Exploring Oral Health in the Field of Dementia

Objectives: An ageing population, an estimated 47 million people currently living with dementia, and predictions of a 3 fold increase in people living with dementia by 2050 have led the WHO to declare dementia a public health priority. Emerging research also suggests that dementia is linked to poor oral health. The objective of this paper is to use Bourdieu’s concepts of field and capital to explore experiences and practices relating to oral health of people living with dementia.
Methods: This paper presents an analysis of ethnographic interview data (n=) from participants with dementia, carers and carer/diagnosed dyads participating in a qualitative semi-structured interview study of the mouth and oral health in the field of dementia.
Results: The results of this analysis suggest that Dementia can be seen as a field with biologically determined/socially constructed parameters. Within this field people with dementia and their families/carers have to negotiate their way through the complex, interlocking structures that shape the field to access health, social, charity and/or commercial services and care. Their ability to do this depends on access to capital resources and particularly social capital in the form of family care networks who act as the link to a range of sources of care. Dentistry has low visibility within the field, but it is important to people living with dementia and their families. Oral Health becomes a priority only when it impacts on other aspects of life such as the ability to eat or live without pain.
Conclusions: We argue that adopting a Bourdieusian approach provides a way of contextualising experiences of oral health within dementia and un-picking the multi-layered impact of structure, institutions, biology, resource mobilisation and self in the context of a progressive disease which ultimately challenges knowledge of the self and the ability to interact with the world around us.