Oral Health in Aged Care: Addressing oral health inequality and unmet dental care needs in residential aged care

Older adults living in residential aged care facilities (RACFs) have the highest prevalence of poor oral health, with untreated dental caries (decay), estimated to be as high as 70%.

Background

Poor oral health causes pain and infection, with major consequences to quality of life as well as broader physical and mental health, impacting the ability to eat, speak and engage socially with others. More than two-thirds of people living in RACFs also live with moderate to severe cognitive impairment, further complicating their ability to maintain oral self-care and access dental care.

Without identification and treatment of dental caries, the disease progresses to pain, impairment, and poorer oral and general health-related quality of life for older adults. Untreated dental caries are associated with impaired cognitive function, poorer nutrition, increased frailty, a heightened risk of respiratory infections, and declining overall health. Specifically, there is a direct impact on dietary intake, nutritional health status, physical frailty, and the ability to live an active life without pain.

Individuals with dental diseases that affect their facial appearance or speech are more likely to avoid social interactions due to concerns about their appearance, how they feel, and their ability to communicate. These isolating effects can have significant consequences for overall mental and physical health, as social isolation and loneliness are regarded as a critical public health problem and policy issues for older adults. There are challenges when delivering appropriate treatments that protect and improve oral health in residential aged care (RAC). To be both feasible and scalable, oral health care services in aged care need to be delivered onsite.

Vision

Arresting dental caries and sealing exposed carious cavities would substantially reduce residents’ caries progression, toothache and food impaction, risk of aspiration respiratory infections, and by extension, improve their nutrition and ability to perform many important activities of daily living. This approach does not require onsite specialised equipment or a clinic.

About the project

This Medical Research Future Fund (MRFF) project, with its industry partners, aims to develop and implement an adapted oral health assessment and referral system and evaluate the effectiveness and acceptability of this tool in reducing carer burden and improving quality of life for older people living in RACFs.