Table 2.

Summary of current oral health policies for older adult populations in the selected countries/regions.

Country/region	Current oral health policies and schemes	Formal training of geriatric dentistry	Number of trained dental professionals in geriatric dentistry	Geriatric dentistry recognized as a specialty	Main challenges or future plans
Australia	Limited large-scale programs addressing the oral health of older adults Older adults with low income (eligible for government pension) are eligible for public dental care but often with a co-payment	No	A small number	No	Shortage of dental personnel, lack of expertise in geriatric dentistry A promising approach is to place oral health therapists in residential aged care facilities to support dental hygiene and referral
Brazil	Older adults are prioritized to have preferential access to oral health care within the primary health care Oral health promotion and prevention, dental clinical care and oral rehabilitation with partial and complete dentures as well as advanced dental treatments are provided	Yes	275	Yes	Limited access to dental services An inefficient bureaucracy
China	Cost of dental treatments is partially covered by the medical insurance system “Free denture” programs for low-income older adults	Yes	Unknown	No	Poor oral health knowledge, economic barriers, perceived lower priority for oral healthcare by older adults Limited dental care resources National Health Commission issued “Healthy Oral Action Plan (2019–2025),” advocating older adults to pay attention to their oral health
Hong Kong	No specific oral healthcare policy for older adults Two public funded dental care service programs for older adults	No	Unknown	No	Shortage of dental personnel, lack of expertise in geriatric dentistry Insufficient collaboration between dental and other primary healthcare workers, and inadequate oral health care training for healthcare providers
India	No specific oral healthcare policy for older adults Occasionally, some district health cells and dental schools provide “free denture” services for older adults	No	Unknown	No	Planning and implementation of healthcare schemes differ in different states Lack of budget Low dentist to population ratio in the rural areas Poor awareness about oral health and government schemes
Japan	Re-designed system to deliver dental care to institutionalized older adults Collaborations among dentists, dental hygienists, physicians and long-term care professionals Costs for testing oral function and controlling oral hypofunction are covered in medical insurance	Yes	Unknown	Yes	Reforms and continuous reviews of the medical insurance system and the long-term care insurance system are being carried out Efforts are being made by academic societies and educational institutions to train dental care workers to be active in the super aged society
Switzerland	Dental care is excluded from the basic health insurance No specific oral healthcare policy for older adults	Yes	Unknown	No	Main obstacle is the exceptional and independent organization between the cantons and that oral care is excluded from the basic health care insurance
Thailand	National Oral Health Plan for the Elders 2016–2022 (NOHPE) is the main driver for a wide range of programs and activities regarding oral health care for older adults	Yes	Unknown	Yes	Lack of budget Challenging for dentists and dental nurses to provide and coordinate community oriented and “continuing” person-centered care, rather than traditional chief-complaint-based or acute care National level consensus on the competencies of primary care dentists and dental hygienists working in the aged society has not been formulated
Australia UK	Oral healthcare services for older adults are provided through the publicly funded National Health Service (NHS) A broad range of dental treatments are offered, including restorative and periodontal care, but there is limited access to dental implant treatment	No	Unknown	No	Better implementation of the National Institute for Health and Care Excellence (NICE) guideline on maintaining and improving the oral health of care home residents
USA	Dental care is primarily out-of-pocket, but only 29.2% of older adults have dental health insurance and this percentage declines with age Medicare, a federally funded medical health insurance for older adults, only covers certain oral surgery procedures and non-dental oral soft tissue lesions Medicaid provides healthcare coverage for low-income people but dental care for older adults is optional and depends on individual state funding	Yes	Unknown	Yes	Older adults with lower socio-economic status have multiple barriers accessing oral healthcare, including transportation, finding a dentist educated in geriatric dentistry, paying for dental care, and a lack of understanding about the availability of financial assistance programs