Geriatric dental care in the Netherlands faces growing blind spot
- Geriatric dental care is facing a growing blind spot in the Netherlands as more older adults retain their natural teeth later in life but struggle with daily maintenance.
- Today's older generation largely keeps a significant portion of their own teeth, crowns, bridges, and implant structures.
- When older adults transition into institutional care due to medical events like a stroke, oral care frequently slips through the cracks.
Geriatric dental care is facing a growing blind spot in the Netherlands as more older adults retain their natural teeth later in life but struggle with daily maintenance. While roughly 82 percent of the Dutch population visits a dentist, that participation drops to about 70 percent among individuals over the age of 75, according to observations shared by Amstelveen-based geriatric dentist Claar Wierink.
The Shift Toward Retaining Natural Teeth
Today’s older generation largely keeps a significant portion of their own teeth, crowns, bridges, and implant structures. Maintaining these complex dental setups requires sufficient hand strength and fine motor skills for detailed brushing and interdental cleaning. Conditions like artrose can limit hand mobility, while common medications often cause dry mouth, stripping away saliva that naturally protects teeth. Early-stage dementia can lead individuals to simply forget their daily oral hygiene routines. “Kwetsbare ouderen hebben soms zoveel andere fysieke problemen dat de mond naar de achtergrond verdwijnt. En als iemand geen pijn heeft, wordt een bezoek aan de tandarts makkelijk uitgesteld,” notes Claar Wierink.
Care Home Realities and Access Barriers
When older adults transition into institutional care due to medical events like a stroke, oral care frequently slips through the cracks. The experience of 85-year-old Annie van Willigen illustrates how quickly conditions can deteriorate. Following a brain hemorrhage in 2025, she required temporary nursing home placement where her teeth did not receive adequate attention. Within a single year, her dental health declined to the point of developing a severe oral abscess that impaired chewing, swallowing, and eating. Finding an accessible dentist proved difficult because she could no longer use a standard dental chair, though Wierink’s practice eventually accommodated her in a wheelchair using specialized lifting equipment. Busy schedules compound the issue, as medical appointments with general practitioners, hair salons, and specialists take priority over routine dental checks. Wierink points out that while general practitioner visits increase with age, dental visits decline. She suggests that dentists could take a more proactive stance by reaching out to older patients who miss appointments to determine whether transportation barriers or other challenges are preventing their visit.
Intimacy Barriers and Medical Oversight
Performing oral hygiene for someone else introduces unique challenges for professional caregivers and nursing staff operating under tight time constraints. Cleaning another person’s mouth can feel intimate, uncomfortable, or invasive if the patient resists care. “Bij jezelf poetsen is makkelijk. Het is intiem, het kan als vies worden ervaren en soms wil iemand helemaal niet dat je in zijn mond komt,” explains Wierink. Specialist in elderly medicine Gert-Jan van der Putten emphasizes that medical professionals in care settings must incorporate oral checks into routine physical examinations. Reflecting on his early work in nursing homes, Van der Putten notes that clinicians routinely inspected patients’ throats while leaving the teeth and gums unexamined.