CONSIDERATION of the relationship between age and oral health is important for two reasons. First, 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 such rules.

The process of transmitting general cultural information, including ideas about health, is termed primary socialisation. Research suggests from a 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 a group of mothers who were interviewed.

They all had young babies and the survey was done to establish the degree of comparison between mothers’ and children’s intake of sugar. It confirmed that both their babies with a high sugar consumption also had mothers with a high sugar consumption. The concern was that 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. Scientific analyses identified associations between parent and offspring oral health behaviours, such as tooth brushing and the drinking of sugar-free mineral water. It was further proven that children should be the number one priority in the development of dental services so that the dental health of future adults can be safeguarded.

A second reason for being interested in the relationship between age and oral health is that 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. Of course, retaining one’s teeth in a relatively healthy state until one attains an advanced age, has genetic implications. One study which 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.

When investigated, it was found that the social impact of oral conditions in older people was important. Older age was associated with significantly greater amounts of impact, with edentulous (without any natural teeth) males reporting higher impact scores than edentulous females. About 10 per cent 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 dental anxious, with older individuals having lower scores than the younger. An older dentally anxious person was 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 a sensory function. It has been proposed that organisations of oral health origin, develop alliances between primary and oral medical care teams, to ensure general health assessment of an older person.

So physicians who see elderly patients for medical conditions must include an oral component whereby the patients are routinely referred to dentists, and that oral conditions, once identified, are treated.