Oral Health Challenges in Aged Care: Calls for Policy Action

Key Takeaways:

• Many aged care residents struggle with maintaining oral hygiene as they age, highlighting gaps in support.
• Experts advocate for a seniors’ dental benefits scheme to address limited access to dental care.
• Poor oral health in seniors can lead to severe health complications, including hospitalisation and death.
• Advocates urge political commitment to fund oral health initiatives during the upcoming federal election.

The Growing Struggle for Seniors

AUSTRALIA: Aged care resident Arlene Freeland openly admits that maintaining proper oral hygiene has become increasingly difficult as she grows older. “I try my best and some days it’s not good enough, really,” she says. Her experience reflects a broader challenge faced by many elderly individuals living in residential care settings.

“There should be more help for us oldies, who need as much help as we can get,” Ms Freeland adds. Her concerns are echoed by dental professionals and advocates calling attention to the lack of resources dedicated to oral health care in aged care facilities.

Educating Residents and Carers

Dental therapist Leonie Short recently visited Ms Freeland’s Ipswich aged care facility, west of Brisbane, as part of an initiative to educate residents and their carers about preventative oral health practices. This effort is part of a research collaboration involving the University of Southern Queensland, UnitingCare, and Oral Tech AI. The project aims to develop a digital platform to improve oral health awareness, education, and screening in aged care settings.

“Some of it was tips I didn’t know,” Ms Freeland said after attending one of Ms Short’s sessions. “They have been helpful.”

The program addresses a critical gap, as most aged care facilities lack the resources to provide such services. According to Ms Short, the consequences of neglecting oral health can be dire. “The consequences of poor oral health are illnesses, for example, having a tooth abscess … but also hospitalisation and unfortunately, death, and that could be from aspiration pneumonia, which is preventable, and also infective endocarditis,” she explained.

Infective endocarditis, a condition where bacteria settle in the lining of the heart valves, can be triggered by staphylococcus bacteria found in dental plaque.

Advocacy for Policy Change

With Australians preparing to vote in the upcoming federal election, Ms Short has called for a commitment to dentally-led training for aged care workers. “Oral health hasn’t rated,” she noted, emphasizing the need for better integration of oral health practices into aged care routines.

Her advocacy aligns with recommendations made by the Royal Commission into Aged Care Quality and Safety, which, four years ago, urged the federal government to establish a seniors’ dental scheme. Despite these recommendations, no such scheme has been implemented. A Senate report in November 2023 reiterated the call for a seniors’ dental benefits scheme (SDBS).

Perth resident Amina Schipp, who founded the grassroots advocacy group Aged Care Reform Now, has been vocal about this issue since her mother’s death in 2019. Her mother, Maria, was advised against bringing her dentures to residential care due to fears they would be misplaced.

“She did the best that she could herself and used rinses and that sort of thing, but over a period of time, chewing and eating without dentures in put a lot of pressure on the gums and the jaws,” Ms Schipp said. “That was when the issues started with the sores on the gums which led to infections and pain.”

Maria lost 17 kilograms, dropping to just 36 kilograms, and began experiencing dizzy spells and falls. “She was no longer able to enjoy eating, which was one of the few pleasures left for her,” Ms Schipp recalled.

While there have been policy changes since Maria’s passing, including findings from the aged care royal commission, the Inspector-General of Aged Care noted last year that the federal government could do more to ensure nursing home residents have access to doctors and dentists. “We still have a long way to go,” Ms Schipp said.

Limited Access to Dental Services

The challenges faced by aged care residents are compounded by limited access to dental care. A report by the Aged Care Quality and Safety Commission identified personal and oral hygiene among the top five complaint issues in the first quarter of the current financial year.

Council on the Ageing Australia CEO Patricia Sparrow highlighted the barriers faced by residents. “People in residential care often have limited access to dental care because they may not be able to get out to see a dentist,” she said. “Or, there may not be a dentist that’s prepared to go into a residential care setting.”

Ms Sparrow reiterated calls for a seniors’ dental benefit scheme. “In this election year, we would hope to see that government would commit to funding a seniors’ dental benefit scheme and making sure that all Australians, and we look particularly at older Australians who can’t get to the dentist … can get the oral health care that they need,” she stated.

Calls for Targeted Support

National Seniors Australia has also advocated for a seniors’ dental benefit scheme in its recent pre-budget submission. “As people get older and increasingly frail, the ability to adhere to good oral health practices can decline dramatically,” the submission reads.

CEO Chris Grice acknowledged the financial constraints of including dentistry under Medicare but suggested targeted assistance for seniors. “What we’re looking for is some sort of contribution in the form of $500 a year to support, in particular, pensioners as a targeted cohort to help them be able to fund dental care,” he said.

Federal Health Minister Mark Butler acknowledged the public’s desire for dental coverage under Medicare but tempered expectations. “I’ve tried to be honest with people that the government’s focus right now is strengthening Medicare and rebuilding general practice,” he said. “I can’t say to people that in the short term there’s going to be any change to dental.”

The Coalition was contacted for comment but had not responded at the time of publication.

This article is based on reporting published by https://www.abc.net.au/.