Older Australians deserve good oral care

from LASA Fusion Winter 2021

Redefining aged care and

ORAL HEALTH FOR OLDER AUSTRALIANS WAS IGNORED IN THIS YEAR’S FEDERAL BUDGET, DESPITE BEING KEY TO OVERALL WELLBEING

Access to appropriate oral health care services is not a privilege but a basic human right.

While other allied health services such as podiatry are provided via Medicare to older Australians to assist with mobility and the prevention of falls, there are no such provisions made for oral health.

It was hugely disappointing, therefore, that the recent Federal Budget ignored several recommendations from the Royal Commission into Aged Care Quality and Safety aimed at transforming the oral health of older Australians.

These included a recommendation—as made by the Australian Dental Association NSW alongside a coalition of key stakeholders in a submission to the Royal Commission—by Commissioner Lynelle Briggs for every care provider to engage an oral health practitioner to help address the oral health needs of older Australians receiving care.

There’s huge unmet need in the care and maintenance of natural teeth in a population who are often frail and dependent on others for personal care. The Royal Commission heard distressing evidence, for example, of residents in aged care going without basic oral health items such as toothbrushes and toothpaste. Tooth decay and gum disease are the most common chronic diseases in Australia. Despite these diseases being extremely prevalent, they are not identified by residential aged care staff or carers due to gaps in their knowledge and understanding and reticence to look in residents’ mouths. Both are preventable by the provision of simple, regular oral health care.

However, the oral health status of the frail elderly is equally poor, whether they live in residential facilities or are being cared for at home.

As this population transitions from independent living to needing assistance with their daily activities, levels of dental

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plaque, calculus and food debris can become extremely high due to the significant barriers in provision of adequate oral hygiene measures.

Within the majority of aged care homes, only minimal oral hygiene care is provided as more urgent needs such as toileting, bathing and feeding are prioritised by the already over-stretched facility staff.

Residents with dementia and other cognitive disabilities can be challenging for staff to manage, creating further barriers to their provision of oral care. In addition, their inability to report oral health problems may mean that significant oral health issues go unnoticed.

Poor oral care for older Australians has been estimated to cost $750 million a year, starkly underlining the critical need to address this situation.

ADA NSW attaches no blame to aged care providers for the current situation. Oral health is a specialised area which must be overseen and provided by those trained to do so. Many if not most aged care staff will lack knowledge of dental issues to provide sufficient care for residents. In NSW there are currently models of care and workforce capability that can be scaled up to help ensure older Australians receiving care have their oral health needs met by ensuring they at least have access to a dental practitioner and professional oral care. Programs such as the successful and cost-efficient Senior Smiles project, which has been running since 2009, offer a blueprint for achieving this.

Ensuring that older Australians can live free from oral pain and be able to gain adequate nutrition, communicate freely and have the best possible quality of life is essential. Having oral health recognised by the Royal Commission was a terrific first step, but more now must be done.

As graphically illustrated over the last two years, the substantial overhaul of the aged care sector was critical to ensure our older Australians receive the care they need and deserve. While the lack of funding in this year’s Budget was a huge missed opportunity by the Federal Government, ADA NSW and other stakeholders will continue to advocate for the transformation of oral health services for older Australians receiving care.