Oral Health Implications of the Ageing Population - Report Example

Oral Health Implications of the Ageing Population Introduction Advancement in modern medicine has made it possible for people to live a longer and healthy lifestyle. Added to the fact that birth rate has continued to decrease especially in the developed countries, the modern society is characterized by an ageing pupation and increased number of people who are in their eighties and beyond. Such a high number of older persons in society increase the challenge of health care within a country due to the special needs that come with ageing. There are a number of health complications that are more pronounced in older persons than in those in their younger years, which makes the establishment effective health care facilities and resources an important social policy. Among the health needs that acquire an increased importance because of ageing population is oral health provision. Older persons are more susceptible to oral health complications such as dental caries, periodontal diseases and other opportunistic infections that result from the oral complications. Having a problem with their oral health can result to other negative effects in the older persons’ quality of life. Consequently, oral health for an ageing population can have other effects on the overall lifestyle of people apart from the usual discomfort caused by pain or loss of teeth. This essay explores the oral health implications of the ageing population and the increasing numbers of people living into their eighties and beyond in addition to accessing how sociological theories of ageing explain the implications. Impact of Oral Health on Physical Health The oral health implications of ageing population and increased numbers of people living into their eighties and beyond first of all is an increased number of patients reporting teeth decay. People in their old ager are even more prone to teeth decay especially those that are retained during advanced age. The increased risks of teeth decay can be attributed to the fact that older persons are also predisposed to other interrelated conditions such as teeth wear and gum diseases. These ages are also at risk of gingival recession, which further complicates matters as decay in old age in most cases involves root-surface caries that is difficult to manage. The increased trend where many of the patients who seek dental care want to retain their teeth means there will be an increased demand for endodontic treatment especially molar endodontics (Sheiham, et al, 2001). Further oral health implications of having an increased number of ageing and more people in their eighties and above in the population is the increase in the number of edentate patients over the years. According to the results of the research carried out by (Sheiham, et al, 2001), the aged with edentate reported the condition had a negative effect on their pattern of daily activities. The impact of being edentate was experienced in almost all their daily activities such as eating, speaking, emotional stability and sleeping. Ritchie, Joshipura, Silliman, Miller and Douglas (2000) note there was a connection between older adults who were edentate with low consumption of energy and proteins. Ritchie, Joshipura, Silliman, Miller and Douglas (2000) also note that such individuals also record low intake of food that has micronutrients like calcium and vitamins A, C, and E. These problems are brought about by food avoidance tendencies among the aged especial those who are also edentate. A consequence of avoidance of food for this group is having the ageing population that also faces weight loss and malnutrition. The avoidance of food among this group can be blamed on a number of factors among them difficulty in chewing with older people having to change the composition of their meals and methods of cooking to make it more easy for them to chew food. These adjustments and difficulties in food consumption have other generalized effects on the older persons as some of them take a longer time to complete their meals while others are uncomfortable eating in front of others due to lack of confidence in how others perceive their oral health (Sheiham, et al, 2001). Therefore, the implication of aging population and more people being in their eighties and beyond is the straining of available resources due to the special needs of this group of patients especial given that the aged and those of over eighty years of age require health special programmes to ensure they continue with healthily eating habits and social engagements. The implication of having an ageing population and increased number of those in their eighties and beyond does not only require dental attention but might also result in a situation where other opportunistic diseases and infections become a concern for oral health providers. The dietary restrictions that older people with dental diseases experience have the potential of compromising their nutritional status over time therefore placing their overall health at risk due to a further weakening of their body’s defence against other infections. Vargas, Kramarow and Yellowitz (2001) note the consequence of periodontal diseases on the overall health of older persons can be attributed to other complications such as bone loss and gingival recession that build up over time. Apart from dental caries and periodontal diseases, people aged sixty-five and above have been found to be at an increased risk of suffering from oral cancer. Oral cancer can appear in several areas, which include lip, oral cavity, and pharynx therefore increasing the health concerns for this group of people. Vargas, Kramarow and Yellowitz (2001) note individuals aged sixty five and above are at an increased risk of getting oral cancer with the odds being up to seven times more than those under sixty five years. Further, Vargas, Kramarow and Yellowitz (2001) points out that older people are more likely to die from oral cancer than from skin cancer. The consequence of ageing population increases other health complications such as bacterial endocarditis, which is fatal infection that affects the lining and valves of the heart. About a quarter of the reported bacterial endocarditis infection has been found to be on involving older persons especially those of age sixty and beyond. The main cause of this infection is when bacteria find its way into the bloodstream though an injury to the lining of the mouth, but can also pass through unhealthy gums, as is frequently the case with gum disease. When this happens, the individual is predisposed to Infections of the heart, but those with existing heart valve complications are at potentially more predisposed to the risks of infection (Beers, 2004). Consequently, Vargas, Kramarow and Yellowitz (2001) point out that adopting a preventive approach towards periodontal diseases should be encouraged given that a number of studies have indicated a possible link between these oral diseases and chronic diseases such as diabetes and cardiovascular complications among the elderly population. Given the fact that lack or irregular access to preventive and professional dental care can result to continued deterioration of oral health in addition to other devastating impacts on overall health of patients, there is need for the oral health professionals emphasizing preventive care to their patients. England does not have a specific oral health policy for older people, but oral care provision for older people is included in other general frameworks that cover the health of English citizens such as Choosing Better Oral Health: An Oral Health Plan for England. However, there are provisions within the framework especially those related to the previous document titled An Oral Health Strategy for England. Among aspects of oral health covered within the framework is the establishment of evidence-based practice, implementation of a targeted population approach in quest for oral health improvement and applying a complementary range of actions to promote health among other actions. The limit of this framework in taking care of the oral health of ageing population is that older people’s oral health is explicitly referred to only in relation to general oral health promotion. This category of people in need of health care is implicitly integrated with other adults in a number of the framework’s other objectives (Whelton, Kelleher, & Crowley, 2007). The lack of an explicit framework to deal with matters of oral health for the older members of the society means that individuals will have to come up with their own health care measures to ensure maintenance of oral health. However, financial and overall health of this group of patients presents a challenge given that a number live in residential care setup and old people’s homes while those who live in their own homes might lack the necessary financial capacity to access regular oral health care. Further, unequal distribution of health facilities with most being concentrated in urban centres means that the older people will have to travel for some distance to access oral health services. This might not be possible given other health complications especially for those who are in their eighties and beyond such as joint pains and other physical disabilities that make it painful for them to move. However, oral health providers can create a flexible arrangement for treatment with the venue being decided based on the comfort of the patient. This means that apart from the dental and medical offices, old people’s homes and residential care setup (Chalmers, 2003, Choo, Delac, and Messer, 2001), oral health providers can also access the older persons for preventive treatment through community groups, governmental agencies, members of their family, and caregivers (Chalmers and Ettinger, 2008). Impact of Oral Health on Quality of Life Oral health has the potential of affecting the overall psychosocial well-being of individual with (Petersen, 2003) asserting oral health is among essential determinants of quality of life for individuals. Dental diseases has a negative effect on performance of various functions such as speaking, smiling, kissing, touching, drinking, smelling, tasting, chewing and swallowing which are played by various components of the oral cavity such as teeth, lips, mouth and jaws. By hampering the performance of these functions, oral diseases reduce the quality of life of individuals. Consequently, given that the older members of the society are more prone to oral health diseases such as dental caries, periodontal diseases and oral cancer, the risk of having high number of individuals with low quality of life style is high due to having an ageing population and increased number of people in their eighties and beyond. A number of studies have explored the impact that any aspect of damaged teeth, lips, mouth and jaws have on the quality of life of individuals especially with emphasis being on implications for self-image, well-being, self-esteem and identity of older persons (Vargas, Kramarow and Yellowitz, 2001; Zainab, et al, 2008; Kumar, et al, 2009; Sheiham, et al 2001). These studies are based on the self-perception about the impact of oral health and disease on the individual’s psychosocial and physical well-being in addition to how they saw their oral health affect their general quality of life (Inglehart and Bagramian, 2002; Allen, 2003). Based on the result from studies on quality of life for older persons about how they perceived the relationship between their quality of life and oral health as well as dental diseases, it is apparent that this is a predictor of their self-rated general health, self-esteem, and overall life satisfaction (Benyamini, Leventhal & Leventhal, 2004). Given that the oral health of the elderly has implications that goes beyond health attention that require dental attention, the ageing population and increased number of people in their eighties will require more complex health attention. When treating oral health complications, specialists might have to include other interventions that will help improve the general quality of life of their patients. As patients visit the health facilities, specialists must also include other aspects of treatment such as ensuring the patient is free of pain and discomfort, has a restored satisfying and nutritious diet in addition to enabling patients to continue enjoying their interpersonal relationships and have a positive self-image. Klages, Bruckner and Zentner (2004) note aesthetic restorative dental treatment can be the solution due to the positive effect the treatment option has on the self-esteem of patients. The ageing population will strain the available resources, as more patients will be demanding oral health care. There is a need for more dentists to carter for this increase in order for oral health care to be available to every aged person in need of the service. Even in cases where available dentists might be enough to meet the oral health care needs of older persons, there is need for more dental hygienists and assistants to offer support to the core services provided by the dentists. Apart from the need for oral health providers, their distribution should also be an area of concern to ensure the balanced distribution of oral health professionals especially in the rural areas. This is because the high number of ageing population means that there is a section of the population that can easily access oral health care especial those around urban centres that are equipped with facilities and oral health professionals. However, others have very limited access especially those in rural areas that lack the necessary oral health support (Whelton, Kelleher and Crowley, 2007). Vargas, Kramarow and Yellowitz (2001) note the high demand of oral health care can be managed comfortably by the available resources given the ongoing trend where the persons of age sixty five and above are more concerned with early detection of oral health complications such as dental caries, periodontal diseases and oral cancer. Vargas and colleagues note persons 65 years of age and older are increasingly reporting higher levels of education, are affluent, and are increasingly more likely to want to keep their natural teeth as they progress into their later years. The positive development in oral health of the ageing population implies that oral diseases and tooth loss continues to be less inevitable with aging in addition to the fact that teeth now be expected to last in good condition throughout the person’s life. The challenge for the ongoing situation where the ageing population are maintaining their teeth is that there is a need for the available resources to satisfy their dental care needs such as preventive, restorative, and periodontal services. However, Vargas, Kramarow and Yellowitz (2001) claim this might not be possible given that even when the resources such oral health professionals are adequate to carter for the current and future needs, dental care financing for older people continues to difficult compared with other age groups. The authors blame this scenario on government support to the dental insurance programs that cover regular dental services while as low as 22 percent of older persons have taken private dental health cover. Given this circumstance, Vargas and colleagues warn there is a risk that universal dental health care older persons will be unattainable especially since most of those in this group live on a fixed income. The challenge placed on the oral health provision sector as a result of the ageing population and more people being in their eighties and beyond can be attributed to the fact that oral health care is more complex for the older persons than it is for the younger adults. Older people undergo significant changes in their oral health as they progress through the years especial when taken into consideration that dental caries and periodontal diseases which the most common oral health complication for this group are cumulative. The oral health problems experienced by older persons begin from their younger years and many with different complication endure the effects of their oral from their younger years Sociological Theories of Ageing Explanation of Oral Health Implications of the Ageing Population A number of sociological theories of ageing can help explain oral health implications of the ageing population and those people living into their 80s and beyond. Theories such as disengagement theory, the theory of the third age and structured dependency theory can be applied in the ongoing oral health situation of the ageing population. i) Structured Dependency Theory Structured dependency theory claim that the aged live in poverty since the available government pension cannot adequately take care of their lifestyle. Putting in place social measures for the provision of oral health care to the aged members of the society can be explained based on the structured dependency theory (Wilson, 2000). Further, the government is tasked with coming up with the necessary oral health policies that will ensure the ageing population and those reaching their eighties and beyond access the required facilities. The government can do this by subsidizing the cost of oral health treatment for the aged so that oral health care is accessible to those who are not able to fully finance their treatment. Additionally, the government can provide the necessary facilities need in the treatment of older persons. This facilities should be spread in such a manner that even those in the rural areas can access the oral health they deserve to ensure they discomfort caused by diseased teeth is handled according to their needs. While having the necessary facilities will go a long way to ensure the aged access oral health care, the government should staff them with the required number and type of experts such as dentists in addition to hygienists and dental assistants who support the services offered by the dentists. ii) The Theory of the Third Age The ‘Theory of the Third Age’ challenges aspects of the structured dependency theory by opposing the view that the ageing population have nothing more to offer the society. ‘Theory of the Third Age’ opposes the view that human beings go through three stages by adding a fourth and therefore disapproves the notion that the third age is characterized by health complication and death. The ‘Theory of the Third Age’ asserts that by the third age, individuals still have the capacity to enjoy their lives as they still have a relatively good health and affluence (Wilson, 2000). Based on this theory, the ageing population still want to maintain their teeth since they still want to take part in some of their past activities such as social interactions and enjoyment of leisure, which means many, will require preventive oral health care that will help them maintain high standards and hygiene in oral health. The ‘Theory of the Third Age’ can explain the increased demand for oral health services by older persons who want their oral treatment to reduce discomfort that might be caused by dental diseases. Given that most of these individuals still want to take part in social activities, having oral health complications might contribute to negative self-perceptions therefore affecting their quality of life. It due to such perceptions about the effects of oral health on the quality of life that those who believe in the ‘Theory of the Third Age’ believe poor oral health has a negative impact on self-esteem, social interaction, wellbeing and the identity of older persons. Therefore, it is necessary for the older persons to access preventive oral health care to ensure they maintain most of their dental composition and a high standard of general oral health. When preventive oral health care has failed, health care provides should put in place corrective measures that will improve the oral health of the patient thereby improving the overall quality of life for the older persons. iii) Disengagement Theory The theory claims that the aged should be prepared for their retirement by being allowed to gradually reduce their level of participation in their previous functions. Based on this perspective the aged do not have a lot to offer to the society, but should be taken care of by the younger generations who assume the duties previously played by the aged. Further, the theory claims the aged should be psychologically prepared to face the changes that are inevitable in their life as they progress through the years (Wilson, 2000). Consequently, the aged are seen as people with no income generating activities with some of them living in old people’s homes and residential care setup. Based on the interpretation of the structured dependency theory of ageing, members of the family and other concerned individuals should ensure the aged can access the necessary oral health attention whether for preventive or curative purposes. The disengagement theory explains the need for psychological support of older persons who have oral health complications especially through. Patients can be helped transition through the changes in their lives that are brought by lost teeth therefore ensuring they are able to properly adjust to the new requirements. For instance, loss of teeth might result in discomfort when chewing some food types therefore making it necessary for the food prepared for the aged to be cooked for a longer period or preparing soft types of food that can be chewed easily. Oral health providers collaborate with members of the aged person’s family to ensure they are prepared to meet these changes in their lives. Conclusion The ageing population and increased number of people in their eighties and beyond have increased the need for oral health care in society. Oral health for an ageing population has the potential affecting the physical health especially since older persons have been found to experience increased level of oral health complications such as teeth decay, lost teeth, dental caries, periodontal diseases and oral cancer. Having this complication could also result to other opportunistic diseases some of them being chronic such as diabetes, cardiovascular and bacterial endocarditis complications. Further, older persons have also been found to exhibit low quality of life when they suffer from oral health complications especially when there is damage to their teeth, lips, and jaw among other parts of the oral cavity. There are some sociological theories of ageing such as disengagement theory; theory of the third age and structured dependency theory that can help explain oral health implications of the ageing population in order to gain a better perspective on how to take care of those suffering from oral health conditions. These theories provide additional insights into how oral health care should be provided indicating the roles played by different concerned groups. References Allen, P.F. (2003) Assessment of Oral Health Related Quality of Life. Health and Quality of Life Outcomes, 1:40. 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