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The crisis in oral health care for older people in Northern Ireland must be tackled now

Blog Author Caroline Lappin

Blog Date 15/03/2019

Older patient and child dentist


​We continue to highlight the growing pressures on dentistry in regards caring for our ageing population in Northern Ireland, and we have been featured in a recent article for Irish Dental Magazine on the subject, calling for urgent action.

Northern Ireland has the fastest-growing ageing population amongst the UK countries, and the Northern Ireland Statistics and Research Agency (NISRA) has projected that the number of adults aged 65 and over is to increase by a massive 64% between 2013 and 2033.

The pressures for those working in the community dental service will continue to mount and older people's oral health continues to pose significant challenges for dental commissioners, both now and in the future.

We know that people's teeth are more susceptible to decay as they age. This can result in tooth loss, but increasingly, we are seeing older people keeping their teeth in later life – the rates of edentate adults in Northern Ireland is rapidly falling.  In 1979 33% of adults had no teeth, today it is around only 4%.

The numbers of people living in care homes is also rising sharply, as people live longer and experience long-term health conditions. And we know that the oral health of those in care homes tends to be worse than those living in the wider community.

The reasons for this are multi-faceted, but there is something the dental profession can do about it, with the appropriate investment in a truly preventative strategy. The lack of any strategy to deal with these challenges is beyond concerning.

We've pointed out the huge gaps in provision, and the need for the community dental service and the general dental service to be part of a joined-up policy approach to improve the oral health of those in care homes, with a holistic approach involving other healthcare professionals.

Richard Graham, NIDPC Chair recently wrote to the Chair of the Health and Social Care Board (HSCB) to highlight a number of issues, mainly the recent dental budget underspend, the financial pressures GDPs are under and the gaps in service as far as the older population is concerned – the fees currently make it a charitable activity for GDPs to undertake domiciliary visits; it simply doesn't stack up financially.

BDA Northern Ireland representatives also attended the February meeting of the Health and Social Care Board, at which Michael Donaldson, Head of Dental Services delivered a presentation on current gaps in ageing provision. The case for additional resources both at CDS, and at GDS level was clearly articulated.

Ageing population issues are just one visible demonstration of why we need a new oral health strategy now – one that we can put into action to benefit our full range of patients.


Now that the evidence has been presented to the HSCB we will be ensuring that they, and the Department, start to meaningfully address this issue.

We will keep pressing for action on your behalf.

caroline-lappin-125px.jpgCaroline Lappin, BDA Northern Ireland Council


BDA Northern Ireland

BDA Northern Ireland supports, represents and promotes, the interests of all dentists working in Northern Ireland. Working with elected committee members, we negotiate on behalf of the profession on terms and conditions, pay and contracts. Join us.