Discussions on oral health care among elderly Chinese immigrants in Melbourne and Vancouver

Factors affecting oral and dental services` utilization among Elderly: a scoping review

BACKGROUND

Regular use of oral and dental services by the elderly is one of the important factors in reducing oral and dental diseases. This study aimed to identify the factors affecting oral and dental services` utilization among elderly.

METHODS

The published articles on the factors affecting oral and dental services` utilization among elderly were found through a scoping search and using related keywords in PubMed, Scopus, Embase, and Web of Science databases within January 2000 - December 2022 according to the PRISMA guidelines. The data were analyzed using the thematic analysis method.

RESULTS

Among the 2381 articles retrieved from the databases, forty-two were extracted. The factors affecting oral and dental services` utilization among elderly were classified into five main components as follows: access, demographic factors, social factors, health level, and mental factors. The results showed that income, education level, living area, number of teeth, and importance of care were the most frequent in the main components of access, demographic factors, social factors, health level, and mental factors, respectively.

CONCLUSION

Equitable utilization of oral and dental services is the right of all members of the society, especially the elderly. Therefore, it is necessary to provide the elderly with suitable conditions to utilize such services, which are mostly luxury items. Furthermore, increasing the elderly's awareness and encouraging them to use oral and dental services regularly can help reduce the burden of oral and dental diseases.

Immigrants experience oral health care inequity: findings from Australia's National Study of Adult Oral Health

BACKGROUND

Oral health service utilization contributes to positive oral health and indicates realised access to services. The study aimed to describe patterns of oral health service use among overseas-born and Australian-born populations and assess equity in access to services.

METHODS

The study used data from Australia's National Study of Adult Oral Health 2017-2018 and was guided by the Aday and Andersen framework of access to health and Australia's National Oral Health Plan. Descriptive analyses of service use by perceived need, enabling and predisposing factors were compared between four groups: Australian-born and overseas-born who mainly speak English and Australian-born and overseas-born who mainly speak a language other than English.

RESULTS

Overseas-born who mainly speak a language other than English experienced greater oral health care inequity, largely driven by financial difficulty (avoided care due to cost: 42% vs 27%-28%; avoided/delayed visiting due to cost: 48% vs. 37%-38%; cost prevented treatment: 32% vs. 18%-24%). The most favourable visiting patterns were among the Australian-born population who speak a language other than English.

CONCLUSIONS

The study shows clear inequity experienced among immigrants in accessibility as measured through indicators of oral health care utilization and factors related to inequity, such as the ability to pay for services.

Factors Associated with Knowledge, Attitudes, and Practices Related to Oral Care Among the Elderly in Hong Kong Community

Background: The oral health of elderly populations is a significant concern, as it is closely linked to general health and health-related quality of life. Poor oral health exacerbates oral diseases, leading to an increased risk of non-communicable diseases and self-care dependence, particularly in the elderly, worldwide. Knowledge, attitudes, and practices (KAP) play influential roles in individual oral care. However, the evidence of KAP related to oral care among the elderly is still inadequate. Objective: This study aimed to examine KAP and their associated factors related to oral care among the elderly community. Methods: A cross-sectional descriptive design was used. The eligible subjects were recruited, using convenience sampling and snowball sampling. Results: A total of 385 elderly individuals were included, and 51.4% were women. The mean age was 71.66 (SD 6.28). Knowledge was reportedly poor, as more than 50% elderly answered several questions incorrectly. The mean attitude and practices scores were 44.94 (SD 6.33) and 68.90 (SD 10.44), respectively. There was a significant correlation among knowledge, attitudes, and practices (p < 0.001). Multivariable regression analysis revealed numerous factors had remarkably significant association with knowledge [R² = 0.30, F (4,380) = 11.96, p < 0.001], attitudes [R² = 0.28, F (6,378) = 9.27, p < 0.001], and practices [R² = 0.31, F (5,379) = 12.34, p < 0.001], particularly education levels, full-time employment, and self-care independence. Conclusions: Based on the KAP theoretical model, KAP are closely interrelated. Identified factors associated with KAP are useful to understand at-risk groups. Elderly individuals at lower education levels, with poor family support and inadequate self-care independence, have poor KAP related to oral care. Therefore, this study improves insight for health promotion developers, suggesting that more attention should be paid to at-risk elderly groups’ oral health. To enhance participation in dental care and improve oral care performance in the elderly, educational program containing oral health knowledge should be offered to at-risk groups. Family support and involvement are also important for improving oral care among elderly individuals.

Oral health needs of older migrants with culturally and linguistically diverse backgrounds in developed countries: A systematic review

OBJECTIVES

To identify and synthesise the available evidence regarding the oral health needs of and the oral health promotion provided for older, cultural and linguistically diverse (CALD) migrants in developed countries.

METHOD

Databases were searched using search terms to identify all relevant English-language research studies published between 2000 and January 2018.

RESULTS

Thirty-nine articles met the review criteria. Thirty-three papers reported on the oral health needs of CALD older migrants and 6 on oral health programs provided for older migrants.

CONCLUSIONS

Cultural and linguistically diverse older migrants have high oral health needs and poor oral status and face a variety of barriers in accessing oral health care in their host countries. Recommendations to improve their access to oral health programs include building transcultural dental training into the educational requirements of dental students and developing oral health promotion programs that include culturally and linguistically customised information.

Developmental regulation of lifelong dental experiences and beliefs in Guangzhou and Hong Kong

AIMS

The aim of this study was to explain through the life-course and life-span perspectives of developmental regulation theory the controls on dental experiences and beliefs throughout the lives of older people in Guangzhou and Hong Kong.

BACKGROUND

Dental diseases and disabilities among older people are serious public health concerns in China.

METHODS

A facilitator conducted eight focus groups, three in Hong Kong and five in Guangzhou, involving a total of 51 participants. She encouraged discussions about lifetime events to explain dental experiences and beliefs. Transcripts were coded and analysed using a constant comparative approach to identify themes that explained the regulators of dental experiences throughout the participants' lives.

RESULTS

Participants explained the influence of culture and history through critical events, and how external and internal factors regulated their current oral health status and beliefs. They emphasised the role of Traditional Chinese Medicine and family, and the stress of social upheaval compounded by a scarcity of dental services. They revealed also how current choice of dental services and health promotional programs, helped by personal food choice, self-reliance, and scepticism, helped them to adjust and cope with dental diseases and disabilities and the commercialisation of dental services.

CONCLUSIONS

Dental experiences and beliefs of older people living in Guangzhou and Hong Kong were regulated strongly during personal development by culture and history during critical events, and by various controlling factors, such as health promotion and choice of services supplemented by food choice, nutritional balance, self-reliance, scepticism and social adjustments.

Health Status and Health Determinants of Older Immigrant Women in Canada: A Scoping Review

Increasing international migration in the context of aging populations makes a comprehensive understanding of older immigrant women's health status and determinants of their health particularly urgent. Using Arksey and O'Malley's framework, we conducted a scoping review to examine the available literature on the health of older immigrant women in Canada. We searched CINAHL, PsycINFO, Embase, Medline, and Cochrane databases for the period of 1990 to 2014 for Canadian-based, peer-reviewed studies on the topic. A total of 20 articles met the inclusion criteria. These articles were divided into six areas of focus: physical health; mental health; abuse; health promotion and chronic disease prevention; barriers to healthcare access and utilization; and health beliefs, behaviours, and practices. Our results show that the health of older immigrant women is affected by the interplay of various social determinants of health including the physical and social environment; economic conditions; cultural beliefs; gendered norms; and the healthcare delivery system. Our results also revealed that older immigrant women tend to have more health problems, underutilize preventive services, such as cancer screening, and experience more difficulties in accessing healthcare services.

Community dental clinics in British Columbia, Canada: examining the potential as health equity interventions

Community dental clinics (CDCs) have emerged to provide oral healthcare for those with low incomes. In British Columbia, the establishment of community clinics has been quite rapid in recent years. However, the expansion has occurred with very little assessment of their impact or effectiveness. While oral health inequities are well recognised, there is limited documentation on healthcare interventions to reduce oral health inequities. This study examines CDCs as health equity interventions from the perspectives of individuals establishing and operating the clinics. The study included interviews with 17 participants--4 dentists, 6 dental hygienists and 7 clinic managers--from 10 clinics operating in British Columbia, Canada in 2008-2009. A thematic analysis of the interview transcripts, explored through a health equity framework, found many ways in which the CDCs exemplify health equity interventions. Although their design and mandates are varied, they potentially enable access to dental treatment, but without necessarily ensuring sustainable outcomes. Moreover, the scalability of CDCs is questionable because frequently they are limited to emergency care and are less responsive to the gradients of needs for populations facing multiple barriers to care. Many of them operate on a charitable base with input from volunteer dentists; however, this foundation probably eases the pressure on dentists and dental hygienists rather than offering a safety net to underserved populations.

The impact of oral health on body image and social interactions among elders in long-term care

OBJECTIVE

The objective of this study was to explore how social interactions and body image are influenced by perceived oral health among older people who live in long-term care facilities.

BACKGROUND

Social interactions among frail elders in long-term care (LTC) facilities are limited, but to what extent body image and oral health influence their social relations is poorly understood. A positive body image and the perception of adequate oral health are linked to increased social contacts, as well as improved health and well-being irrespective of age. However, as frailty increases, it is unclear whether appearance and oral health priorities remain stable.

MATERIALS AND METHODS

Open-ended interviews were conducted with a purposefully selected group of cognitively intact, older men and women who exhibited varying degrees of frailty, social engagement and oral health conditions and lived in one of seven long-term care facilities. The interviews were analysed using a constant comparative technique, and a second interview with participants checked the trustworthiness of the analysis.

RESULTS

Three major categories were expressed by the participants: (1) My mouth is fine; (2) It depends; and (3) Not that important. Within each category, there were several contributing and influencing factors.

CONCLUSIONS

Social interactions among residents in LTC may be negatively impacted by poor oral health, but only if other personal and social issues are less bothersome than conditions with the mouth.

Oral Healthcare Challenges for Older Punjabi-Speaking Immigrants

Cette étude a exploré comment les immigrants âgés d’origine sud-asiatique, parlant le pendjabi (quatre groupes de discussion; 33 participants) de Surrey en Colombie-Britannique, perçoivent leur santé buccale et les problèmes connexes. L’analyse a relevé deux thèmes généraux: les interprétations de la condition bucco-dentaire et les défis de santé bucco-dentaire. Le thème des interprétations avait quatre sous-thèmes: les dommages causés par lewai, les perturbations causé par la carie, l’adaptation aux prothèses dentaires, et qualité de vie; alors que le thème des défis considérés: remèdes à domicile, dentisterie occidentale; et difficultés d’accès aux dentistes. Les participants ont expliqué les maladies bucco-dentaires en termes d’une infection systémique (resha) et ont dit préféré les remèdes faits maison pour diminuer les écarts de chaleur (wai) dans la bouche. Nous concluons que les immigrants âgés d’origine sud-asiatique parlant le pendjabi interprète la santé et les maladies bucco-dentaires dans un contexte mixte de traditions occidentales et Ayurvédique, et gèrent leur santé buccale au moyen de remèdes traditionnels faits maison, complémentés au besoin par des soins d’urgence dispensés au Canada.