Oral health of older people admitted to hospital for needs assessment.

Abstract

Objectives: To describe the clinical oral health status, treatment needs and oral-health-related quality of life (OHRQoL) of older people admitted to older persons' wards at Dunedin Public Hospital due to a sudden worsening of their general health. Participants and methods: A systematic oral assessment was undertaken for a consecutive case series of 200 patients (59.5% female; mean age 82.6 years, sd 6.6) admitted to older person's wards at Dunedin Public Hospital. The Oral Health Impact Profile-20 (OHIP-20) was used to assess OHRQoL.

Results: One in three (36.0%) had been living independently at home prior to admission, and over half (55.0%) had been admitted for a medical reason which required assessment. Half (50.0%) of the participants were dentate (with an average of 16.8 teeth). There was an average of 1.9 decayed teeth present in the dentate group; 70.7% of individuals required restorations or extractions, and about 90% required only simple scaling of the teeth and prophylaxis. A reline or a replacement denture were required by three-quarters of those with dentures. Almost two-thirds of participants did not have a regular dentist, and fewer than one in three had made a dental visit in the previous year. One in six described their oral health as 'fair' or 'poor', and just under one-third reported dry mouth. Dentate participants, those without xerostomia, and those reporting better oral health had better OHRQoL, reflected in lower OHIP-20 scores. Affecting 37.1% of participants, functional limitation was the most commonly experienced of the OHIP-20 domains, followed by physical disability and physical pain (18.0% and 15.6% respectively).

Conclusions: The oral health of medically compromised and functionally dependent but cognitively competent older people in this study is generally poor. If transfer to long-term care is indicated, early and proper preventive measures and appropriate dental contact should be advocated in order to reduce morbidity and improve quality of life for older people.