BEING A DENTATE OLDER IN THE LUCKY COUNTRY! OR, how I grew up to live

with the bomb, bureaucrats and believers!

Clive Wright 5 mins of PHAA Sig FamePerth, September 2014

ORATION[aw-rey-shuh n, oh-rey-] /ɔˈreɪ ʃən, oʊˈreɪ-/ noun 1. a formal public speech, especially one delivered on a special occasion, as on an anniversary, at a funeral, or at academic exercises.

Definitions

CHAT /t at/ʃverb1.talk in a friendly and informal way.

noun1.an informal conversation

The 400 who came to hear Mr Abbott deliver the Sir John Downer Oration, were jeered and abused by the protesters but there was no physical contact.

Protesters rally against Prime Minister Tony Abbott’s appearance at Adelaide University by: MILES KEMP From: The Advertiser August 22, 2014 8:41AM

THE ORATION

THE CHAT

Professor Matthew Nock (right), Harvard College Dean Evelynn M. Hammonds, and 20 students gathered at Hammonds' home for a fireside chat. The event was the second in a new series meant to connect undergraduates with faculty members in an open, informal, and welcoming atmosphere.

Dr Martin Dooland AM

First PHAA Sig Oration/Chat

• Would I have done things differently?• What are the issues currently facing dental public health?

REVOLUTION

CERATHEGERIATRIC

REVOLUTION

Q1. Yes - I would have become a marine biologist!Q2. Grumpy older people!

Current Speaker’s Answers in 2014

Overview

What are the issues – underneath the issues?

• Values• Beliefs• Prevention

Why are grumpy old people important?

• More of them• Better bite• Nothing to lose

Global Context• Economic challenges; Displaced refugees; Ageing populationDeterminants of Health & Disability• Social determinants of health – interaction of individual, lifestyle and social environment... “only 40% of the population are highly motivated to adopt healthy lifestyles... 60% have negative and fatalistic attitudes”Future Patterns of Disease & Disability• Shift from communicable diseases to non-communicable (number of older people with care needs to rise by 61%)• Increase co-morbidity

Where in Health is the World going?

Medical Advances • New hope in neurodegenerative conditions• Low-cost genetic sequencing, genome mapping etc leading to personalised treatments Information Technologies “By 2032 everyone should be able to access the internet everywhere”. New opportunities to capture & interpret information in home & other settings.• Impact of social mediaHealth Workforce• Oversupply of consultants; Undersupply of nursesPublic Attitudes & Expectations• Health & social services will need to play closer attention to relational aspects of care: Respect & Dignity

In the Australian context - what are the current Issues ANDDo we have a Road Map?

Australia’s Oral Health Roadmaps

DRAFT

• Foundation Areas• Population Groups• Consensus across jurisdictions

Or do we need a GPS for the GOP* Crisis?

Why is a paradigm shift so difficult?

*GOP - Grumpy Older Population

A Simple Navigational Toolkit for the Issues Under

the Issues

• Based on “best” evidence at the time...• Applicable across ALL communities...• Recognises the complexities of human existence...• Integrates oral health into global bio-social systems...

• Values & beliefs• Education• Access equality• Prevention• General heath

•Beliefs recognition• Culture• Generation

• Professional• Allied health• Community• Civil society training• Dental professional• Dental products

What do we know about Values; Best Practices; & Beliefs?

What do we know about Values; Best Practices; & Beliefs?

* Wayne Richards, Dental needs and priorities in dental care. British Journal of Heath Care Management 2004: 10:178-181.

Lee JY & Divaris K (2013) The ethical imperative of addressing oral health disparities: a unifying framework. J Dent Res XX (X): 1-7, Online, DOI: 10.1177/00220034513511821

Why is a paradigm shift so difficult?

Is our focus too individualistic & proximal?

Proximal factors

“Ecosystem factors”

Why is a paradigm shift so difficult?