Improving the oral health of older people: the approach of the WHO Global Oral Health Programme

Abstract

The proportion of older people continues to grow worldwide, especially in developing countries. Non-communicable diseases are fast becoming the leading causes of disability and mortality, and in coming decades health and social policy-makers will face tremendous challenges posed by the rapidly changing burden of chronic diseases in old age. Chronic disease and most oral diseases share common risk factors. Globally, poor oral health amongst older people has been particularly evident in high levels of tooth loss, dental caries experience, and the prevalence rates of periodontal disease, xerostomia and oral precancer/cancer. The negative impact of poor oral conditions on the quality of life of older adults is an important public health issue, which must be addressed by policy-makers. The means for strengthening oral health programme implementation are available; the major challenge is therefore to translate knowledge into action programmes for the oral health of older people. The World Health Organization recommends that countries adopt certain strategies for improving the oral health of the elderly. National health authorities should develop policies and measurable goals and targets for oral health. National public health programmes should incorporate oral health promotion and disease prevention based on the common risk factors approach. Control of oral disease and illness in older adults should be strengthened through organization of affordable oral health services, which meet their needs. The needs for care are highest among disadvantaged, vulnerable groups in both developed and developing countries. In developing countries the challenges to provision of primary oral health care are particularly high because of a shortage of dental manpower. In developed countries reorientation of oral health services towards prevention should consider oral care needs of older people. Education and continuous training must ensure that oral health care providers have skills in and a profound understanding of the biomedical and psychosocial aspects of care for older people. Research for better oral health should not just focus on the biomedical and clinical aspects of oral health care; public health research needs to be strengthened particularly in developing countries. Operational research and efforts to translate science into practice are to be encouraged. WHO supports national capacity building in the oral health of older people through intercountry and interregional exchange of experiences.

Knowledge of oral health of nursing staff caring for disadvantaged older people

“…The World Health Organization (WHO) recognizes older people as a target population for oral health and non-communicable disease interventions. [3,5] Prominent non-communicable diseases with modifiable risk factors identified by the WHO include cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease and are commonly affecting the older population with association to poor oral health. [3,5] Modifiable risk factors of these non-communicable diseases are similar to modifiable risk factors of many oral diseases.…”

“…[3,5] Prominent non-communicable diseases with modifiable risk factors identified by the WHO include cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease and are commonly affecting the older population with association to poor oral health. [3,5] Modifiable risk factors of these non-communicable diseases are similar to modifiable risk factors of many oral diseases. [1,6] The process of aging also presents specific concerns related to the oral health of older people including caries, tooth loss (edentulism), difficulty chewing, reduced salivation, oral cancer, xerostomia (dry mouth), craniofacial pain and discomfort, gingival overgrowth, and oro-facial bone resorption.…”

Comparison of two assessment instruments of quality of life in older adults

“…According to Brondani et al (2008) 8 , little is known about the complexity of personal factors that affect the perception of oral health. The negative impact of oral conditions for older person's quality of life is a public health problem, which has to be contemplated by public health policies 9 .…”

Periodontitis and health‐related quality of life in hemodialysis patients

“…Periodontitis also may cause halitosis, which can negatively impact on daily life activities such as socializing and communication with other people (Azodo, Onyeagba, & Odai, 2011). In addition, periodontitis and tooth loss causes embarrassment, negatively affecting appearance and self‐esteem (Petersen & Yamamoto, 2005; Abrahamsson, Wennstrom, & Hallberg, 2008), and can restrict social interactions. Furthermore, large epidemiological studies indicate that poor oral health could have an adverse effect on general health in people with reduced kidney function.…”