Exploring what should be quality indicators of oral health programs for older adults: a case study of Nakhon Pathom Province, Thailand

Measuring the number of teeth alone may not adequately reflect the quality of oral health programs for older adults. The objective of this study was to explore and identify a set of indicators for measuring the quality of oral health programs for older adults, using Nakhon Pathom Province in Thailand as a case study. The perspectives of older adults and dental nurses, who serve as frontline workers, provided qualitative data to develop meaningful indicators for assessing program outcomes. Data was collectedfrom three focus groups conducted from June 2023 to January 2024. Two rounds were conducted with older adult groups from each district in Nakhon Pathom Province, and one round with dental primary care providers, with six to eight participants per session.Based on the WHO’s Health System Performance Assessment, a framework analysis was used to develop a set of oral health indicators for the participants. Participants revealed that the presence of a certain number of teeth is an inadequate benchmark for assessing oral health. Indicators should include additional oral health outcomes based on the needsand perspectives of older adults such as chewing function, absence of pain, hygiene, and social participation, which may differ between dependent and independent individuals. This study also identified numerous challenges to achieve the outcomes. Participants recommended assessing the quality of structure, process, and outcomes using selfdefined,incremental criteria for improvement.