Oral Health for an Ageing Population Partnership Results of a Survey on Oral Conditions in the Elderly

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INTRODUCTIONThisreportshowstheresultsofasurveyonoralconditionsintheelderly,conductedaspartofthe“OralHealthforanAgeingPopulation”(OHAP)partnership.OHAPisajointinitiativeofFDIWorldDentalFederation(FDI)andGCInternationalAG(GC).Launchedin2015,itaimstogiveaninsightintotheoralhealthrelatedchallengesposedbyageingpopulations.

SURVEYOVERVIEWThesurveywasconductedbyFDIbetweenJanuaryandDecember2016andwasaddressedtoNationalDentalAssociations(NDAs).EachNDAwasaskedanumberofquestionsonwhetherandhowtheycollectdataonelderlyoralhealthaswellasthemodelofelderlydentalcoverageintheircountry.

RESULTSAmongthe140RegularMemberNDAscontacted,62responded.Thisrepresentsa44%responserate,whichisahighlevelofengagementwhencomparedtopreviousNDAsurveysconductedbyFDI.Table1summarizesthenumberofresponsesperregioncomparedtothetotalnumberofNDAsinthatregionandthepercentresponserate(Resp.rate).

Table1–NDAresponserateperregion

Responsestoeachquestionaredescribedbelowandpresentedusinggraphics.Fromquestion2onwards,theresultsrefertonumberofanswersfromNDAsthathaveansweredtothespecificquestion.MiddleEastisincludedinAsiaPacific.

1. Doesyourcountrycollectdataonoral

conditionsofolderadults?63NDAsrespondedtothisquestion

Options Percent NumberofNDAs

Yes 46% 29No 54% 34

NDAsthatanswered

TotalNDAsinregion

Responserate

Europe 30 59 51%

AsiaPacific&MiddleEast 15 35 43%

Africa 10 28 36%

LatinAmerica 6 13 46%

NorthAmerica 2 5 40%

TOTAL 63 140 44%

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2. Ifyes,howoftendoyoucollectthedata?22NDAsrespondedtothisquestion

Options Percent NumberofNDAs

Annually 30% 7Everyfiveyears

57% 13

Everytenyears

13% 3

3. Whocollectsthedata?(chooseallthatapply)30NDAsrespondedtothisquestion

4. Isthereanexaminerorisitself-report?

34NDAsrespondedtothisquestion

5. Whatdatadoyoucollect?(chooseallthat

apply)33NDAsrespondedtothisquestion

47%

44%

6% 3%NationalAgency

DentalprogramsatUniversity

Stateorprovinces

73%

27%

Examiner Self-report

6

6

7

10

10

12

13

13

15

Mucosalintegrity

Numberofoccludingteeth

Severityofthecaries

Healthandoralhealthbehaviour

Reasonforlastvisit

Useofdentalcare

Numberofteethornumberofteethperarch

Periodontalconditions

Numberofteethwithcaries

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6. WhatAgegroupsdoyouinclude(chooseallthatapply)?33NDAsrespondedtothisquestion

7. Doyouincludeolderadultsinalong-term

carefacility,olderadultslivingathomeorboth?26NDAsrespondedtothisquestion

8. Isthedatapublished?27NDAsrespondedtothisquestion

Ifyes,whereisthedatapublished?Pleasedescribe14NDAsgavedetailaboutwherethedataispublished

Mostcommonresponseswere:

• Ministryandnationalbodies• Academictheses• Academicjournals

9. Listotherdataelementscollected

8NDAsrespondedtothisquestion

• Thepercentageofadultsthatneedprosthodontisttreatment.

• Thefrequencyofnon-diagnosedandnon-treateddiseasesoforalmucosainadults.

• Thefrequencyofcasesconcerningoralcavitydiseasesrequiringurgentintervention.

• Differencesinthepresenceofcariesandperiodontaldiseaseindifferentregionsofthecountry.

• Thepercentageofadultswithprosthodonticappliances(removableandfixed).

• Thepercentageoftemporo-mandibularjointdiseases.

• Adescriptionoftheattitudeofadultsinthe35–44and65–74yearagegroupsregardingtheirattitudetooralhealthandbehaviour.

• Evaluationandavailabilityforanduseofthehealthcaresystembyadults.

• Evaluationoforalhealthandqualityoflifeinoldage.

• Evaluationofhealthbehaviourinthe65–74yearagegroup.

• Levelofdependency,associatedgeneralpathologies.

• Statisticsonhealthonchildrenandyoungadults,lostteethperagegroup,gingivalorperiodontalcases,childrenpopulationwithoutmalocclusions,morbidityandmortalityrateduetooralcancer.

• Knowledgeofnursesonoralhealthonageingpopulationinlong-termcarefacilityoradultslivingathome.

• Conditionofprosthesis.

10. Doyouconductregularactivitiestopromoteoralhealthforageingpopulations?Kindlydescribe.

Amongthe55NDAswhorespondedtothisquestion,halfofthemreportednotcarryingout

14

17

26

16

14

45-54

55-64

65-74

75-84

85+

4

3

19

Olderadultslivingathome

Olderadultsinalong-termcarefacility

Both

0 5 10 15 20

AfricaAsiaPacific

EuropeLatinAmericaNorthAmerica

No

Yes

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anyspecificactivitytargetingolderpopulations.Amongthosethatdid,themostcommonactivitiesincludedspecifictrainingandconferencesaswellascampaignstargetingaffectedpopulations.

11. Whopaysfordentalcareofelderlyinyour

country(chooseallthatapply)?30NDAsrespondedtothisquestion

CONCLUSIONBasedontheresultsofthissurvey,itisevidentthatlessthanhalfoftheNDAscollectsomedataonelderlyoralhealth.ThisfigureislowerinAfrica,whereonlyoneNDAreportedcollectingsuchdata.AmongNDAsthatcollectdata,80%doitevery5yearsorless.

DataismainlycollectedthroughNationalAgenciesorUniversityDentalProgrammes,withtheroleofstatesandtownsbeingminor–only9%ofanswerscitedthemasameansofdatacollection.

Accordingtotheanswers,dataismostlycollectedthroughtheparticipationofanexaminer.Mostofitisdisseminated,mainlythroughacademicthesisandjournals.

Regardingcoverageoforalhealthcosts,NDAsreportdifferentnationalhealthsystemswithmodalitiesthatcombineuniversalcoverageorgovernmenthealthinsuranceswithmodelsbasedonprivateinsuranceornoinsurance.

DISCUSSIONThesurveyshowsroomforimprovementregardingdatacollectionanddissemination.Furtherdataonelderlyoralhealthcouldbecollectedifmoreself-reportingmodelswereputintoplace,aslessstaffwouldbeneededforthattask.Furthermore,moreandbetterdatacouldbecollectedthroughinstitutionsthatareclosertothepopulation,ratherthanthecurrentsituationinwhichmostdatacomesfromnationalagenciesoruniversities.

Ontheotherhand,amajorpartofthedisseminationisdonemainlythroughacademicjournalsandthesis,whichcanpreventanimportantpartofthepublicfromaccessingvaluableinformation.Here,moreopennesswithregardsaccesstodataonelderlyoralhealthcouldenablestakeholderstohaveabetterinsight.Thuseasingtheprocessintacklingthecurrentandfuturechallengesposedbyageingpopulationsinthecontextoforalhealth.

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13

16

21

Universalhealthcoverage

Privatehealthinsurances

Governmentalhealthinsurances

Nohealthinsurance

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ANNEX–RESPONDENTNDAs

Afghanistan AfghanistanDentistAssociation

Australia AustralianDentalAssociation

Austria AustrianDentalChamber

Bangladesh BangladeshDentalSociety

Benin AssociationdesChirurgiensdentistesduBénin

Brasil ABCD/APCD

Bulgaria BulgarianDentalAssociation(BgDA)

BurkinaFaso L'associationdeschirurgiensdentistesduBurkina

Canada CDA

Chile ColegiodeCirujanoDentistadeChile

CostaRica UniversidadSantaPaula

Croatia CroatianDentalChamber

Croatia CroatianDentalSocietyCma

Cuba SociedadCubanadeEstomatología

CzechRepublic

CzechDentalChamber

Denmark DanishDentalAssociation

Egypt EgyptianDentalAssociation

Egypt EgyptianDentalSyndicate

Estonia EstonianDentalAssociation

Finland FinnishDentalAssociation

France UFSBD

Germany Bundeszahnärztekammer(GermanFederalChamberofDentists)

Greece HellenicDentalAssociation

Greece StomatologicalSocietyofGreece

Honduras ColegioDeCirujanosDentistasdeHonduras

HongKong HongKongDentalassociation

India IndianDentalAssociation

Iran IranianDentalAssociation

Ireland IrishDentalAssociation

Israel IsraelDentalAssociation

Japan JapanDentalAssociation

Lithuania LithuanianDentalChamber

Macedonia MacedonianDentalChamber

Macedonia MacedonianDentalSociety

Mali AOSMAAssociationDesChirurgiensDentistesDuMali

Mauritius MauritiusDentalAssociation

Norway TheNorwegianDentalAssociation

Pakistan OPD-OrganizationForPeople'sDevelopment

Pakistan PakistanDentalAssociation

Poland PolishDentalSociety

Portugal PortugueseDentalAssociation

RepublicDemocraticoftheCongo

ANCD(AssociationNationaleDesChirurgiensDentistes)

RepublicofKorea

KoreanDentalAssociation

SaudiArabia SaudiDentalSociety

Serbia DentistryOfPrimaryHealthCare

Serbia SerbianDentalSociety

Seychelles DentalAssociationofSeychelles

Singapore SingaporeDentalAssociation

Slovakia SlovakChamberofDentists

Slovenia SlovenianDentalAssociation

Spain ConsejoGeneraldeDentistasDeEspaña

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Srilanka SrilankaDentalAssociation

Sweden SwedishDentalAssociation

Switzerland SSO

Tanzania TanzaniaDentalAssociation

TheKyrgyzRepublic

Stomatological(Dental)AssociationofTheKyrgyzRepublic

Tunisia STMDLP

Turkey TurkishDentalAssociation

Ukraine UkrainianDentalAssociation

UnitedArabEmirates

EmiratesDentalAssociation

UnitedStatesofAmerica

AmericanDentalAssociation

Uruguay AsociaciónOdontológicaUruguaya

Zimbabwe ZiDA