Specialist dental clinic for elderly with medical, cognitive conditions

4/5/2023 11:37:00 AM | The Straits Times

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SINGAPORE - The National University Centre for Oral Health Singapore (NUCOHS) has set up its first satellite specialist clinic at Alexandra Hospital (AH) to manage and treat dental issues of elderly patients with pre-existing or cognitive and other chronic conditions.

By joining forces with AH, which already has a programme that helps seniors with age-related cognitive, functional and mobility challenges, the specialist clinic makes it convenient for these senior patients to seek preventive and restorative dental treatment.

Basic non-surgical management and oral hygiene instruction, and minimally invasive procedures such as tooth decay management and extractions, will be provided to restore the oral health of elderly patients.

These are seniors who are not suitable to be seen by regular dentists because of existing medical conditions such as diabetes, dementia and cancer, which require special considerations and treatment plans.

It is a little known fact that oral disease in seniors can increase the risk and worsen the control of common conditions like diabetes, hypertension, heart disease and chronic obstructive pulmonary disease, said AH chief executive Jason Phua.

This worsens their quality of life, he added.

“This is why we have built the NUCOHS Dental Clinic @ AH within our hospital, where dental professionals and other specialists and members of our team can work together as one to care for seniors, both hospitalised and from the community,” he said.

This is in line with AH’s identity as an integrated general hospital providing holistic care, where all the needs of a person are considered, and fighting against “fragmented care in which different professionals separately focus on different organs rather than the human being in front of them”, Dr Phua said.

About the size of two five-room Housing Board flats, the clinic has five treatment rooms equipped with specialised geriatric dental equipment such as a wheelchair-tilter to enable patients with mobility issues to remain in their wheelchairs during treatment.

Other facilities include en-suite radiographic equipment and hoists to safely transfer patients when needed. The clinic is able to accommodate bed-bound hospital patients taken down on trolley beds from their wards for treatment.

The specialist dentists at the clinic treat gum diseases, loose and missing teeth, and chewing difficulties, as well as deal with dentures and pain relief.

Operational since March and now seeing an average of about 80 patients a week, the specialist dental clinic was officially opened by Senior Parliamentary Secretary for Health Rahayu Mahzam on Monday.

“As we tackle the challenges of a rapidly ageing population, there is a need to place more emphasis on prevention and appropriate intervention,” she said at the opening.

One in four adults in Singapore will be 65 years old and above by 2030.

She cited Project Silver Screen and the National Dental Centre Singapore’s Oral Health Movement 8020 and Tele-Dentistry Oral Care for Seniors as examples of programmes aimed at improving the oral health of older adults and helping them retain at least 20 of their natural teeth beyond the age of 80.

Madam Rahayu added that it is crucial to increase access to dental care in the community for Singapore’s ageing population, especially those with multiple medical conditions, to facilitate their co-management across dental, medical and other allied healthcare professionals.

It was in June 2016 that Singapore’s first one-stop specialty dental clinic for geriatric and special needs patients was officially opened at the National Dental Centre within the Singapore General Hospital campus.

Called the Geriatric Special Care Dentistry Clinic (GSDC), it provides integrated oral care for patients with complex medical needs, geriatric conditions, and intellectual and physical disabilities at subsidised rates when they are referred by polyclinics or their clinicians.

GSDC has treated almost 9,000 patients in the last seven years.

The siting of the geriatric-dentistry specialist clinic at AH, staffed by dental surgeons and specialists from NUCOHS, is beneficial as it is in Queenstown, where about 20 per cent of the area’s 10,000 resident population is aged 65 and above.

Queenstown is slated to be Singapore’s first health district to support residents’ well-being across their life stages, and be a model of a healthy and active community. AH is redeveloping to provide more comprehensive facilities by 2030 to respond to the planned development and housing expansion in the area.

The NUS Faculty of Dentistry offers a Graduate Diploma in Geriatric Dentistry to train qualified dentists to manage the oral health of the elderly, especially those with complex needs.

“Through this new dental clinic, the faculty will be able to provide enhanced clinical training opportunities for qualified dentists pursuing the graduate diploma. In addition to postgraduate training, the faculty also incorporates the teaching of geriatric dentistry in its undergraduate curriculum. This ensures that newly qualified dentists are able to competently manage senior patients,” Madam Rahayu said.