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PROVIDING CARE FOR AN AGEING POPULATION: THE CHALLENGES FACED BY DENTAL PROFFESIONALS

PROVIDING CARE FOR AN AGEING POPULATION: THE CHALLENGES FACED BY DENTAL PROFFESIONALS

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The newly qualified dentist will encounter over the course of their career a rapidly ageing population. Future generations will retain more teeth into old age and consequently introduce an evolving set of clinical problems that are traditionally seen in much lower numbers. This paper aims to outline these new challenges for practitioners and how they will affect patient management.
The newly qualified dentist will encounter over the course of their career a rapidly ageing population. Future generations will retain more teeth into old age and consequently introduce an evolving set of clinical problems that are traditionally seen in much lower numbers. This paper aims to outline these new challenges for practitioners and how they will affect patient management.

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Published by: Undergraduate Awards on Sep 01, 2012
Copyright:Attribution Non-commercial

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02/15/2014

 
 
PROVIDING CARE FORAN AGEINGPOPULATION: THECHALLENGES FACEDBY DENTALPROFFESIONALS
Harry Stevenson
105165351
 
 
Providing care for an ageing population Page 2
PROVIDING CARE FOR AN AGEING POPULATION:
THE CHALLENGES FACED BY DENTAL PROFFESIONALS
For new graduates the ageing
 populations‟
oral healthcare will become a prominentchallenge in their professional lives. W
ith every generation the western world‟s
population will continue to age substantially and by 2043 it is forecast that one quarterof the population will be over sixty five years of age
1
. This age demographic will notonly retain more of their teeth until later life, their expectations regarding a functionaland aesthetic dentition will also be higher. Efficient long term treatment planning willbecome paramount. Changes in the oral tissues and environment associated with theageing process will make treatment outcomes more variable and bring to the forecertain problems not seen as readily in the young. In this paper I will discussphysiological changes associated with ageing including xerostomia, gingivalrecession, dentine sclerosis, toothwear, tooth loss and how they will affect restorative,periodontal and prosthodontic treatment to a greater degree in the future.
The shifting demographics
A fall in birth rates coupled with a reduced mortality in the elderly population isfundamentally responsible for the worldwide epidemiological changes beingpredicted. Advances in medical care are giving those in later life a higher standard of living with the number of those over 65 yrs old without longstanding and limitingdisease increasing dramatically. It is important to note that there will be changeswithin the elderly demographic. The number of woman will continue to rise andparticularly in the plus 75 age group. Males and females show a variance in diseasesaffecting them. Woman show higher levels of arthritis compared to men possiblycontributing their standard of oral hygiene. Ethnic populations are increasing overalland within these subgroups there are large percentages of under 16 year olds with
 
 
Providing care for an ageing population Page 3
poor regard for oral health. In years to come they may therefore require a greatamount of care.
It is easy to think of “pensioners” as frail and
homebound but in reality a relativelysmall number will be in a care homes; although access to a dentist may be difficult ineither case. It is regularly seen that those in care homes do not receive a high level of oral healthcare
2
.The elderly of the future will be more prominent in the decisions made in regard totreatment planning and have higher expectations of their outcomes. It is hard toestimate how financially sound this generation of elderly will be. The currenteconomic climate is an uncertain one. This may well affect the kind of treatmentavailable to them in the future
3
.
 Age associated threats to the dentition - Xerostomia
Oral tissues are subject to natural and pathological change with ageing. These changes
may undermine the patient‟s ability to maintain good oral hygiene and retain their 
teeth as well as creating significant challenges for the dental practitioner.A major determinant of oral health in the dentate elderly is saliva. Flow rates of unstimulated and stimulated whole saliva have been shown to decrease with age by amyriad of studies
4
. Xerostomia compromises the dentition through lowered bufferingcapacity, reduced cleansing action and a fall in antimicrobial salivary constituents.Allowing caries, candida infections, toothwear and periodontal disease to rapidlyprogress in some. Aside from the ageing associated fibrosis of the glands, xerostomiamay be exacerbated in the elderly. Head and neck therapy is used frequently in cancer
cases causing gland obliteration. Sjorgren‟s syndrome and diabetes
will also reduceproduction. Drug associated xerostomia may be described as prevalent is this age

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