20 July 2023

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Rethinking oral health in aging

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Poor oral health affects the health and well-being of older adults in many ways. Despite years of international research investigating poor oral health among older adults, it has remained a largely unresolved problem.

Rousseau et al. (2014) captured how the stigma of compromised oral health in aging, the grief around tooth loss and the shame of wearing dentures can greatly affect an individual’s well-being. These issues interface with ageism, reflecting negative and often discriminatory views about older people, compounded by issues such as racism and sexism directed at people in minority groups.

With the older adult population increasing in number and proportion, beliefs are changing that tooth loss and poor oral health are a natural consequence of normal aging (Slade et al. 2014; Bassim 2018). However, with aging can come reduced mobility and cognitive function and declining financial security and access to healthy nutrition, resulting in the increased need for dental services yet with difficulties accessing them (e.g., transportation, financing; Bassim 2018; Kotronia et al. 2021).

The aim of this article is to explore the combination of two key frameworks, ecosocial theory and intersectionality, to guide our exploration and understanding of oral health and aging and help inform research, education, policy, and services.

Proposed by Krieger, ecosocial theory is concerned with the symbiotic relationship among embodied biological processes and social, historical, and political contexts. Building on the work of Crenshaw, intersectionality explores how social identities such as race, gender, socioeconomic status, and age interconnect in ways that can enhance privilege or compound discrimination and social disadvantage.

Intersectionality offers a layered understanding of how power relations reflected in systems of privilege or oppression influence an individual’s multiple intersecting social identities.

Understanding this complexity and the symbiotic relationships offers an opportunity to reconsider how inequities in oral health for older adults can be addressed in research, education, and practice and increase the focus on equity, prevention, interdisciplinary care, and use of innovative technology.

Slack-Smith L, Ng T, Macdonald ME, Durey A. "Rethinking Oral Health in Aging: Ecosocial Theory and Intersectionality." Journal of Dental Research. 2023;102(8):844-848. doi:10.1177/00220345231175061