Health-Related Social and Ethical Considerations towards the Utilization of Dental Medical Services by Seniors: Influencing and Protective Factors, Vulnerability, Resilience and Sense of Coherence

Abstract

The aim is to analyze protective and modifying factors (e.g., vulnerability, resilience, sense of coherence) in relation to the utilization of dental services by seniors at different levels of the healthcare system. Terminological imprecision in the use and transfer of existing terms (sense of coherence, resilience, salutogenesis) to gerodontology is clarified. Factors influencing a reduced utilization (static/dynamic factors) can occur isolated or in combination and, thus, model the risk of a reduced utilization of dental services (influencing-factor mechanism). Protective factors of utilization include patient-specific factors for self-motivation and factors that promote oral-health-related resilience. Resistance forces that counteract can be identified as oral-health-related resilience factors. Achieving social and individual appreciation and establishing a prevention-oriented approach to utilization will be increasingly challenging, since the population is becoming older and access is not equal in terms of opportunity. Resistance forces need to be strengthened in an ethical context. Studies should increasingly present resilience processes, determinants and modes of action at the various interfaces in the healthcare system, which can ensure sustainable medical care in old age. The concepts conveyed here are generally valid and able to point out inequalities and ageism in access to dental services.

Dentists’ Opinions in Providing Oral Healthcare to Elderly People: A Questionnaire-Based Online Cross-Sectional Survey

“…Most often, these are a lack of time and insufficient financial compensation [15,22]. Important mechanisms for improving the oral health of the elderly are based on raising awareness of the importance of oral health, encouraging preventative programs at the national level within the framework of dental healthcare, and educating and training staff to provide services and care for the elderly [23,24].…”

Impact of an Oral Hygiene Intervention in People with and without Dementia on Oral Health Parameters—Results from the Oral Health, Bite Force, and Dementia (OrBiD) Pilot Study

“…This trend is also observed in the field of dentistry. Here, at the same time, the reduced utilization of dental services can be observed [ 4 ]. However, patients with advanced dementia are not able to take care of their oral and denture hygiene on their own.…”

Influence of cognitive impairment and dementia on oral health and the utilization of dental services

“…Furthermore, oral health is dependent on the regular utilization of dental services [ 19 – 21 ]. The utilization of dental services is dependent on several factors [ 22 , 23 ]. In turn, utilization depends on the possibilities in access to dental services [ 24 ], which is more difficult for people with dementia and in need of care, and on cognitive status [ 25 ].…”