Barriers and enablers for dental care among dentate home-based older New Zealanders who receive living support.

Objective To explore the structural, social and individual barriers to, and facilitators for, accessing dental services and remaining dentate, among a purposive sample of dentate home-based older people who receive living support (HBOPWRLS). Background Studies on the oral health of older people have largely been quantitative, while fewer studies have specifically explored the dental service utilisation patterns of dentate HBOPWRLS, especially in New Zealand. Materials and method In early 2019, semi-structured interviews were conducted with a purposive sample of 40 dentate HBOPWRLS from one region of New Zealand. A parallel coding and thematic analysis of the interview data was conducted, based on the constant comparative method. Results Barriers to accessing dental services included the cost of dental treatment, negotiating transport issues, social isolation, traumatic childhood dental experiences, lack of role modelling for good oral health and hygiene, self-ageing and drawing upon discourses of older people, and health conditions impacting on mobility and access to oral health care. Facilitators for accessing dental services included having a support network, parental role models, healthy diet, knowledge of the link between oral and general health, dental clearances for surgery, not wanting dentures and having a strong dislike of them, and agency to resist dentists' advice to have a full extraction. Conclusion The expense of dental care is a major barrier to HBOPWRLS accessing dental services at a life stage of reduced income. Strategies for boosting dental service access among socially isolated older people need further exploration.