Oral hygiene practice: the experiences and perspectives of older adults

Abstract

Increasing longevity has brought with it evolving trends in dental health. Older adults are, now more than ever, maintaining their natural teeth longer in life. The benefits of preserving a natural dentition are considerable and among other advantages have shown to increase one’s quality of life. Alongside the maintenance of natural teeth many older people have partial or complete dentures to care for and maintain, therefore oral care has the potential to become more complicated. Rates of periodontal disease are recognised to increase substantially with age while rates of dental decay in the older population increase. These concerns have been raised by experts in the field and the World Health Organisation have urged countries to implement suitable strategies to improve the oral health of older people.

This study seeks to investigate the experience of oral hygiene maintenance and explore the challenges that older people are faced with when trying to maintain appropriate oral hygiene practices at home. The opinions of independently living older adults were sought as little is known about their personal oral health practices and associated experiences.

In an attempt to understand the potential impact ageing may have on oral hygiene practices, the aims of this research comprise;

1. Explore the narratives of older adults regarding the maintenance of natural teeth in older age.

2. Identify the most common practices adopted by older adults to care for their natural dentition and explore the associated behaviours and influences.

3. Determine if there are challenges which impact oral hygiene behaviour/practice later in life.

4. Theorize about this phenomenon in order to provide better insight and understanding of how teeth are cared for/maintained in old age.

5. A constructivist grounded theory methodology was adopted which allowed the generation of substantive theory - A theory of ageing and perspectives on oral hygiene (APOH). It is hoped this theory will assist in providing an insight and better understanding of the common oral hygiene behaviours and practices of the independently living, older adult population. As well as this, the theory developed offers an interpretive explanation of why older adults may fail to identify problems in their personal practice The perspectives of this older cohort were gathered from 2 separate semi structured interviews. A 2 week oral hygiene diary was also maintained by participants in-between in an attempt to further pursue the everyday thoughts and experiences/practices of older people maintaining an oral health routine at home.

Three core categories were developed from the data and were intimately linked with one contributing to or impacting upon the next. The 1st core category identified that the meaning and significance of dental health, as well as the experience of personal oral hygiene, changes and evolves over the course of an individual’s life. The 2nd core category highlights how natural teeth become a prized possession and oral hygiene self-care is perceived to improve significantly by independent older adults, later in life. As a result, and detailed in the 3rd and final core category, challenges impeding practice were much less of a concern and rarely considered among this ageing cohort.

‘A theory of ageing and perspectives on oral hygiene’ contributes to knowledge by explaining the viewpoints of the independent older adult regarding personal oral hygiene, providing a better understanding of common practices. It also explains how and why older adults may become less aware of issues within their personal oral hygiene practice, later in life.