Concepts of Healthcare Need in Dental Geriatrics: A Global Perspective

The global increase in aging populations poses significant challenges for health and social services everywhere, and there is urgency about developing strategies that will manage the expected growth in demand for healthcare. The high prevalence of gingivitis and caries, for example, among frail elders infers that the need for dentistry will increase substantially in the near future as people live longer burdened of chronic disability. Yet, there are remarkably few data on the incidence and long-term impact of oral diseases in ageing populations. Consequently, accurate predictions of need for special mouthcare and oro-dental treatments are practically non-existent. Recent conceptual models and frameworks of oral health focus on the psychosocial determinants of health and the need to temper biological perspectives on treatment need with practical consideration for the coping and adaptive strategies that people use when physically and cognitively impaired. A critical scoping of evidence suggests that the more damaging impacts of oral diseases occur in relatively small segments of the older population, and that the more prevalent oral diseases could be managed successfully by relatively simple programs of oral hygiene and healthy nutrition. It seems sensible, therefore, that global resources of oral healthcare be directed towards those who are particularly vulnerable to these diseases, and to enhance oral health generally by promoting personal hygiene and healthy diets as part of a global policy of healthcare and disease control.