(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
ONE IN five Singaporeans above the age of 40 has issues with her or his ability to speak, chew, or swallow.
They have difficulty chewing, swallowing or speaking. Yet, most do not consult a dentist.
These are the preliminary findings of an ongoing study by the National Dental Center Singapore (NDCS) that screens for oral “frailty”, defined as a decline in oral function.
Being orally frail has been found to increase the risk of physical frailty, sarcopenia (an age-related loss of muscle mass), disability and mortality, said Dr. Chan Pei Yuan, a consultant at NDCS’ Restorative Dentistry Department who leads the screening initiative.
The screening, called the Oral Health Movement 8020, targets people aged 40 and above to retain at least 20 of their natural teeth beyond the age of 80, the Straits Times (Singapore) reported.
It is in line with the new focus of the Ministry of Health on preventive health called Healthier SG. A public consultation that ends on August 15 is ongoing.
The free screening program is scheduled to end in November.
Under the Oral Health Movement 8020, 288 people were screened, most of them 60 and above.
They were given comprehensive oral examinations and oral frailty assessments conducted by a dental professional as part of NDCS’ pilot intervention program, reports Joyce Teo, the Senior Health Correspondent of the Straits Times newspaper.
The screening showed that 22 percent or 64 of them were orally frail or at the stage just prior to being in a frail state.
All except one discovered that they needed dental prostheses like dentures. Three were referred to speech therapists because of their swallowing issues.
Most of those who were screened declined enrolment in the intervention program due to mobility issues, said Dr. Chan.
“It goes to show that collaboration with primary care and community partners is crucial to ensure the residents receive their much-needed care,” she told the Straits Times.
“A large proportion of the population visits the dentist only when there is pain, and by then, they may require extensive and expensive treatment like root canal treatment to restore their dentition.”
Tooth loss not only affects one’s chewing ability, but possibly also one’s food choices and nutritional status, Dr. Goh Siew Hor, the immediate past president of the Singapore Dental Association, told the newspaper.
“In some individuals, it may also have a psychosocial impact as they may be embarrassed by their appearance and therefore limit their social interaction and type of activities.”
The NDCS pilot study hopes to identify those at risk of oral frailty and address oral disease and risk factors early on. For it to have an impact on population health, the screening needs to be done at the community level by tapping dental general practitioners, Dr. Goh continued.
“Educating other community service providers on possible signs of oral frailty and need for appropriate dental referrals can also be helpful in early identification of those who may be at risk of oral frailty.”
Dr. Goh, the head of clinical services at NTUC Health, said Project Silver Screen (PSS), a Singapore-wide health screening regime for the elderly, offers simple checks on the eyes, ears and mouth.
PSS is only for those aged 60 and above, and some of them have already lost too many teeth to function well. The NDCS initiative will screen and identify those who are potentially at risk of oral frailty, Dr. Goh explained.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
