Exploring strategies to enhance the oral health of older Australians living in residential aged care

Abstract

The aim of this thesis was to explore sustainable strategies to improve and manage the oral health of older people living in residential aged care facilities (RACFs). We provided an overview of the demographics of older Australians and identified barriers inhibiting them from improving. We described a domiciliary oral health service in RACFs (Reach-OHT); developed a standard of procedure manual; and appraised other models of care. Based on Reach-OHT, the oral health status of newly admitted residents living in RACFs confirmed that a large proportion of them had pre-existing dental problems and oral health concerns. Furthermore, almost half of them had an unsatisfactory oral cleanliness score. From our 3-year descriptive summary of the services provided in RACFs, we found that of the 88% of residents who consented to an oral health assessment (OHAT), 69.1% were referred for treatment after completion of OHAT. More than half had one or more caries; 40% showed sign of periodontal disease; a higher proportion had an unsatisfactory level of oral cleanliness. Majority of services provided were diagnostic, preventive, and restorative care. Using Rapid Estimation of Adult Literacy in Dentistry, we found lower score (18.5) amongst our aged care workers in RACFs. We analysed the oral health data from the Concord Health and Ageing in Men Project, a cohort study of the health of a representation sample of community living older men aged 70 and over. We found no participants free from dental caries; 90.9% were indicative presence of periodontal disease. These findings suggested that greater attention needs to be given to oral health of older people in the community. Reach-OHT demonstrated success to the access to services for older people living in RACFs and feasible on a larger scale. Findings and implications in this thesis contributed to further developing strategies and policies improving the oral health of older people living in RACFs.