The University of Newcastle, Australia

The University of Newcastle’s Senior Smiles program proves good oral health can deliver multiple benefits.

For nearly a decade, the university’s Senior Smiles program has helped elderly residents on NSW’s Central Coast improve their oral health.

The program was created by Associate Professor Janet Wallace, who has spent her professional life demonstrating the connection between oral health and overall well-being and quality of life.

Older adults are particularly vulnerable to poor oral health due to changes in diet, increased medications and reduced ability to care for their personal hygiene needs.

Our older citizens also report that the cost of dental services is a barrier to accessing services.

With the number of people over the age of 65 expected to grow considerably over the next few decades, Senior Smiles targets aged care facilities specifically and is giving residents much more than just quality dental care.

The problem

Oral health is fundamental to overall health. Those with poor oral health are more likely to suffer ongoing pain, difficulties swallowing and speaking, disrupted sleep, disrupted work routines, anxiety and depression.

Research has also linked poor oral health to serious medical conditions including cardiovascular disease, diabetes, stroke and dementia.

According to the Australian Institute of Health and Welfare, people between the ages of 55 and 74 have, on average, 22 decayed, missing or filled teeth. The number of affected teeth goes up the older we get.

While allied health services such as podiatry and occupational therapy are provided to Australia’s elderly via Medicare, oral health care is not. This puts our older citizens at considerable risk for painful and costly health conditions.

A new model of care

With the goal of creating a scalable and sustainable model of care for residential aged care facilities, Associate Professor Janet Wallace translated her PhD research into practice and created Senior Smiles in 2014.

Since then, the program has trialled in five residential aged care facilities and has four core elements:

  • an oral health practitioner who works on-site in the residential aged care facility
  • regular oral health risk assessments and care plans
  • referral pathways to dentists for more complex needs
  • collaboration with the residential aged care staff to enhance oral health skills.

The Senior Smiles pilot was financed through a $100,000 grant from NSW Medicare Local in Erina. The grant covered the cost of having a registered dental hygienist in five residential aged care facilities on the Central Coast.

Following the success of the pilot, Associate Professor Wallace and her team secured a $540,000 grant from the Elderslee Foundation Australia Ltd in 2017 to enhance the program.

Leading the way in oral health

The Senior Smiles program has already resulted in nine additional residential aged care facilities employing oral health care practitioners in their facilities – and this is before Phase 2 of the trial has even been completed.

Under Professor Wallace’s leadership, the University of Newcastle has become an expert in this area of research and education.

In addition to setting its sights on expanding the Senior Smiles program, the University has also created a one-of-a-kind Bachelor of Oral Health Therapy, which includes a student placement program involving 17 aged care facilities along the Central Coast.

The students receive real-world learning while providing critical intervention care for residents.

Associate Professor Wallace also continues to advocate that oral health care is mandated as part of the accreditation process for aged care facilities in Australia to ensure residents receive more holistic health care that improves their overall quality of life.

Evidence of impact

The Senior Smiles program has worked with 600 elderly residents across five residential health care facilities to provide:

  • 1,630 oral health assessments
  • more than 1,320 oral health care plans
  • over 380 dental treatment referrals. *

An independent economic analysis of the program found that every dollar spent on preventative oral health care in the residential aged care setting delivered $2.40 in benefits to the healthcare system and an additional $3.18 in social benefits.

The program has proven benefits including:

  • improved nutrition
  • lowered risk of pneumonia
  • improved dentures care
  • decreased doctor visits
  • avoided admissions to hospital
  • decreased prescription costs
  • improved quality of life
  • decreased mortality.

Endorsed by all of Australia’s national dental and oral health professional associations, Senior Smiles is the only translational research program providing preventive oral health care in residential aged care facilities.

* Data accurate as of October 2019.


Download the case study (PDF, 700KB)

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