While there’s plenty of evidence from the past thirty five years that barriers exist for older people accessing dental care, only recently have researchers been trying to figure out why frail older people value caring for their own teeth, but don’t value going to the dentist. But new research from the Netherlands sheds new light on the subject.
Researchers interviewed 51 older people between 2009 and 2012, all of whom were in assisted-living facilities. Some lived there full-time. Others went there during the day only. Unsurprisingly they found frail older people favour long-established oral hygiene routines to sustain a sense of self-worth; discontinue oral hygiene routines when burdened by severe health complaints, in particular chronic pain, low morale and low energy; and experience psychological and social barriers to oral health care when institutionalized.
However, when they asked by the subjects had stopped taking care of their teeth, they identified lack belief in the results of dental visits and tooth cleaning; the older people trivialize oral health and oral care in the general context of their impaired health and old age; and they consciously use their sparse energy for priorities other than oral healthcare.
Cost is a commonly recognized barrier to dental care. However, the people in this study said they would not visit a free dental clinic, even though most had some form of dental discomfort. To them, the benefits did not exceed the effort needed to visit the dentist: It simply wasn’t worth it.
The authors suggest focusing on interactions between nursing-home staff and elderly people. Compassionate listening, paying attention to what’s important to each resident, and more careful observation could help staff understand the priorities of each person and support oral care.