Dental attendance patterns among older people: a retrospective review of records in public and private dental care in Sweden.

OBJECTIVES: Nowadays, older people retain their natural teeth more frequently and so are at increased risk of oral disease. At the same time, discontinued contacts with dental services prevent access to preventive care and increase the risk of undetected disease. This study aims to evaluate how often older people discontinue regular dental visits and to establish the reasons. METHODS: This study is a retrospective review of records of patients aged ≥75 years from seven Swedish clinics, three in the public dental service (PuDS) and four in the private (PrDS). All patients were examined in 2010, and their dental attendance records from 2010 to 2014 studied. Data included gender, dental insurance system, last performed planned examination, emergency visits, registrations in the recall system, cause of discontinued care and number of teeth and implants. RESULTS: In total, 993 records were studied, 303 in PuDS and 690 in PrDS. In both groups, 10% of patients had no complete dental examinations between 2010 and 2014 after baseline examination in 2010. One-quarter were not registered in the recall system after their last examinations, and this was more common in PrDS than PuDS. In many cases, no reason for discontinued regular visits were described in the records. The mean number of natural teeth was 19.0 in both groups, but there were more implants in the PrDS group. CONCLUSIONS: A large proportion of the participants risked losing regular contact with dental services. Dental services appeared to lack strategies for maintaining regular dental care for elderly patients.

Older people's description of factors that facilitate and impede regular dental care - a qualitative interview study.

OBJECTIVES: The aim of this study was to achieve an understanding of older people's view of the benefits of regular dental care and investigate factors that facilitate and impede regular dental care. METHODS: A qualitative research method was used. To gain a deeper understanding of the elderly people's views, individual interviews were conducted. Fifteen respondents, eleven women and four men aged between 65 and 95, participated, all recruited from senior social centres. All interviews were tape-recorded and transcribed verbatim, and the content analysis method was then used. Meaning units were identified and condensed into codes which were labelled and grouped into categories and subcategories. RESULTS: Findings were grouped into three categories: experiences of dental care, obstacles and facilitators to dental care and about oral health and responsibility. The elderly had experience of both regular and irregular dental care. Obstacles to visiting dental services included high costs and complicated dental insurance, other practical obstacles, lack of confidence in dentistry and seeing no benefits of dental care at their age. Views of the importance of oral health varied, and some people thought poor teeth were shameful. Some expressed that oral health was your own responsibility, while others thought that oral health was the responsibility of the dental services. CONCLUSIONS: Several factors which hamper regular dental care have been identified, and taken together, these obstacles often became unsurmountable. However, individuals taking their own responsibility for their dental status and dental services making certain adaptations, both encourage people to seek regular dental care.