Prof. Iain Pretty
Professor of Public Health Dentistry
The University of Manchester
There has been much emphasis on the challenges faced by children and their parents in securing optimal oral health. Indeed, the research base for fluoride interventions is largely centered on school age children. With policies and public health groups firmly focused on this population its easy to forget the other end of the life line - the so called "elderly" where there has been little attention paid to challenges and barriers to maintaining and securing good oral health.
This gap in both research and practice is all the more poignant given the recognised demographic shift that is occurring in Western populations - a move to a decreased birth rate and an ageing population that represent a significant challenge to health care systems world wide.
In 2013 Colgate-Palmolive supported a conference in Seattle, Washington that aimed to investigate the challenges of this important group of patients and develop a care pathway to integrate evidence-based interventions to ensure that best practice was employed in the management of older adults. This article highlights some of the findings from this meeting.
Dental caries is one of the most prevalent chronic non-communicable diseases in the world, and the older population is at a disproportionately high risk. In Australia, the Australian Dental Association Oral Health Tracker estimates that only 10.7% of adults over 15 years have never experienced tooth decay.
A healthcare professional guide to oral care for older patients: Seattle Pathway | Colgate® Professional
Oral disease processes are insidious and progressive, often remaining invisible to the layperson until the end stage. Self-diagnosis is often delayed until patients notice irreversible signs - frank cavitation as caries undermines marginal ridges and advances inexorably towards vulnerable pulps, progressive tooth mobility or gingival recession with declining periodontal health and functio laesa in the case of expanding oral cavity neoplasms that may have begun as subtle precursor lesions. If evading the watchful eye of a supervising dental practitioner, ailments of the intraoral hard and soft tissues can easily go unchecked until patients experience advanced disease, at which point it becomes increasingly invasive and expensive to manage. Dental professionals have the capacity to identify disease risk factors and to detect signs of disease at the pre-symptomatic stage, at which point it is possible to arrest and reverse disease progression by providing tailored lifestyle counselling to encourage health-promoting behaviours. This article will delve into current barriers to our transition away from the reactive modus operandi of dental healthcare towards a more medical, person-centred model of caries management to break the restorative death spiral and curb rates of edentulism in our community
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