Rapid Oral Health Deterioration in Older People—A Narrative Review from a Socio-Economic Perspective

Abstract

Poor oral health is a common morbidity in old age with older adults less likely to attend dental care and more likely to have dental disease; this situation is exacerbated by older adults retaining more teeth often with complex restorations. Evidence suggests that some older adults experience rapid oral health deterioration (ROHD). While more clinical and population level evidence is needed, current evidence suggests upstream changes addressing disadvantage through the social determinants of health (SDH) may impact broader disorders such as ROHD, often occurring as older adults become dependent. The aim of this paper is to conduct a narrative review to explore the social determinants of ROHD in older adults. The social determinants of health are important in understanding oral health including ROHD. This includes the important influence of the economic determinants. We explored the SDH as relevant to oral health and ROHD including using a framework based on that of the Fisher-Owens conceptual model (for children) but adapted for older adults. Better understanding of these relationships is likely to assist in future prevention and care.

Rethinking Oral Health in Aging: Ecosocial Theory and Intersectionality

“…Upstream: Little is being done upstream to change these downstream outcomes. Focus is on treatment rather than prevention; costs are prohibitive in many settings with limited attention given to oral care in primary health care, including that in residential aged care (Cohen et al 2017;Slack-Smith et al 2023).…”