Dental attitudes and behaviour among a sample of dentate older adults from three English communities

Improvements in oral health have resulted in impressive reductions in edentulousness in the middle aged and elderly. As part of a large, three-centred survey of adults aged 60 or over, 1211 dentate subjects were interviewed about their dental attendance pattern, their reasons for non-attendance, attitudes to edentulousness, treatment preferences and oral hygiene practices. The three areas sampled allowed north-south and urban-rural comparisons to be assessed. 19-28% of all subjects were dental non-attenders, but the prevalence was highest in the north. A perception that there was no need to seek dental care was the commonest reason given for non-attendance. Subjects from the northern samples were less likely to be upset at the prospect of edentulousness and less likely to opt for restorative treatment than their southern counterparts. Gender differences were pronounced in the north, with men being less concerned about edentulousness, less likely to opt for restoration and less likely to visit the dentist than women. In the south this difference was less evident. Generally, expectations were high and attitudes were based on the preservation of natural teeth. This is a positive development, but caution must be exercised to ensure that expectations are realistic.