Caring for our ageing population
Dr Angie Nilsson is the Clinical Director of Oral Health Services for Townsville Hospital and Health Services and is a passionate advocate for closing the gap of oral health inequalities. She is set to tackle the gap in oral health care for older people with her PhD research at JCU. Dr Nilsson explains how she intends to help prepare the dentists of tomorrow to care for our ageing population.
There is an oral health bomb ticking. It’s in Australia, it’s in India, it’s in Japan, it’s in every single country. Between the years 2020-2030 Australia's older population is projected to increase by 139 per cent. The worse thing about it is that we have known about it for years, experts and advocates for oral health in older people and have been saying it for ages, this call for action.
The day I realised this time bomb was ticking for me, was when I was working as a dentist in Tasmania. Having a chat with my boss about how I was going to look after my patients who were moving into aged care facilities.
"Oh we don't do that," he said. "Insurance won't cover it."
"So who does do it?" I asked. "Who's going to fix up Mrs Smith's teeth now that we have been looking them over her five year decline into frailty and care dependence?”
"No one. No one's going to go there. No one really wants to," he said.
I started looking into how we are going to support future dentists to deal with this explosion of older people. Because this group of people have changes happening in their mouth that is different to other aged groups and comes in a package of co-morbidities and complex medical histories. Not only this, but oral health is linked to our general health. People in residential aged care facilities are more likely to get aspiration pneumonia because of poor oral health.
Preparing dentists for the future
My PhD question is whether Australia is preparing a workforce of dentists to manage this growing population of frail and care-dependent people. We have paediatric dentist specialists; surely we should be looking into getting some geriatric dentist specialists as well? Gerodontology is the branch of dentistry that deals with the oral health of older people, and it is recognised as a specialty in one country, Brazil. So if dentistry hasn't moved with the times by the time I’m 65, Rio looks like a pretty good place to retire!
We all age differently, it is not about numbers. The definition of an older person might be 65, if you talk to someone from the Australian Bureau of Statistics. Aboriginal and Torres Strait Islander people define older when they reach 55. Ageing is different for everyone but one thing we know for sure is our population is getting older faster than ever before and we are keeping our teeth for longer than ever before.
Dentistry has changed, materials are getting better, techniques are getting better. Societal norms for how we view having teeth have changed. It is not acceptable to have a set of plastic teeth when a person enters a nursing home anymore, because our quality of life and our general health is improved by having our own dentitian.
So of course, we need a future workforce of health professionals to be equipped with the skills, knowledge and attitude who are ready to look after our teeth now, and into older age. My project will explore the stakeholder perceptions of gerodontology education in dental schools to provide the goals, objectives and educational strategies to inform a curriculum that will enable our dentists to be ready to manage Australia's older population.
Featured researcher
Dr Angie Nilsson
JCU's College of Medicine and Dentistry
Dr Angie Nilsson is an experienced dentist, educator and leader with a diverse and broad clinical capability. She is the Clinical Director of Oral Health Services for Townsville Hospital and Health Services. In her role, Dr Nilsson is responsible for developing, delivering and maintaining a clinical standard of excellence for public oral health services in the Townsville region, through research, teaching, supervision and service development.
Dr Nilsson developed an aged care dental curriculum for dental students as part of a Master's research project, to highlight the need for change in aged care dentistry. Her PhD research area is centred on gerodontology and closing the gap in inequality for the oral health of older people.