Who will provide dental care for housebound people with oral problems?

Abstract

There are currently 9½ million people in England and Wales over retirement age and nearly 4 million of these are over 75 years. 1 Age itself is not a disease and 70% of the population over 65 are functionally independent. However, ageing is associated with an increase in the prevalence of chronic disease and disability 2 and 20% of people over 65 years are frail and a further 10% are functionally dependent, either homebound or institutionalised. 3 The implications of this demographic change on oral health has been investigated. Reports show oral health for the well elderly is improving, 4 creating a demand for dental services, which this group are able to access, but maintenance of oral health and access to dental treatment is a problem for disabled elderly people, who, for their daily activity are dependent on carers.

Access Barriers to Dental Health Care in Children with Disability. A Questionnaire Study of Parents

“…This form of therapy is currently not very popular in Poland. But in some European countries it is commonly accessible to patients with disability or chronic illness who cannot move and leave home to visit the dental surgery (Simons 2003;Smith & Freeman 2003).…”

“…It also seems that there is no satisfactory solution for dental treatment in chronically ill, bedridden patients who cannot leave their homes (Fiske & Lewis ; Simons ; Smith & Freeman ).…”

The effect of a domiciliary denture service on oral health related quality of life: a randomised controlled trial

“…Access and availability of dental domiciliary services for disabled older people is poor. 7,44,45 There is a need for primary care trusts to invest in domiciliary denture care services and more research is required into the effectiveness of other dental treatment in the domiciliary setting.…”

“…5 However, analysis of health service records reveals that less than 40% of dentists make home visits and this fi gure is fall ing. 6,7 The United Kingdom community dental services (CDS) act as a safety-net for people unable to obtain care within the general dental service. Even so, only a minority of com munity dentists provide domiciliary care.…”

Iowa dentists’ involvement in care for patients who are homebound

“…Older adults who are homebound have been reported to have a high level of perceived need and clinical unmet need coupled with a decreased frequency of dental visits 13 . However, very little is known about the numbers and characteristics of dentists who are involved in providing care to patients who are homebound.…”