Oral health and healthy ageing in the Hong Kong context

Abstract

Aim: (1) To determine older people’s views of oral health and healthy ageing in the Hong Kong context using a mixed methods approach; and to identify variations in their perceptions. (2) To evaluate the impact of a healthy ageing and oral health intervention on changing perceptions to oral health and healthy ageing.

Methods: At three day care centres for older people in Hong Kong, elders attending (119) were invited to participate in an a face-to face interview survey on ‘oral health and health ageing’. Following on six focus group discussions were held at two of the centres and transcripts were analyzed qualitatively using a thematic approach. An oral health education talk was delivered and follow-up assessments of their views of oral health and healthy ageing one month later were obtained.

Results: 63.9% (76/119) of day care elders participated in the survey. Oral health was largely viewed in terms of caries and periodontal health status - ‘teeth and gums’ (73.7%, 56) – with little understanding of the importance of other oral tissues. There was awareness of relationship between oral health and systemic health (61.8%, 47). Awareness of the impact of oral health on quality of life was relatively common (47.9%, 44) but limited in perspective to physical attributes. Awareness of potential oral health related risk factors for health ageing was poor and limited.

Thematic analyses identified differences in perceptions of oral and healthy ageing but retaining natural teeth was not consistently perceived as important for health ageing, particularly in older age. Dentures were perceived as having limited value. The relationship between oral health and systemic health was not well understood or believed. There was limited perceptions of the value of oral health beyond ‘eating’ and ‘comfort’. Hygiene was perceived as key to oral health and healthy ageing.

The response rate to the healthy ageing and oral health intervention was 79.3% (42/53). The ‘oral health and healthy ageing’ initiative did increase awareness of oral health beyond ‘teeth and gums’ (p<0.05), but the importance of other oral tissues as integral to oral health remained low. There was no significant improvement in awareness of relationship between oral health and systemic health (p>0.05). The oral health and healthy ageing initiative did significantly increased awareness of the impact of oral health to quality of life (p<0.05) and also the multidimensional nature of oral health (p<0.05). Awareness of the multiple potential risk factors for oral health and healthy ageing did not significantly improve (p>0.05), and remained low.

Conclusions: Many older people at the day care centres who participated in our community health project did not perceive oral health as contributing to healthy ageing. Understanding of the potential benefits of dental prosthesis was poor. Risk factors associated with poor oral health were not well understood. An intervention programme improved perceptions of oral health and healthy ageing (at least in the short term); but failed to improve understanding of potential risk factors that are important for oral health and healthy ageing.