health care
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
5. Advocate for change
a. Advocate for provincial
standards for care
facilities
b. Advocate revised
provincial regulations
for Dental Hygienists
c. Advocate that all
students in health
professions learn oral
health needs of seniors
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Vision
 General awareness of
importance and implications
of seniors’ oral health
 Oral health services to seniors in various
living situations
 Oral care programs sensitive to concerns of
the elderly and reflect the diversity of their
financial, physical and mental conditions
 No financial and physical barriers to care
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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healthy communities
Creating the Future
No single, simple, strategy
It requires effort,
perseverance,
resources and changes
in attitude
Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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