Senior dental scheme urgent, research shows
Barriers to oral healthcare are leading to older people being hospitalised for largely preventative problems and researchers are concerned it is the tip of the iceberg.
Research involving 360,305 people who were living in residential aged care in Australia between 2017 and 2020 – completed by the Registry of Senior Australians research centre – has revealed that one in five residents have a significant oral health problem and little access to dental services.
It also found that 19.6 per cent of older people entered residential care with at least one oral health concern and more than 5,000 aged care residents were hospitalised with a dental or oral health-related diagnosis during the study period. Almost a quarter of these hospitalisations were potentially preventable.
The research was done collaboratively with the South Australian Oral Health Plan Older Person’s Working Group and was supported by the Hospital Research Foundation.
Lead researcher Professor Gillian Caughey said the hospitalisation analysis included all residents from South Australia, New South Wales and Victoria – due to data availability.
However, Dr Caughey emphasised the dental or oral health-related hospitalisations are just the tip of the iceberg.
“We know poor oral health is linked to a number of comorbidities with the potential to increase the risk of poor health outcomes, such as cardiovascular disease, pneumonia, and cognitive decline,” she told Australian Ageing Agenda.
“Systemic barriers to better oral health care for our older population include poor access, high staff turnover, limited dental or oral health education, high costs, and poor integration between aged care and health sectors.
“Providing mandatory training in basic oral health assessment and care to all care staff in residential aged care would also help. If we’re serious about improving the wellbeing of older Australians, urgent policy and practice changes to prioritise oral health care need to be adopted.”
Dr Caughey said that despite clear recommendations from the Royal Commission into Aged Care Quality and Safety in 2021 – including improved access to dental services and the establishment of a senior dental benefits scheme – there has been little progress. The dental system is still siloed from general health, she said.
“Better integration of oral and dental health care into primary health care, including within Medicare was also recommended. This includes adding oral health assessments to existing health assessments provided under Medicare, and introducing a thorough oral health assessment as entry into residential aged care,” Professor Caughey told AAA.
“Increasing the role of dental hygienists and other oral health professionals to provide preventative and basic care are some of these key recommendations.”
Researchers say the findings provide further evidence of the need for a senior dental benefits scheme.
“If we’re serious about improving the wellbeing of older Australians, urgent policy and practice changes to prioritise oral health care need to be adopted,” Dr Caughey said.
Affordability a major barrier for seniors
The Australian Dental Association also announced the results from its annual study, which found 55 per cent of the 25,000 participants – all over 65 – delayed seeking dental treatment.
Affordability was the main reason, with 64 per cent of over 65s delaying dental trips in the last year because they couldn’t afford it.
The ADA research also found 47 per cent of over 65s reported debilitating oral issues including recent tooth or gum pain, mouth or face swelling, or a mouth infection, compared to 36 per cent of the rest of the community.
“These findings provide a clear picture of what’s happening to the mouths of thousands of Australians over 65,” said ADA president Dr Chris Sanzaro. “They can’t get to the dentist regularly because they can’t afford it and so their mouths become a battleground of pain and infection management.”
Some end up in the emergency departments Dr Sanzaro added, with the ADA finding 16,000 older people were admitted to hospital for treatment of painful dental issues in 2022-23.
“That figure is expected to rise to 22,630 by 2027-28, representing a 42 per cent increase from an already unacceptable level. It’s a health trend that worsens by the year,” he said.
Peaks add calls for dental scheme
Older people’s advocacy body Council on the Ageing Australia has also called for dental care to be funded for seniors through Medicare in its 2025 federal election statement. Chief executive Patricia Sparrow said the new statistics released by the ADA today highlight why older Australians are urging political parties to introduce a seniors dental benefit scheme in the lead up to the election.
“The number of older Australians skipping vital dental treatment because they can’t afford it is ridiculously high,” Ms Sparrow said.
“Good oral health is important for people of every age, and we know people across the board are struggling with the cost, but as we get older the stakes get higher. Evidence shows that poor dental health increases the risk of diabetes, heart disease and chronic malnutrition in older people, as well as embarrassment and social isolation.
“Older Australians are putting their health at real risk because they’re nervous they can’t afford to pay for the treatment they need.”
Dr Sanzaro said with 76 per cent of Australians supporting the introduction of a seniors dental scheme, it clearly demonstrates the groundswell of public opinion supporting ADA’s long sought after seniors dental benefits schedule to provide affordable care to older Australians who need it.
“If that’s not clear proof that most Australians are behind the seniors’ scheme and want to see it put into action, then nothing is.”
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