Oral health and functional capacity of centenarians

Abstract

The number of very old individuals, namely centenarians, is growing fast. In dentistry, the increasing number of older adults retaining natural teeth present new challenges for preventive and restorative dental care. However, there is a considerable lack of knowledge on the oral health status and needs in this exceptional age group. The aim of this population-based study was to identify the prevalence of oral diseases, therapeutic needs and functional capacity (evaluating centenarians’ autonomy and their capabilities regarding treatment and oral hygiene) in centenarians. Subjects born before 1920 were recruited from population registries in South-Western Germany, providing information on dental health experiences, oral health behaviors and undergoing dental examination. 55 centenarians participated in the study (mean age ± SD = 101.2 ± 1.6, 83.6% females). Results were compared to epidemiological data on adults aged 75–100 years examined in the Fifth German Oral Health Study. Adherence to recommended dental behaviors and dental check-ups was lower in the centenarian population. Moreover, with the exception of a lower Root Caries Index, centenarians showed a higher caries experience, and presented with a mean DMFT of 25.2 ± 3.9, a DMFS of 111.0 ± 21.8, a root caries prevalence of 34.5% and a Restorative Index of 54.0%. Centenarians’ functional capacity was also considerably lower. Non-existent or greatly reduced treatment capabilities and oral hygiene capabilities were registered in 63.7% and 43.6% of cases, respectively. Centenarians with a lower educational level (p = 0.018), in a care facility (p = 0.045) or in need of nursing care (p = 0.001) were more likely to have a low functional capacity. 98.2% of centenarians received help in their daily activities but only 12.7% in their oral hygiene. In conclusion, although most still have natural teeth, a decline of oral health can be perceived. As compliance with recommended behaviors is limited and most centenarians can no longer undergo dental treatment, the lack of assistance in daily oral health care is problematic.

A Systematic Review on Caries Status of Older Adults

“…The included studies reported caries prevalence or experience of older adults at the age of 60 or above in 20 countries from six continents (Table 1). Most of them were conducted in Asia (n = 20, China [11][12][13][14][15][16], India [17][18][19][20][21][22][23][24], Singapore [25], Turkey [26][27][28][29][30][31][32][33][34][35][36][37][38] and Vietnam [29,30]) and Europe (n = 10, Finland [31], Germany [32,33], Ireland [34], Kosovo [35], Norway [36], Poland [37,38], Portugal [39] and Romania [40]). There were three studies conducted in North America (Mexico [41,42] and USA [43]), one in South America (Brazil [44]), two in Oceania (Australia [45,46]) and three in Africa (...…”

Association of Dental and Prosthetic Status with Oral Health-Related Quality of Life in Centenarians

“…In our study cohort, notably limited by its relatively small sample size, OHRQoL was not influenced by the question of institutionalization, nursing care or mental state, which are factors that have been shown to have an influence in studies with younger participants. We have previously shown that these factors also had no impact on centenarians’ cariological or periodontal status [ 33 , 34 ]. At the age of 100 years and older, all participants received some kind of help or nursing care, whether at home or in a care facility; this may have alleviated differences.…”

“…Since older adults, especially centenarians, are often reduced in their mobility, access to dental care is limited [ 46 ]. Only approximately half take part in regular check-ups [ 34 ] and, due to their lower resilience, dentists may opt for uncomplicated, sometimes provisional care, possibly causing the relatively high prevalence of denture sores by these means.…”

“…For further information regarding interview and clinical examination methods, dental health behaviors, caries experience, functional capacity, periodontal and peri-implant conditions, please see our previous publications [ 33 , 34 ].…”

Health Behaviors and Self-Reported Oral Health among Centenarians in Nanjing, China: A Cross-Sectional Study

“…Centenarians may also have different oral hygiene behaviors compared with other groups of people. Many may decrease toothbrushing frequency or lose the ability to perform oral hygiene independently because of functional and cognitive impairment [ 35 , 36 , 37 ]. However, some may maintain this lifelong oral hygiene practice.…”