# The stories of the ageing population in Luton, United Kingdom on their experience of periodontal diseases healthcare

## TL;DR

This study explores how cultural, financial, and emotional factors affect oral health among older Indian adults in Luton, UK, highlighting barriers to dental care and the need for culturally sensitive solutions.

## Contribution

The study provides new qualitative insights into the oral health experiences of older Indian adults in Luton, emphasizing the need for culturally competent dental care.

## Key findings

- Participants had low knowledge of periodontal disease and viewed gum issues as a normal part of aging.
- Access to dental care was hindered by cost, complexity, and mistrust of NHS and private services.
- Cultural beliefs, systemic barriers, and psychosocial factors collectively impact oral health behaviors and care-seeking.

## Abstract

Oral health is an important part of general wellbeing, but in the United Kingdom there are substantive inequalities, especially based on ethnic minority and ageing. There is a poor quality of life, a lack of awareness and preventive measures, and periodontal disease contributes to loss of teeth, poor nutrition, and poor quality of life. Ageing adults among Indians in Luton are an under-studied group whose experiences could inform the interface of cultural, structural, and psychosocial determinants of oral health.

The research aimed to understand the lived experiences of ageing Indian adults in Luton with respect to periodontal health, dental service provider access, and the impacts of cultural, familial, and emotional factors on oral health behaviours.

A qualitative research design was adopted where semi-structured interviews of 10 ageing Indian adults living in Luton were conducted. Data were analyzed in terms of their themes using theoretical frameworks of the Health Belief Model, the Social Cognitive Theory, and Intersectionality to identify patterns and meaning in participant stories.

The results showed that the level of knowledge about periodontal disease was low; and most of the participants believed that the gum issues were not a big problem and that everyone got gum problems with ageing. The obstacles to care access were that the NHS was too expensive, too long, and too complicated; the quality of care in the private sector was too high, and it was unaffordable. Fear, mistrust, shame (psychology) also discouraged the use of dental services.

This study finds that the interaction of culture beliefs, systemic barriers, and psychosocial variables affects the oral health of older Indian adults in Luton. Periodontal treatment tends to be reactive and symptomatic with little preventive treatment. This research suggests that the main issues will be culturally sensitive oral healthcare education, family- and community-intervention, affordability, access and cultural competence of NHS dental care. It contributes new qualitative evidence on the need for culturally competent, family-engaged, and accessible dental care for ethnic minority older adult in the UK.