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

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.

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