EVALUATION OF A DENTAL PUBLIC-HEALTH PROGRAM FOR OLD-AGE PENSIONERS IN DENMARK

A high priority is given to improvements in the oral health of the eld erly in Scandinavia. In 1987 a Danish municipality established a denta l public health care program for old-age pensioners. All 67-year-old c itizens were offered school-based preventive and curative care using g uidelines and principles established by the Danish Municipal Dental Se rvice for children. Care was provided free of charge. Citizens not wis hing to obtain care through the public system could do so from private dental practitioners. Reimbursement for care obtained from the privat e system was provided by the National Health insurance and the municip ality. The purpose of this study was to evaluate the outcome of the pr ogram after three years of operation. A follow-up design was used and data were collected by interviews and clinical registrations. At basel ine and follow-up 216 (71%) and 235 (77%) pensioners, respectively, we re interviewed about their self-assessments of dental health, dental k nowledge, attitudes, and behavior. Clinical data were collected only f or the elderly who participated in the public program, and included 19 4 persons at baseline and 187 at follow-up. These data included inform ation on tooth loss, dental caries, periodontal health, and presence a nd function of removable dentures. At the follow-up, 86 percent of all respondents had regular dental visits of at least once a year compare d to 46 percent at baseline; 75 percent participated in the public pro gram and 11 percent obtained care from private practitioners. At the e nd of the intervention period, fewer elderly reported symptoms of poor oral health or impaired function of dentures Moreover, improvements i n self-care, knowledge, and attitudes in oral health were found. The c linical data showed a reduction in unmet need for dental treatment. Mo re preventive care services were given to attenders of the public prog ram than the private one. The present evaluation of systematic public dental care demonstrates positive results in improvment of the oral he alth and life-quality among the elderly.