31
Volume1 Issue1
|
I
ssues and
P
eople
increasedcomorbidities (including
dental comorbidities) canescalate
to inflatemedical expenses across
thepopulation,with far-reaching
consequences for society ingeneral.
Mandatory retirement hasbeen
abolished inmanyprovinces inCanada
andmaybe removedat the federal
level.
34
As such, a largeproportion
of thoseover 65yearsof agemay
wish to remain in theworkforce.
35
However, poor oral healthcancreate
psychological and social constraints, by
undermininggeneral appearanceand
limitingaperson’s confidence in social
interactions
36
andhisor her ability to
secureor retaina job.
19
Furthermore,
older adultswithpoor oral health tend
to leadan inactive lifestyle.
37
More
specifically, theCHMS showed that
approximately40%of those60–79
yearsof age reportedanaverageof
3.5hours lost fromworkor normal
activitiesper year becauseof dental
sickdays.
13
Unexpectedabsence from
work
38
due toacuteoral discomfort or
paincouldcreatefinancial and socio-
economic strains at the individual,
corporateand social levels.
Furthermore,many systemicdiseases
exhibit oralmanifestations, andoral
cancer is among the top10most
commoncancersworldwide.
39
About
3,400newcasesof oral cancerwere
diagnosed in2009 inCanadaalone,
and the incidence increases after age
40.
40
Thus, oral care should remainan
important part of health screening for
theolder population.
LookingForward
TheCHMSprovides an incomplete
pictureof oral health inolder
Canadians. It didnot surveypeople
80yearsof ageor older, although this
agegroupnowmakesupabout 4%
of theCanadianpopulation.
41
It also
excluded institutional residents,who
aregenerallymore frail, areunable to
executeanoptimal standardof oral
hygiene, receive lessdental care, and
havepoor oral healthandgreater
treatment needs.
42,43
Inone study, 58%
of elderlyCanadiannursinghome
residentswere inneedof dental
treatment; and two-thirds (67%) of
theneedwas attributed tocaries and
periodontal problems.
44
Although
dental servicesweremadeavailable to
residentsof the facilities, the incidence
of tooth loss andedentulism increased
over the subsequent 5-year period.
45
Utilizationof dental services inCanada
has risenmodestly, from44% to68%,
since1970.
13,46
Over the sameperiod,
dental expendituresper capitahave
increasedapproximately fourfold,
47
which indicates that either dental
serviceshavebecomemorecostlyor
individual patients areutilizingmore
services. Data from theCHMS indicate
that income is a strongdeterminant
of health status andaccess tocare.
13
The inequitable situation is evenmore
palpable for elderlypeople, especially if
theyhave lost insurancecoverageafter
retirement andhavebecomemore frail.
Thenext article in this 3-part series
will discuss thebarriers tooral health
care facedby theelderlypopulation in
Canadaand theethical considerations
associatedwith inequities inoral care.
a
References
Complete list of references available at:
