Barriers and facilitators to accessing oral healthcare for older people in the UK: a scoping review

Introduction Access to dental services is a growing problem for older people in the UK. The aim of this scoping review is to identify the barriers and facilitators influencing older people's ability to access oral healthcare in the UK based on the existing literature.Methods The scoping review followed the framework proposed by Levac and colleagues (2010). Peer-reviewed literature was retrieved in April 2023 from Web of Science, Medline, PsycInfo and CINAHL for the period 1973-2023. After screening, data were extracted to identify barriers and facilitators mapped to individual, organisational and policy-level factors. The themes generated were used to identify gaps in the literature and policy recommendations.Results Overall, 27 studies fulfilled the inclusion criteria. Most studies published were from England; there was a large representation of opinion pieces. The main barriers and facilitators related to cost of services, perceptions of dentistry, availability of services and both the dental and social care workforce.Conclusion Multiple barriers exist surrounding access to dental care for older people. Various facilitators exist but not all are successful. More research needs to be carried out on older people's access to dental services in the community, particularly for the 'oldest old' and minority groups. This study maps the existing evidence surrounding access to oral healthcare for older adults in the UK.The study highlights that many barriers and facilitators to accessing oral healthcare exist but there are gaps in the literature regarding representation of marginalised groups within this population, such as older people living in the devolved nations, the 'oldest old' (85+) age group, and minority ethnic groups living outside of London.Whilst many barriers and facilitators have not changed in the last 50 years, commissioners and policymakers need to consider how the structure of dental services needs to actively support older people's access-related needs.