Embracing health in older age: older people matter

Introduction: The proportion of older adults over 65 years of age is increasing across the UK and Republic of Ireland and projected to reach 25% of the population by 2050. There is a high prevalence of dental disease in older adults and this is complicated by medical and social circumstances. Aim: The aim of this paper is to describe the oral health challenges that older people present and provide an overview of recent studies that have sought to promote oral health in older adults. Discussion: The oral health needs of older people have changed considerably over the last twenty years, with most now dentate or partially dentate with a high burden of repair and replacement of restored and missing teeth. This presents an unprecedented burden to the health system, and continued reliance on the existing curative model of oral healthcare is not realistic. There is an urgent need to shift the focus away from treatment to prevention of disease across the lifecourse. Barriers to care for older adults, particularly those who are medically compromised or living in care homes, include mode of remuneration and lack of confidence among primary care dentists to provide domiciliary care to older patients. There is a need for more inter-professional care for older adults, which requires an integrated effort between the stakeholders, including healthcare funders, professionals and patient advocacy groups as we prepare to meet these challenges. Recently developed training initiatives to upskill the dental workforce and develop evidence for care in nursing homes are presented in this paper. Conclusion: There is an urgent imperative to educate and empower the population to further reduce the prevalence of dental disease across the life course. More work is needed to develop the future workforce to manage care needs of an increasingly diverse older adult population.