**6. Barriers to accessing dental care**

The concept of vulnerability can be described as that subject who will not necessarily experience damage, but who is in fact more susceptible since it has higher inequalities. This condition is specially associated with individual and community situations and contexts. Aging involves an augmented risk for the development of vulnerability, since it is a process of variations that influence on life and health conditions of the individual [58].

Vulnerable groups commonly experience barriers to access oral health and are affected by oral diseases. The World Dental Federation [FDI] made a classification of this barriers [59]. See **Table 2**.

On a previous study, we found some different barriers that affect how older adults take care of their health. Lack of time, was reported as the main concern. Older adults sometimes have up to three jobs, because of their working record, since they do not count with a pension. Another example of lack of time is that some older adults (e.g. wife, mother) are caregivers of their partner or parents and therefore no time left for themselves. This is more rooted in women as part of the sociocultural inheritance and traditions; women are more tended to be a caregiver, which affects their social life and self-esteem, increasing stress factors and physical and mental fatigue.

On the other hand, education plays an important role too. Even knowing the consequences of not having good habits, older adults let the time go by without receiving oral health attention and only assist to the dentist in case of an emergency and when the pain is unbearable [60].

Moreover, is important to identify that some subjects experience accumulative challenges as they relate to simultaneous vulnerable groups. For example, an unemployed adult with physical disabilities living in a non-urban community, from a native group. In this way, more efforts are needed to facilitate access for this groups and specially be focused in address the complicated nature of the barriers meted [61].


#### **Table 2.**

*Barriers for access on oral health services.*
