Oral health status and need for oral care of care-dependent indwelling elderly: from admission to death

Clin Oral Investig. 2017 Sep;21(7):2189-2196. doi: 10.1007/s00784-016-2011-0. Epub 2016 Nov 28.

Abstract

Objectives: The objective of this study is to assess oral health and oral status of elderly patients newly admitted to a nursing home from admission until death.

Materials and methods: Oral health, oral status, need for dental care, cooperation with dental treatment, and given dental care were assessed by two geriatric dentists in all new long-stay patients (n = 725) admitted to a nursing home between January 2009 and December 2013. All patients were followed from admission until death or until they left the nursing home.

Results: At admission, dementia patients were significantly older than somatic patients; median [IQR] ages were, respectively, 85 [79-89] and 81 [76-87] (p = 0.001). In addition, edentulous patients were significantly older than patients with remaining teeth, 83 [79-89] versus 80 [74-86] (p = 0.001) years. Thirty percent of the admitted patients died within 12 months after admission. A small minority (20%) of the patients had their own teeth. In this group, poor oral hygiene (72%), caries (70%), and broken teeth (62%) were frequently observed. Edentulous patients were significantly more cooperative with treatment than patients with remaining teeth (64 versus 27%). Finally, significantly less professional dental care was given to edentulous patients when compared to patients with remaining teeth (median 90 [IQR 60-180] versus 165 [75-375] min).

Conclusion: When compared to edentulous elderly patients, patients with remaining teeth were younger at admittance, were more often non-cooperative, and had a poorer oral health and higher need for dental care.

Clinical relevance: It is important that health care workers ensure adequate oral health and dental care to frail elderly, especially for elderly with remaining teeth.

Keywords: Care-dependent; Cooperation; Dental implants; Elderly; Nursing home; Oral health status.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dental Care for Aged*
  • Female
  • Health Services Needs and Demand*
  • Health Status*
  • Humans
  • Male
  • Netherlands
  • Nursing Homes*
  • Oral Health*
  • Patient Compliance