Dentistry and a Geriatric First

by Catherine Wilson, Editor

In 2000, there were an estimated 3.8 million Canadians aged 65 and over; up 62 percent from 2.4 million in 1981.

In fact, the senior population has grown about twice as fast as the overall population since the early 1980s. As a result, more than one out of every eight Canadians is a senior. In 2000, 13 percent of the population were seniors: in 1921, five percent of people living in Canada were seniors. StatsCanada has projected that by 2021 there will be almost seven million seniors who will represent almost 20 percent of the population.

Writing on geriatric dentistry in P&G’s Dental ResourceNet Practitioner Forum, Dr. Kenneth Shay notes the proportion of very old North Americans is growing faster than the proportion of any other age group. If for this reason alone, he says, geriatric dentistry–including familiarity with the diseases and disabilities of aging and their impact on dental health and the provision of dental care–will need to become an area of skill and familiarity for most dentists.

“Restorative materials and techniques will need to become more compatible with aged, darker, more brittle dentin and the generally higher chroma, lower valued hue, and highly translucent appearance of aged teeth.”

In this vein, The Centre for Aging and Health at Providence Health Care and the UBC Faculty of Dentistry has opened the Geriatric Dentistry Program, the first of its kind in Canada. Its goal is to promote healthy dental hygiene for long-term care residents, treat simple and complex issues, educate staff and residents and conduct research.

Oral health is often overlooked in the elderly, especially those living in long-term care facilities. The problem is often complicated when dentists are not equipped to deal with the impairments of the frail elderly.

The Program will bring preventative services and treatment to all of Providence’s 850 long-term care residents either at bedside, in UBC’s Specialty Clinic or under general anesthetic at St. Vincent’s Hospital. Dental residents and undergraduate students will be trained at UBC’s Faculty of Dentistry and onsite at Providence facilities. While the program will initially focus on residential patients at Providence Health Care facilities, plans are in the works for expansion into community care.

An assessment conducted by the Vancouver Coastal Health Authority found that half of all long-term care residents in Providence Health Care facilities still had natural teeth and of these, 71 percent had dental decay in at least one tooth and 47 percent had gum disease. The assessment also found that more than half of residents wearing dentures had problems and one-third had soft tissue abnormalities.

A survey also showed that 85 percent of BC’s practicing dentists feel inadequately prepared to provide bedside treatment in a residential care facility. Many private dental clinics are poorly equipped for the physical and cognitive limitations common among the frail elderly.

As Dr. Chris Wyatt, program leader says, oral health treatment and preventative services are crucial to the quality of life of those in residential care.

Programs such as this will help all of the elderly–not just the healthy ones –keep more of their teeth.