THERE is the concept of socialisation, which is the term given to the process whereby we learn the values and norms of a group or society.It is an ongoing and gradual process which continues throughout life. By the age of three years, for example, children know many of the basic norms and conventions practiced, in their culture, such as the ‘correct’ toys for boys and girls and the occupations that adult males and females typically enter.

Children are very adept at picking up norms and rules which make health care in general and oral care in particular, an important aspect at this stage in everyone’s life.

The process of transmitting general cultural information, including ideas about health, is termed primary socialisation. MacEntee et al. (2011) suggest from their study of 521 people aged 70 years and over that the oral health and related behaviours established early in life are crucial.

An interesting oral health example was provided by King (2012), who interviewed a group of mothers with young babies to establish the degree of comparison between mothers’ and children’s sugar intake.

This researched discovered that mothers who consumed excess sugary foods had the bad habit reflected in their infant off springs. For example, mothers had a habit of sampling their babies’ feed before giving it to them. If the mother has a so called “sweet tooth”, they would tend to sweeten the child’s milk to suit their (mothers) own taste. So, the experiment showed babies with a high sugar consumption also had mothers with a high sugar consumption.

These early childhood habits, once learnt, would have a longer term impact upon the permanent dentition and possibly lead to obesity. The outcome of the parent acting as a role model for the child has also been demonstrated in adolescence. There is a proven association between parent and offspring oral health behaviours, such as tooth brushing and the drinking of sugar-free mineral water.
Children should be the number one priority in the development of dental services, so that the dental health of future adults can be safeguarded.

There is also the relationship between age and oral health, where older people often present particular oral health problems. Those who have always attended the dentist regularly will probably continue to do so and retain some or all of their teeth.

One study investigated the oral health-related quality of life reported less dental pain or discomfort, fewer eating problems and less were positively related to use of dental services.

Researchers Slade and Spencer (2013) investigated the social impact of oral conditions in 1217 older people. It was found that older age was associated with significantly greater amounts of impact, with edentulous males reporting higher impact scores than edentulous females. About 10% of this sample reported problems with chewing food and avoidance of certain foods fairly or very often. These impacts reflect a lifetime of disease experience.

Levels of dental anxiety may also vary by age. The Corah Dental Anxiety Scale was administered to a sample of 580 people aged between 50 and 89 years of which were classified as anxious/fearful.

Older individuals had lower scores than the younger, meaning that they were more willing to be treated, although when an older dentally anxious person scored high they were less likely to have a source of regular dental care, less likely to have avoided or delayed dental treatment.

Members of the primary dental care team should recognise that the general quality of life is clearly linked to oral health in older people. The dental condition may contribute to nutritional intake.

Systemic diseases and the medications taken to treat them will also often have sensory function. It has been proposed that organisations of oral origin development of alliances between primary and oral medical care teams, to ensure that any general health assessment of an older person included an oral component, and that oral conditions, once identified, are treated.

Dr BERTRAND R. STUART, DDS