DEAR: Dental Elder Abuse Response

Project Goals

The Canadian Centre for Elder Law worked with Runnymede Dental Centre in Toronto to develop materials and training focused on preventing abuse and neglect of older people, and supporting older adults to develop advance care plans around dental care and oral health.

The DEAR project has three fundamental goals:

  1. To make seniors, substitute decision makers, family and supporters, dentists and clinicians think about “dental elder abuse”—often for the first time.
  2. To support people in making advanced plans around dentistry and oral health, thereby reducing the chance of financial elder abuse or physical neglect around dentistry in later life.
  3. To bring dentists in the field of elder abuse awareness and prevention for the first time by creating a successful replicable project which can be brought to scale in other public and private clinics across Canada. This goal also includes creating a network of certified dentists concerned about elder abuse, through leveraging the National Initiative of Care of the Elderly (NICE Network’s) ability to create a new “Dental Theme Team”.

Download DEAR project brochure.


  • Webinar series
  • Wishful Thinking Workbook for advance planning re dental care
  • Wishful Thinking poster
  • Super 6 Postcard for identifying keys oral health care goals and wishes
  • Super 6 poster

Go to the Archer Dental website to download tools for free.

Background: Elder Abuse and Dental Care—The Connections

Dental care and oral health have significant connections to elder abuse:

1. Older people’s substitute decision makers sometimes deny the older person dental care, rationalizing that the person is so old that it is not worth saving their teeth.  In reality maintaining the health of a person’s mouth can be crucial to their ability to chew, digest food, absord nutriants and maintain quality of life. The denial of dental care can increase discomfort, reduce quality of life, and shorten a person’s life expectancy. Denying an older person dental care that she can afford can be a form of mistreatment.

2. Neglected oral health can be a sign of neglect of an older person who does not have the mental capacity to make their own decisions about dental care or make and follow through on appointments. Such circumstances may be a sign that the older person would benefit from a trusted person assisting them with health care planning and follow through, or providing other support and assistance.

3. Although some dental care can be cosmetic, a person does not lose the right to purchase dental services they can afford because they have become older. A healthy mouth can be linked to self-esteem and self-worth. Elder abuse can be present where a substitute financial decision maker is denying any service linked to quality of life.

4. Injuries to the mouth detected by a dentist or dental hygienist can be a sign that an older person is being physically abused. In this respect dentists and other dental professionals can be key to detecting and responding to elder abuse in our communities.

5. Sometimes it is difficult for family members and substitute decision makers to determine whether or not to authorize dental care for a older person they are representing or assisting. This project will support older people to decide for themselves in advance what kind of dental services they want to receive as they age. The documentation of their wishes will help substitute decision makers and family to take actions to fulfill the older person’s wishes.

Natalie Archer and Runnymede Dental Centre

Natalie Archer is an award winning dentist committed to oral health for people as they age.

Runnymede Dental Centre is located within the Runnymede Health Centre in Toronto. The clinic is designed particularly for geriatric and special-needs patients who would not otherwise have easy access to proper dental care. Runnymede serves a diverse clientele with medical, physical, developmental or cognitive conditions, and includes equipment to safely assist clients using walkers, wheelchairs and other mobility devices.

For more information on the Runnymede Dental Centre and Archer Dental.

This project is funded by Employment and Social Development Canada through the New Horizons for Seniors Program.

Government of Canada

Related Files

Below you will find additional, relevant and specific documentation, backgrounders, research, resources, media releases and summaries that have been, or will be incorporated into our final publications and study papers.

If you have questions about these or other specific documents, please reach out to BCLI using our contact page or at the bottom of each page of our website.

Practical Tools and Resources