PETALING JAYA: Malaysia must effectively integrate oral healthcare into its broader elderly care framework as the country moves towards becoming an ageing society, says a senior consultant geriatrician.
The call comes as the country faces a rapidly changing demographic landscape, with the Health Ministry setting a target of 50% of elderly people having at least 20 natural teeth by 2030.
Based on the National Oral Health Survey of Adults 2020, only 34% of senior citizens have at least 20 natural teeth.
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Prof Dr Shahrul Bahyah Kamaruzzaman of Universiti Malaya said oral healthcare is only partially integrated into broader elderly care frameworks, despite being referenced in national policies.
The Health White Paper and the National Oral Health Strategic (NOHS) Plan 2022–2030 include provisions on elderly care, including the 6020 campaign – a Health Ministry’s initiative aimed at promoting lifelong oral health.
“Oral healthcare in Malaysia is partially integrated but insufficiently so. Despite being acknowledged in national policies, it still remains somewhat siloed.
“Guidelines on Oral Health Care for the Elderly introduced in 2002, as well as inter-ministerial taskforces on healthy ageing, are already in place.
“However, findings from the National Oral Health Survey of Adults 2020 continue to show significant gaps, with 94.6% of adults requiring dental care and previous surveys showing low tooth retention rates of only 23.9% among those aged 60 and above,” she said.
Dr Shahrul Bahyah said policymakers should shift the focus from reactive treatment to preventive care by strengthening the integration of oral healthcare within national ageing frameworks, expanding workforce capacity and improving community-level services.
She said rising elderly numbers would require larger oral healthcare teams, but Malaysia still faces a shortage of skilled personnel equipped to address geriatric needs.
Limited outreach services also remain among the most significant barriers preventing many older adults, particularly those in rural and underserved communities, from accessing dental care, she said.
Universiti Kebangsaan Malaysia’s Family Oral Health Department’s Assoc Prof Dr Tanti Irawati Rosli said that while some level of integration exists at policy level, implementation remains uneven.
The NOHS Plan 2022–2030 prioritises healthy ageing and oral health prevention and preservation among older people, while the Kembara Senyuman initiative offers services such as denture provision to communities and rural areas.
“But the gaps are interconnected rather than isolated issues. As many older adults have limited mobility, routine preventive care can be difficult, and if delayed, problems can become severe,” said Dr Tanti Irawati.
“Others may include financial constraints, cognitive limitations and perceptions that oral healthcare is non-essential or low priority.”
She said oral healthcare should be more closely integrated into broader health systems, including non-communicable diseases and nutrition policies, given its impact on eating ability, chronic disease management and quality of life.
As such, she said oral health assessment should be part of routine geriatric screening in primary healthcare settings, similar to blood pressure and diabetes monitoring.
“There is also a need to expand community and domiciliary dental services, especially for frail and dependent elderly patients,” she added.
UKM Faculty of Dentistry’s Assoc Prof Dr Hsu Zenn Yew wrote to The Star in May, pointing out that tooth loss should not be accepted as an inevitable part of ageing.
“When an elderly parent or grandparent begins to eat less, avoids certain food, complains about loose dentures or becomes reluctant to smile, these may be signs that dental care is needed.
“Sometimes, the first step is simply to help them arrange a dental appointment,” she said.
