A Generation Game
Featured Products Promotional FeaturesPosted by: Dental Design 11th January 2024
To deliver the highest quality of dental care, we as professionals must tailor our approach to each and every patient. From how we communicate to them to how we plan their treatment, every step of their dental journey should be provided in an appropriate way for them. It is pertinent for the team to consider a wide range of patient factors in order to do this successfully, including their education level, understanding of dental health, physical or mental impairments, budget and age.
This last one is becoming increasingly important as we face the challenges that come with an ageing population. The 2021 Census[i] found that 11 million people were aged 65 years or older in England and Wales – that’s up from 9.2 million just 10 years previously. This has a significant impact on the entire healthcare system, with a growing number of people requiring more extensive services and therefore costing the economy more.[ii]
Increased dental need
When it comes to dentistry, there are many reasons why the older population present with more challenging dental needs. It was estimated in 2018 that 7.5% of the over 85s, 4.4% of 75 to 84-year-olds and 1.3% of 65 to 74-year-olds were edentate in England.[iii] Around the world, an estimated 70% of adults over 65 have periodontal disease[iv] and 96% have had a cavity.[v]
There is also a higher prevalence of chronic medical conditions like heart disease, stroke, cancer, diabetes and respiratory diseases among older people, which further increases their risk of dental caries, periodontal disease and tooth loss.[vi] [vii]
It follows that the greater the incidence of dental problems, the more complex the treatment indicated will be. For instance, endodontic treatment is more commonly required by older patients, with one study suggesting that 38% of all root canal treatment is performed on patients in the 50 to 64 age group.[viii]
For the dental team, we must consider our patient as a whole and treat their oral condition with their overall health in mind. The care we provide must be respectful of the medications that patients may be taking. Routine check-ups may need to be more often to ensure regular mouth cancer screening and oral hygiene recommendations must be tailored to allow for any dexterity issues that develop over time. Where appropriate, a referral to specialists could provide access to advanced treatment solutions.
Truly holistic dental care
However, the physical needs of an older patient demographic are not the only consideration for dental professionals. We place a lot of emphasis on building rapport with all our patients so that we can truly get to know them, understand their priorities and help them optimise their oral hygiene at home. This can also help us to enhance the patient’s experience throughout in the entire dental practice. All of this influences how a patient feels when they visit for their dental care, whether they need a routine check-up or an advanced procedure. It will also have an impact on if they will return to the practice in the future and how well they respond to professional oral health recommendations.
For example, a study in the US found that patients under the age of 40 were most interested in conversations involving aesthetic dentistry, orthodontics and topical fluoride application, while those over 40 were more concerned with regular dental check-ups, dental implants and diet.[ix] An English study from 2019[x] focused solely on the desires and expectations of the over-60s. This found the most important issues for these patients to be smile aesthetics, communication, continuity of care and treatment experience.
Alongside these elements, we must also consider the social and psychological needs of our patients. Data released in 2020[xi] about who people spend their time with at different stages of their life clearly demonstrates the enormous increase in time spent alone for people in their 60s, 70s and 80s (400-500 minutes per day compared to under 300 minutes for the under 40s). As such, it follows that older patients who may live on their own or generally interact with fewer people in everyday life may enjoy the personal connection with dental practice staff. Where feasible, small adjustments like adding 5 minutes onto appointment times for these patients could go a long way to improving their experience.
Quality reigns supreme
It goes without saying that, no matter what age our patients are, it is our responsibility as dental professionals to deliver the highest quality care we are capable of providing. More complex patient needs may necessitate collaboration between dental professionals, with specialists in their field and even with the wider healthcare team. Together, we can ensure all our patients receive the care they deserve.
For further information please call EndoCare on 020 7224 0999
Or visit www.endocare.co.uk
[i] Census 2021. Profile of the older population living in England and Wales in 2021 and changes since 2011. Released April 2023. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/profileoftheolderpopulationlivinginenglandandwalesin2021andchangessince2011/2023-04-03#:~:text=2.,from%2016.4%25%20to%2018.6%25. [Accessed September 2023]
[ii] UK Health Security Agency. Ageing and health expenditure. January 2019. https://ukhsa.blog.gov.uk/2019/01/29/ageing-and-health-expenditure/ [Accessed September 2023]
[iii] Statista. Share of adults with no natural teeth in England in 2018, by age. https://www.statista.com/statistics/1130841/adults-with-no-natural-teeth-in-england-by-age/ [Accessed September 2023]
[iv] Centres for Disease Control and Prevention. Periodontal disease. https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html#:~:text=47.2%25%20of%20adults%20aged%2030,and%20older%20have%20periodontal%20disease. [Accessed September 2023]
[v] Centres for Disease Control and Prevention. Older adult oral health. Facts about older adult oral health. https://www.cdc.gov/oralhealth/basics/adult-oral-health/adult_older.htm#:~:text=Nearly%20all%20adults%20(96%25),5%20have%20untreated%20tooth%20decay. [Accessed September 2023]
[vi] Winning, L., Linden, G. Periodontitis and systemic disease. BDJ Team 2, 15163 (2015). https://doi.org/10.1038/bdjteam.2015.163
[vii] Oluwagbemigun K, Dietrich T, Pischon N, Bergmann M, Boeing H. Association between Number of Teeth and Chronic Systemic Diseases: A Cohort Study Followed for 13 Years. PLoS One. 2015 May 6;10(5):e0123879. doi: 10.1371/journal.pone.0123879. PMID: 25945503; PMCID: PMC4422697.
[viii] Vehkalahti, MM, Palotie, U, Valaste, M. Age-specific findings on endodontic treatments performed by private dentists in Finland in 2012 and 2017: a nationwide register-based observation. International Endodontic Journal, 53, 754–763, 2020.
[ix] Kakudate N, Yokoyama Y, Sumida F, Matsumoto Y, Riley JL 3rd, Gordan VV, Gilbert GH. Practice-based research agenda priorities selected by patients: findings from a dental practice-based research network. Int Dent J. 2019 Jun;69(3):183-191. doi: 10.1111/idj.12447. Epub 2018 Oct 23. PMID: 30350855; PMCID: PMC6478567.
[x] Cook, N, Kelly, A, Kanagasingam, S, Tagiyeva, N. Let us talk about it: An exploratory qualitative study of older adults’ priorities for oral health in North West England. Gerodontology. 2023; 00: 1-12. doi:10.1111/ger.12678
[xi] Our World data. American Time Use Survey (2009-2019) and Lindberg (2017) https://ourworldindata.org/time-with-others-lifetime[Accessed September 2023]
