A high priority is given to improvements in the oral health of the elderly in Scandinavia. In 1987 a Danish municipality established a dental public health care program for old-age pensioners. All 67-year-old citizens were offered school-based preventive and curative care using guidelines and principles established by the Danish Municipal Dental Service for children. Care was provided free of charge. Citizens not wishing to obtain care through the public system could do so from private dental practitioners. Reimbursement for care obtained from the private system was provided by the National Health insurance and the municipality. The purpose of this study was to evaluate the outcome of the program after three years of operation. A follow-up design was used and data were collected by interviews and clinical registrations. At baseline and follow-up 216 (71%) and 235 (77%) pensioners, respectively, were interviewed about their self-assessments of dental health, dental knowledge, attitudes, and behavior. Clinical data were collected only for the elderly who participated in the public program, and included 194 persons at baseline and 187 at follow-up. These data included information on tooth loss, dental caries, periodontal health, and presence and function of removable dentures. At the follow-up, 86 percent of all respondents had regular dental visits of at least once a year compared to 46 percent at baseline; 75 percent participated in the public program and 11 percent obtained care from private practitioners. At the end of the intervention period, fewer elderly reported symptoms of poor oral health or impaired function of dentures Moreover, improvements in self-care, knowledge, and attitudes in oral health were found. The clinical data showed a reduction in unmet need for dental treatment. More preventive care services were given to attenders of the public program than the private one. The present evaluation of systematic public dental care demonstrates positive results in improvment of the oral health and life-quality among the elderly.
