The history of dental programs for older adults.

Compared with other age groups, the elderly have less access to oral health care services and poorer oral health status. Most provinces have no publicly funded programs to address these inequities and the volunteer efforts of professionals and hospital-based programs have had little effect. In Ontario, two expert committees have called for seniors' programs augmented by a strong outreach component to be delivered by public health services. Their recommendations have not been implemented and, worse, some public health programs have lost the capacity to maintain the preventive services they once provided. The development of public policy to address the needs of the elderly is thwarted by the narrow definition of public health problems, the reluctance of the dental profession to lobby for public funding, the bias toward investment in younger groups, and the persistence of a "reverse public funding program" whereby the employed, more affluent receive dental care as a tax-free benefit and the retired, lower-income elderly pay in after-tax dollars.