Oral health improvement amongst the elderly

In many developing countries significant increases in the elderly population are expected by 2025. As people age, their susceptibility to chronic and life-threatening diseases as well as acute infections increases, exacerbated by compromised immune systems. In addition to cancer, cardiovascular diseases, diabetes, and infections, poor oral health, most notably tooth loss and severe periodontal conditions, is prevalent in this age group. Barriers to oral health care among the elderly are considerable. Impaired mobility impedes access to care, particularly for those who reside in rural areas. The situation is worsened in developing countries when oral health services and domiciliary care are not available. The WHO Oral Health Programme intends to develop strategies for improved oral health of older people. Based on experiences from demonstration programmes in countries, national oral health planners are encouraged to integrate systematic oral health activities towards improved quality of life.

Oral health, general health and quality of life

Oral health is integral to general health. Those with ill health are at greater risk of oral diseases that, in turn, further complicate their overall health20. Some general health diseases manifest in the mouth, and oral lesions may be the first signs of other life-threatening diseases such as HIV/AIDS. The experience of pain, endurance of dental abscesses, problems with eating and chewing, embarrassment about the shape of teeth or about missing, discoloured or Table 1 Percentages of age groups 12 and 35-44 years in selected countries of Africa who saw a dentist over the past 12 months or who never have seen a dentist Burkina Faso14 Tanzania Mainland7 Madagascar4 12 yrs 35-44 yrs 12 yrs 35-44 yrs 12 yrs 35-44 yrs Saw a dentist within the past 12 months 4 10 11 12 11 16 Never seen a dentist 93 61 76 43 83 35 damaged teeth can adversely affect people?s daily lives and well-being. The WHO Oral Health Programme provides analysis-for-policy and analysis-of-policy information instrumental to the integration of oral health into national and community health programmes.

Oral health systems

More than 20 years after its widespread adoption, the strategy of Health for All through primary health care still has not been fully implemented. In many countries, national capacity and resources - human, financial and material - are still insufficient to ensure availability of and access to essential, high quality health services for individuals and populations, especially in deprived communities. In developing countries, oral health services are mostly offered from regional or central hospitals of urban centres and little, if any, importance is given to preventive or restorative dental care. Many countries have a shortage of oral health personnel and generally the capacity of the systems is limited to pain relief or emergency care. In Africa, the dentist to population ratio is approximately 1 : 150 000 and significant proportions of children and adults have never seen a dentist (Table 1)4,7,14.

The WHO Global Oral Health Programme supports the development of oral health services that

The WHO Global Oral Health Programme supports the development of oral health services thatmatch the needs of the country. For developing countries in particular, primary health care models for essential oral health care are encouraged and several community demonstration projects based on sociocultural conditions are supported or carried out jointly with the WHO Oral Health Programme. Oral treatment approaches have been designed21, moreover, the WHO Oral Health Programme has an oral health component for the project Integrated Management of Adolescent/Adult Illness - Guidelines for First-level Facility Health Workers in Low Resource Setting22.