Dental health is a vital part of ageing

For many of us, the increasing silver in our hair is matched by gold (or other metals) in our teeth. We have information on looking after them.

More of us are keeping more of our teeth into later life, making good dental health an important part of ageing well.

Having healthy teeth and gums or correctly fitted dentures is important for overall health and a sense of wellbeing.

Healthy teeth are essential for effective chewing and swallowing and therefore for good nutrition. Our teeth are on show to others when we smile, and for many of us it’s important for confidence and self esteem to feel that our teeth look acceptable.

Nowadays many more of us are able to keep our teeth in older age compared to previous generations. Our attitudes are also changing so that we expect to keep as many of our natural teeth as possible.

As we get older the need for dental care treatment continues and may increase. You may find that old fillings need to be re-done; and you literally become 'long in the tooth': as gums recede more of the tooth root is exposed and is vulnerable to infection.

Dentures may need to be replaced as the shape of the mouth continues to change throughout life.

Affordability of professional dental care is an issue for many people on fixed incomes, whether they have their own teeth or dentures.

Cost of dental care

Despite the importance of good dental health Government support to adults is limited to subsidies towards emergency dental treatment, and dentures for people on low incomes.

Some public hospitals have dental departments that provide low cost services to outpatients such as Community Service Card holders and people with special needs. ACC will pay for costs associated with accident-related dental treatment. There is no general subsidised dental care for older people, unlike the UK where reduced cost dental care is provided under the National Health Service, with additional reductions for people on low incomes.

Discounts: some dentists offer SuperGold Card discounts on the cost of dental treatment.  We recommend asking your dentist about this - it may help reduce your cost a little or encourage your dentist to sign up to the scheme.

Choices

In an AUT research study, a sample of New Zealanders aged 65 – 87 were interviewed about maintaining their oral health.

The researchers found that people put a lot of effort into deciding how to maintain their teeth in the face of competing priorities and high costs.

A range of factors had to be weighed up to achieve a balance: cost versus quality of the dental service, preventative dental check-up visits against visits for problems, and functionality versus appearance. In many cases people had to establish what their bottom line was, and make their decision accordingly.

Rest homes

Studies have shown that older people in rest homes have particular dental care needs. They may be unable to care for their own oral hygiene.  This may affect their ability to eat well and, in turn affect their overall health.

A new oral health guide for caregivers of older people  Healthy Mouth, Healthy Ageing (NZ Dental Association, 2010) should help to improve the oral health of older people in rest homes. 

If you have a loved one in a rest home, be aware that rest home fees don't normally include dental care. Discuss any concerns you have with the rest home manager.

Dentist and researcher Moira Smith has recently published a series of recommendations to improve the oral health and wellbeing of older adults in residential care. Read her article here. [Opens 0.3MB PDF file]

Prevention

All the research we reviewed for this article stressed the importance of taking a preventive approach to caring for your teeth (or dentures) and mouth in older age. In the light of the affordability of dental services this seems to be particularly essential.

A daily routine will benefit your general health and may avoid the need for costly treatment later.

6 steps to keep your teeth and gums healthy

1. Brush twice daily, especially once before bedtime. Make sure that all the surfaces (outer, inner and chewing surface) of teeth and gum are cleaned for effective plaque removal.
2. Use fluoride toothpaste and after brushing spit the toothpaste out. Avoid rinsing the paste from your mouth after brushing as this will wash the fluoride away from your teeth.
3. Floss or use ‘inter-dental’ brushes once daily to clean between your teeth.
4. Avoid eating sugary, sticky and acidic foods and drinks in between meals.
5. Eat a wide variety of nutritious foods.
6. Visit your dentist for regular check-ups. Your dentist can spot and stop any problems with your teeth and gums at the early stages.

Comment

Liz Baxendine reports: "Age Concern New Zealand is calling for Government to improve subsidies for dental care for people over 65 in this country. Research shows that affordability is forcing older people to make compromises. Bad dental health can lead to serious health and nutrition problems.

"You have a role to play too, by taking an active role in safeguarding your oral health."

More information

> READ our seniors' dental care Q&As 

> READ our open letter to dentists

> READ What We're Saying (media release)

> VISIT  The New Zealand Dental Association’s website for information on preventive tooth care for adults.

Resource for caregivers

> DOWNLOAD the New Zealand Dental Association's publication:  
Healthy Mouth, Healthy Ageing: Oral Health Guide for Caregivers of Older People

Acknowledgements

Age Concern New Zealand wishes to thank Lynne Giddings. Barbara McKenzie-Green and Linda Buttle of Auckland University of Technology and Deepa Krishnan of the New Zealand Dental Association for their advice and assistance in the preparation of this article.

References

• Chalmers J.M. Oral health promotion for our ageing Australian Population. Australian Dental Journal 2003 48(1) 2-9.
  
• Consumer magazine. November 2008
  
• Carter G, Lee M, McKelvey V, Sourial A, Halliwell,R, Livingson M. Oral Health Status and Oral Treatment Needs of Dependent Elderly People in Christchurch. New Zealand Medical Journal 21 May 2004, Vol117 No 1194.
  
• Giddings L, Mckenzie-Green B, Buttle L, Tahana K. Oral Health Care for Older People: “I can’t afford not to go to the dentist, but can I afford it?”. New Zealand Medical Journal 2008 121 No 1281
  
• Health and Disability Commissioner. Rest Home/Clinical Manager - Monitoring of deteriorating condition of respite care dementia patient in an aged care facility. (Case 07HDC17647), December 2008 http://www.hdc.org.nz/complaints/opinions?2008
  
• New Zealand Dental Association: www.healthysmiles.org.nz
  
• Word of Mouth Older People’s Oral Health Seminar, 2004 www.maca.nsw.gov.au

Briefing to the Incoming Minister of Health

• Read our information for Hon Tony Ryall. > DOWNLOAD [PDF file, 0.02MB]