Dental prostheses: patients and public health at the heart of the debate
Dental prostheses today constitute a significant public health problem, which concerns more and more patients, particularly among the elderly.
To facilitate access to these devices, denturists represent a new solution in France.
Due to the aging of the French population, the ministries of economy and health estimate that those over 60 will represent 20 million people by 2030, compared to 15 million at present. The number of French people aged 75 to 84 is expected to increase by 50%, from 4,1 million in 2020 to 6,1 million. According to the Research Center for Observation and Living Conditions, this population represents an important market, the silver economy, which already generated a turnover of 130 billion euros in 2020.
Among this category of the population, more and more elderly people reside in retirement homes: there were 611 at the end of 000 according to the DREES, and this figure continues to increase, as does the average age of residents. Also at the end of 2019, half of the residents were over 2019 years old, 88 months more than in 7.
Increased medical needs
“The medical needs of the population will increase exponentially, particularly with regard to dental prostheses,” as a specialist on the subject and delegate for France of the International Federation of Denturology. “Recently, a study estimated that in the 64-74 age group, 16,3% of people had a unimaxillary complete denture and 14,3% a bimaxillary denture, indicating complete edentulism. one and two arches respectively.” And when we focus on retirement homes, this figure jumps: “In most middle-class establishments, which represent the majority of establishments in France, we can estimate that around 60% of residents are carriers. of a removable dental prosthesis,” underlines neurobiology professor Annick Barthelaix from Angers University Hospital, who specializes in aging.
IFD – International Federation of Denturists has consultative status as a non-governmental organization with the United Nations.
Working for denturists around the world
Recognition for denturists around the world
Knowledge for denturists around the world
“Given these figures, it is therefore crucial to do what is necessary to anticipate this inevitable tidal wave, which we will be unable to cope with if we remain in current conditions”
Care made difficult by the lack of caregivers
In a context where medical deserts increase each year, it is difficult for patients needing dental prostheses to receive appropriate care. And retirement homes are just as affected by these problems of staff shortage. This is where the role of the denturist takes on its full meaning, because it facilitates the care of patients at home, in retirement homes or in adapted structures, and frees up time for care in dental offices. overloaded.
This healthcare professional is trained in patient care in addition to his initial profession as a dental prosthetist. He therefore takes care of everything, from taking impressions to fitting the prosthesis, once the dental care has been carried out. “It can bring a certain comfort within medical establishments since it has the possibility of mobility, and can see several patients in one day, providing tailor-made monitoring and being in direct contact with the nursing staff”, “C This is the major difference with dental surgeons who have too busy schedules to allow travel time. » As a result, dentists are often unable to provide the necessary basic care, which leaves more and more patients without dental appliances or follow-up in desertified areas.
“Given these figures, it is therefore crucial to do what is necessary to anticipate this inevitable tidal wave, which we will be unable to cope with if we remain in current conditions”
More patients with access to these prostheses
The denturist falls within the professions of the dental prosthesis and dental sectors, which respectively have 18 workers in 300 laboratories and 3 dental surgeons in France. A denturist in activity can treat around ten patients per week on average, which represents between 320 and 600 per year. Thierry Supplie has set up denturist training courses, the first in France. The profession has existed for 75 years in Canada and has been legalized for 50 years (1995 in the United States, 2009 in England, Finland, Holland, Switzerland, etc.). Thanks to two annual sessions, it would be possible to train 30 people each year, thus increasing the number of patients who can be treated: this represents the possibility of rapidly treating 9000 to 18000 patients in 1 to 2 years, with ongoing development. .
Medical travel for transporting patients to a dentist is also very expensive, and it is sometimes difficult to move certain patients. The consumption of outpatient medical transport amounts to 5,6 billion euros in 2021, an increase of 17%, according to DRESS data. A text published in the Official Journal on September 2 announced that the coverage of non-emergency medical transport would be less well reimbursed by Social Security, increasing the participation of insured persons in supplementary health insurance, which would thus increase from 30/40% to 45/55 %.
The denturist therefore represents a welcome solution for patients in nursing homes, but also for people forced to stay at home. This new link in the oral care chain accelerates the possibilities of care in areas of medical deserts. The denturist can put the prosthesis in place and then follow up with the patient, to check if it is working well and if it is comfortable for the patient. “They are qualified personnel, with unique skills that complement both professions. »
The profession of denturist therefore promotes access to prostheses for patients, while boosting employment by relocating part of the manufacturing activity to France, thus reducing the carbon footprint linked to imports of imported prostheses which has increased significantly in five years, going from 13,6 billion to 32,27.
Disastrous consequences of poor equipment with a public health risk
Currently, the aging population has few or poor devices, particularly in retirement homes. “As we age, the prosthesis will no longer be suitable, because the bone structure that supports the prosthesis changes and hygiene care is not always well taken care of, especially when there are minor cognitive disorders,” explains Professor Annick Barthelaix. “People don't necessarily wash their prosthesis, or they lose it because they took it off due to discomfort when eating. » But without a prosthesis, patients have even more difficulty eating, which causes other problems, an increase in desocialization and a deterioration in general health. “We are therefore seeing an increase in nutritional disorders and aging. It is a vicious circle, which affects life expectancy. »
To face these challenges, one of the solutions lies in the development of innovations. With her research teams, Professor Barthelaix has developed a solution, for which a patent has been filed with Angers University Hospital. “To deal with the loss of these prostheses, as well as the lack of hygiene, the idea came to us to equip them with an electronic micro-device which allows them to be found when they are lost, but also to have data concerning hygiene, the patient's temperature and the nutritional aspect,” explains Professor Annick Barthelaix. “It will be inserted into existing or new prostheses. Tomorrow, we could perhaps monitor other health data such as the occurrence of an infection using an even more innovative micro-device. »
And these innovations could very quickly help patients. “Professor Barthelaix is doing everything she can to ensure that denturists set up this system of connected prostheses in French nursing homes.”
