Rights access and justice in oral health care: justice toward underserved patient populations--the elderly

Recent data indicate that health utilization, calculated on the basis of visits to physicians, specialists, surgery rates, and hospitalization stays, increases with age. Yet, visits to the dentist decrease with age. Although dentistry has made dramatic improvements in the provision of oral health care over the past half-century, access-limited populations including older adults are burdened with the poorest levels of oral health. Many factors contribute to the oral health problems faced by elders. Also, because of its marginalization from general health and public health care delivery systems, oral health does not garner meaningful consideration as a social good. Needs associated with oral health cannot be met without a rethinking of concepts that define oral health and recognition of its impact on general health and quality of life. Determining the extent to which elders endure an undeserved or unreasonable burden of illness and disability is an important first step toward understanding the meaning of "justice" in the context of caring for elders. A clearer understanding of justice allows the oral health community to begin to recognize appropriate levels of responsibility to address the issue of just and respectful caring for this vulnerable population.