Older people get older - and they keep their teeth

Objectives: To review demographic and oral health changes in a global perspective and to discuss the implications of these developments on the dental care systems and expected demand for oral health care. Methods: Selected demographic data sets were accessed and analyzed to assess local and global population developments. Similarly, selected data sets were used to analyze past oral health changes and projected expected developments with special emphasis on the older age groups. Results: Dramatic changes are taking place in the demographics of both developed and developing countries with elderly age groups outnumbering younger people and with the oldest old growing at the fastest rate. These trends have immense implications for social and health care organizations. Parallel to this development the average improvements in oral health during the last three decades have resulted in an elderly population with a different oral health status and very different expectations towards better oral health. Scandinavian data as well as American and Australian data indicate very similar trends including retention of teeth into old age (where edentulousness was the norm thirty years ago); considerable decreases in treatment need in younger populations contrasted by increasing treatment needs in the older age groups, possibly of a more complex nature, and increasing dental dependency in the older age groups. Conclusions: Relatively easily predictable developments in the demographic and in the oral health (as well as general health and welfare) spheres remain under-addressed by the political system. There does not seem to be any past experience to guide the choice of solutions for the next 30-50 years dramatic development. Unresponsive politicians combined with the usual isolation of oral health from the main stream social and health care system may affect the institution of timely and relevant preventive measures and focus on crisis driven change.