gerodontology – the case for education
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Ed i to r ia l
Gerodontology – the case for education
As many contributors and readers of this Journal
are aware, very significant demographic changes
have taken place and continue to do so at a rapid
rate. Not so long ago the subject of gerontology, let
alone gerodontology, was a minority area, which
was of only peripheral interest to the majority of
health care providers. Generally old age with all the
various impacts on activity, socialising and diet was
regarded as a process which was accepted as an
inevitable restriction on daily life. One of the most
profound was the loss of the natural dentition and
their replacement with often inadequate prostheses
leading to a limitation of mastication and therefore
the choice of food. Although the number of
edentulous individuals has fallen dramatically over
the last 30 years, the percentage of this group
having problems with speaking, eating and drink-
ing has remained the same. However, the subject
area of gerodontology had its enthusiasts; among
them people involved with the setting up and
development of this Journal as a forum for
research, exchange of clinical techniques and pro-
cedures and the development of partnerships. Also
part of this process is the education of the profes-
sion and hopefully those that come into contact
with elderly people. One of the best times to
inculcate this understanding is during the educa-
tional process.
In the UK, education in gerodontology now
forms a key passage in the General Dental
Council’s framework for undergraduate dental
education, The First Five Years (2002) and I am
sure this would be replicated in other countries.
They state that ‘the student should be aware of
the presentation of dental and oral diseases and
disorders in elderly people, and the range of
psychological and social factors involved in such
situations… be able to distinguish between nor-
mal and abnormal consequences of ageing’. They
also state that the individual ‘should be able to
formulate management strategies for the dental
care of elderly people, and participate with
members of the dental team in implementing
them’. One very important point is also made
which is almost lost within the text but has much
wider implications than just within a dental
curriculum; ‘…learn to avoid stereotyping elderly
people’. It could be suggested that this maxim
should be applied to society at large.
However, it would appear that this educational
process is very variable, even in countries with a
high proportion of older people in their popula-
tions. In some countries, dental schools have a high
prevalence of departments specially devoted to
geriatric or special care dentistry, whereas others do
not. A study of undergraduate teaching in gero-
dontology in dental schools in three European
countries, reported in this issue, indicated large
differences. These ranged from well-established
courses with clearly defined outcomes to very little
being readily identified in the curriculum. A sur-
prising outcome was the view of some dental deans
who did not want the little that was already
included to be increased. Also, hands-on teaching
in nursing homes was rare although it could be
suggested that this would present the undergra-
duate with an insight into the potential difficulties
and limitations of home-based dental care.
An approach which is being taken by the
Association for Dental Education in Europe (ADEE)
is to harmonise the dental curricula across Euro-
pean countries by developing the criteria for the
profile and competencies for the new European
dentist. The Commission of the European Com-
munities has adopted a directive of the European
Parliament and of the Council on the recognition of
professional qualities. Part of this document states
that ‘member states must ensure that the training
given to dental practitioners equips them with the
skills needed for prevention, diagnosis and treat-
ment relating to anomalies and illnesses of the
teeth, mouth, jaws and associated tissues’. The
ADEE document has been out to consultation to
European Dental Schools so that the major com-
petencies of professionalism, knowledge base,
information handling and critical thinking, diag-
nosis and treatment planning, establishing and
maintaining oral health, and health promotion can
be clearly defined with their supporting compe-
tencies. It is anticipated that this document will be
adopted as a framework at the meeting of ADEE
taking place in September and will form a con-
sensus on the future direction of dental education
in order to improve the oral health care systems for
our patients.
In approaching the education of the older per-
son, it has been reported that participating in
activities that stimulate the mind can have a pos-
itive effect on the mental processes and may offer
some protection against senile dementia. These can
be as diverse as crossword puzzles, chess and ball-
room dancing. It has been suggested that learning
� 2004 The Gerodontology Association, Gerodontology 2004; 21: 121–122 121
to speak a second language can not only broaden
the mind but also goes some way to offsetting the
decline of the brain. Research from Canada, where
11 percent of the population speak two languages,
has shown that these individuals have faster reac-
tion times and are less easily distracted while
completing mental agility tasks than those who
only speak a single language, this being signifi-
cantly greater in the older age group. The other
area which is key to the improved quality of life is
to be able to educate the older person and their
carers in preventive oral health. In Japan, a study is
looking at how a telecare system can address some
of these issues by providing a tutorial programme.
This includes information on oral homecare, edu-
cation on oral and general health care and
enhancement of life skills related to exercise and
interpersonal communication. Initial results in this
issue provide a number of interesting ideas as to
how this concept might be utilised.
The clear message that is coming from all of this
is the need for an integrated approach to meet the
aspirations of future oral health care professionals
as well as the needs of this particular group of
patients.
To borrow the phrase of a well-known Prime
Minister: Education, education, education!
James P. Newton
Editor
� 2004 The Gerodontology Association, Gerodontology 2004; 21: 121–122
122 Editorial
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