Better off toothless?

This Column drew attention to the appalling lack of dental care given to older people right back in 2008.

The article was written after ABC’s Lateline Program interviewed dentistry lecturer, Dr Clive Rogers, who stated, ‘that the neglect of dental care in nursing homes amounts to abuse’. He showed graphic photographs of ravaged mouths and teeth.

Now, in a response to the Productivity Commission’s Inquiry "Caring for Older Australians" Draft Report, we see the problem fully outlined, yet again, by Dr Peter Foltyn, Consultant Dentist at St Vincent’s Hospital in NSW.

This response is ‘must’ reading for all those who care about the treatment of frail older people in residential care.

Dr Foltyn explains how many nursing home residents have had good dental care throughout their life but that, 'unfortunately salivary glands either cease to function properly or are greatly affected by medications, health issues or ageing itself’.

Without saliva, teeth will often decay rapidly. He also mentions that the sweet food, so often provided in nursing homes, along with the absence of teeth-cleaning routines further exacerbates the problem.

Dr Foltyn has long advocated for better dental care for older people and clearly outlines the serious risks related to ignoring the oral health of older people. These include pain and discomfort, psychosocial problems, the effects on the self esteem of the individual and the possible risk of serious illness.

There is a telling section in Dr Foltyn’s submission to the Productivity Commission where he recounts the difficulty of getting oral health on the agenda at those big conferences on aged care that are held so regularly.

He makes the salient point......’To get the message out to all involved in the Aged Care Industry, Key Note speakers on oral and dental health must be involved in Plenary Sessions.’

It is hard to fathom the thought processes that allow authorities to think that the conditions/rights that most of us take as a given need not be granted to those who are old and frail. It is as if, when you are old, you are somehow not quite as human as the rest of us. We see many instances of this in aged care. The community health messages no longer seem to matter. Healthy diets, regular teeth cleaning and dental checks belong to a past life – not the ‘now’.

Of course providing good dental care to people in residential care is not always easy. It takes staff time and the time and skill of dental health care workers. The current low staffing levels which prevail in many of our aged-care homes leave carers and nurses struggling to give full attention to the needs of residents. There is barely enough time to shower, dress and feed residents and cleaning teeth is often not even on the radar.

Dr Foltyn’s response to the Productivity Commission’s Draft Report concludes with many recommendations that, if implemented, would make a huge difference to the well-being of older people in residential care. One would like to think that such a considered and expert voice would be heard. However, much of the tenor of the Draft Report is about opening up aged care even further to market forces and not so much about the actual care provided to residents. It is a terrible thought that if one does actually keep one’s teeth until old age that it will end up being a disadvantage – not a benefit!