Specialised Dental Care Gains Importance as Singapore Ages

SINGAPORE: As Singapore’s population ages, the demand for specialised dental care tailored to seniors is on the rise. According to a report published on https://www.straitstimes.com/, an increasing number of elderly individuals are seeking treatment at dedicated geriatric dental clinics. One such patient is 94-year-old Mr Ibrahim Mohamed, who, after years of neglecting his oral health, received his first set of dentures at the National University Centre for Oral Health Singapore (Nucohs).

Mr Ibrahim’s journey highlights the challenges faced by many seniors in accessing appropriate dental care. When he initially sought treatment in 2020, a private dentist declined to treat him due to his advanced age and underlying health conditions, including heart issues and hypertension. He was referred to a public health institution, where he eventually received extractions, fillings, and dentures. By 2024, when his dentures became ill-fitting, he turned to the Nucohs Dental Clinic @ Alexandra Hospital, which caters specifically to seniors with complex needs.

Dr Tan Mei Na, head of dental services at Alexandra Hospital, noted that Mr Ibrahim’s oral health had significantly deteriorated since his last visit. “We try to approach it in a very holistic manner,” she explained, emphasising the importance of pacing treatments across multiple visits to ensure patient comfort. His son, Mr Mohamed Ismail Ibrahim, expressed gratitude for the care provided, noting that his father had relied on traditional methods like charcoal to clean his teeth for most of his life.

Rising Patient Numbers Reflect Broader Trends

The increase in senior patients seeking specialised dental care is evident in the growing numbers at dedicated clinics. Between April 2023 and July 2024, over 3,000 patients were treated at the Nucohs Dental Clinic @ Alexandra Hospital. Similarly, the Geriatric Special Care Dentistry Clinic under SingHealth’s National Dental Centre of Singapore saw its patient count rise from 8,534 in 2018 to 10,593 by November 2024.

These clinics are equipped with features designed to accommodate elderly patients, including spacious treatment rooms that can fit wheelchairs and specialised equipment like wheelchair tilters. Each room also has an intra-oral X-ray machine, eliminating the need for patients to travel elsewhere for scans. Such adaptations reflect the unique challenges faced by seniors, many of whom have mobility issues or chronic health conditions.

Challenges in Treating Elderly Patients

Treating elderly patients often requires more than just addressing their immediate dental issues. Dr Yang Jingrong, who heads the Geriatric Special Care Dentistry Clinic, highlighted the rising prevalence of chronic diseases among seniors. Conditions such as dementia and Parkinson’s disease complicate dental care, as they can impair cognitive function and affect a patient’s ability to maintain oral hygiene.

“Dementia impairs cognitive function and may result in behavioural changes,” Dr Yang explained, adding that seniors with this condition may be uncooperative during treatment. Meanwhile, neurodegenerative conditions like Parkinson’s disease and stroke can lead to swallowing difficulties, increasing the risk of aspiration during procedures involving water.

In 2023, nearly 74,000 seniors in Singapore were diagnosed with dementia, while approximately 8,000 had Parkinson’s disease. Dr Tan estimates that she has observed a 20 to 30 per cent increase in patients with cognitive impairment over the years.

Training Dentists for Geriatric Care

While undergraduate dental programmes prepare students to treat seniors with minimal special needs, managing patients with complex conditions often requires additional training. Although geriatric dentistry is not yet a recognised speciality in Singapore, efforts are being made to address this gap. In 2019, the National University of Singapore (NUS) introduced a two-year graduate diploma in geriatric dentistry for dentists seeking further expertise.

For those interested in advanced studies, a master’s degree in special care dentistry is available at overseas universities. Dr Yang noted that such training equips dentists with a deeper understanding of medical conditions and their progression, enabling them to provide better care. Dr Tan echoed this sentiment, stating that experience helps dentists recognise how conditions like dementia manifest differently in patients.

Prioritising Oral Health in Healthy Ageing

Despite the challenges, maintaining oral health remains a priority for many seniors. Dr Tan stressed that good oral hygiene should be an integral part of healthy ageing. “We just want people to know that even in the face of challenges as they age, even with their medical conditions deteriorating, that oral healthcare should still be prioritised,” she said.

Mr Ibrahim’s case underscores this message. His son revealed that his father had never visited a dentist before seeking treatment in recent years. “I don’t think he had ever been to a dentist all this while,” Mr Ismail remarked. Yet, like many seniors, Mr Ibrahim values being healthy and presentable, underscoring the importance of accessible and specialised dental care for Singapore’s ageing population.

As Singapore moves closer to becoming a super-aged society by 2026, with one in four residents aged 65 or older by 2030, the need for tailored dental services will only continue to grow. The efforts of clinics like Nucohs and the Geriatric Special Care Dentistry Clinic highlight the critical role of specialised care in ensuring that seniors can age with dignity and confidence.