An increase in the proportion of older people in the population is evidence, with those aged 65 years of age and above expected to increase from 19 to 25 % in Europe by 2025.  Coupled with an improvement in oral health over the past 30 years this means a higher proportion of these older people have more teeth, many of which will have received previous (sometimes complex) treatment.  It has also been shown that older people are less frequent users of dental services.  The aim of this review was to identify barriers of delivering oral health care to older people as experienced by dentists.

The Medline, Embase and CINAHL databases were searched for original English language studies with a descriptive design  (survey, inventory or questionnaire) published after 1990. Two reviewers conducted study selection and data abstraction independently. Study quality was assessed using criteria form the Dutch Cochrane Centre.  A qualitative summary was provided.

• 7 studies were included all were cross-sectional surveys.
• No studies addressed barriers experienced by dentists who deliver oral health care to community-dwelling older people.
• The most common barriers were identified respectively as:
  • lack of adequate equipment in a care home and no area for treatment available (n = 4)
  • lack of adequate reimbursement for working in a care home (n = 5).
  • inadequate training and experience in delivering oral health care to older care home residents (n = 2)

The authors concluded

We suggest that additional research should be initiated to investigate more in detail the barriers dentists experience in delivering oral health care to older people in their own dental practices.

Comment

Ageing populations are beginning to place increased demands on health services and dental services are no exception. If we are to plan and provide better and more appropriate dental services for this increasing sector of the population we need to have a greater understanding of the barriers and potential training needs in order to address them. While this review helps in bringing together the of the available English literature on the topic it highlight the fact that limited work has been done to date in this area.

Links

Bots-VantSpijker PC, Vanobbergen JNO, Schols JMGA, Schaub RMH, Bots CP, de Baat C. Barriers of delivering oral health care to older people experienced by dentists: a systematic literature review. Community Dent Oral Epidemiol 2013.