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| EDITORIAL |
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| Year : 2014 | Volume
: 2
| Issue : 2 | Page : 1-2 |
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Geriatric oral health: The elderly evidence
Sethuraman R
Professor, Prosthodontics, KMSDCH, Sumandeep Vidyapeeth, Piparia, Vadodara, India
| Date of Web Publication | 24-Aug-2018 |
Correspondence Address:
Sethuraman R
Professor, Prosthodontics, KMSDCH, Sumandeep Vidyapeeth, Piparia, Vadodara
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/2347-6486.239540
How to cite this article:
Sethuraman. Geriatric oral health: The elderly evidence. J Integr Health Sci 2014;2:1-2 |
Aging is the process of becoming older; not just by age but also physically, socially and psychologically. With increasing age it is often considered that utmost maturity has been attained and that the human being has attained a state of well-being and satisfaction. However the reverse is also true; in fact it is true most of the times. With increasing age, the person often experiences a feeling of insecurity and depression which invariably has a direct-indirect relation to his systemic and oral health. The past stands strong to the fact that both on the personal, administrative and societal levels systemic health has been preferred and oral health has been a lesser priority. However times are changing. The significance of oral health as an important factor in the general health of the individual has already been recognized. The WHO has framed the WHO Global Oral Health Programme (ORH), as one of the technical programmes within the Department of Chronic Diseases and Health Promotion (CHP). It has framed new strategies for oral disease prevention and oral health promotion. Greater emphasis is put on developing global policies in oral health promotion and oral disease prevention, coordinated more effectively with other priority programmes of CHP[1].
The elderly is a population that is ever increasing. The United Nation estimates the number of geriatric population above 65 years to be around 1200 million by 2025[2]. This increasing number is due to the great improvement in systemic health, improved medical advice, access and education. With increase in sustainability of life, oral health has become a closely associated factor in most systemic conditions with improved evidences proving their close relationship.
The cause, impact and progress of oral health with most systemic conditions like cardiovascular diseases, respiratory diseases and endocrinal conditions has long been researched and established. The association of these conditions with the elderly population has further been a subject of research over the years. Increasing evidences exist to prove this association. However in spite of such quality researches, it is still a sad saga that oral health of the general population is still in primitive stages.
Prevalence studies still stand evidence to prove that people over 65 have with few or no teeth. Though this has often been linked to the elderly often being poor and belonging to low socio-economic strata, the oral health problems of the elderly do cross class lines thus being of a perennial nature. Low awareness, lack of access to oral health services and the misconception that older people will not benefit from health education and preventive measures such as fluoridation, conspire to deprive the elderly of crucial care. In spite of striking evidences that prove that oral health education and access improve geriatric oral health, these evidences are still restricted to literature[3]. These evidences need to percolate into the teaching for dental students and reflected in their clinical training[4].
Evidence based dentistry has slowly taken shape in India with Sumandeep Vidyapeeth pioneering the Evidence based education ideology. However Evidence based Geriatric oral health needs to be recognized as speciality in itself. Although, the education, training and application of evidence based Geriatric oral health care at Sumandeep Vidyapeeth has been in place for the past five years, with treatment protocols and procedures being framed on best evidences; outside the university the student often faces difficulty in implying them in general practice, primarily due to the truth that oral disease is the fourth most expensive ailment to treat in most industrialized countries. Further the burden of oral diseases is likely to grow due to the unhealthy dietary pattern, high tobacco consumption and increasing prevalence of cancer. The situation is further complicated as the resources to control them are still costly and the dentist population ratio still low. As long as this condition persists, the only treatment for dental ailments especially the elderly population will be tooth extraction. Multitude of elders will continue to suffer dental caries, periodontal diseases quietly accepting as an aging process, ultimately undergo adaptation to low oral health related quality of life, tooth loss and eventually be without teeth. In continuation to the problem, though the successful replacement of lost teeth and related structures has advanced leaps and bounds with multitude treatment options available, they are not utilized to the optimum. With most evidences of treatment protocols focussing on treatment efficacies, treatment effectiveness still remains less researched. So long as the effectiveness of every preventive, diagnostic and rehabilitative mode is not researched and established, oral health policies are tough to be framed and implemented on evidence based guidelines. For example, rehabilitative possibilities to the most fortunate elderly population is still restricted to a set of complete dentures when better treatment options exist. With scientific evidences and global meets consenting to implant supported prostheses to be the first and only line of treatment it is still not the most effective method mainly because of the implant cost. With every oral health related quality of life study evidences implant dentures to be the most chosen and proved method of rehabilitation, it is still limited to the affordable class mainly due to the implant costs.
The ongoing discussion leads to three main conclusions viz. firstly generation of evidence based treatment decisions that require a comprehensive and rigorous training be done, second, pertinent high quality research on effectiveness that can lead to a treatment protocols be undertaken and published and third, framing, linking and implementation of oral health policies with special budgeting and insurance schemes be framed at the national level. So long as these facts turn to realities, they would continue to be fancies. A phase-wise implementation of most of these aspects has already been established and such rehabilitative measures have already been into implementation in this university. The educated evidence based dentist thus shaped may be able to apply the same to the plethora of the elderly population only through concomitant update of evidences, timely government policies and an easier access to dental health care which would complete the picture.
A conscious effort of the entire health care profession, and the regulatory bodies will provide a better oral health to the aging geriatric population....... Apply Evidence to tackle Oral Senescence.
| References | |  |
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| 3. | Ahluwalia K. Oral health care for the elderly: more than just dentures. Am J Public Health. 2004;94(5): 698.  |
| 4. | Richards D. Evidence-based Dentistry – a challenge for dental education. Evidence-Based Dentistry, 2006; 7:59. |
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