Oral Health Status and Need for Oral Care in an Aging Population: A Systematic Review

Abstract

Background. The world population is aging. This phenomenon is accompanied by an increase in the number of elderly with dementia, whose oral hygiene care is a challenge. Objective. This paper presents a literature review of oral health status and the need for oral care in people with dementia, as compared to people without dementia and also of the relationship between periodontal disease and cognitive impairment. Methods. A systematic review was conducted in PubMed, CINAHL, and the Cochrane Library. Fifty-six articles met the inclusion criteria and were consequently included for quality assessment and data extraction. Results. No significant differences were found between both groups with regard to the number of present teeth, DMFT Index, edentulousness/use of denture, and orofacial pain. Coronal/root caries and retained roots were more common in people with dementia than in those without dementia. Most of the participants with dementia presented gingival bleeding or inflammation and they suffered from the periodontal disease more than people without dementia. Conclusions. Poor oral health is a common condition among the elderly with dementia. The education process of caregivers might improve the oral health status of people with dementia. Finally, periodontal disease might contribute to the onset or progression of dementia.

Dental Care Access and the Elderly: What Is the Role of Teledentistry? A Systematic Review

“…The preservation of oral health is crucial, as is preventing and possibly treating all the diseases that could lead to edentulism, especially in elderly people [10][11][12]. A high level of unmet oral health needs is very common among elderly people, suggesting that enhancing access to dental care is crucial [13]. Oral diseases could be also responsible for the triggering or promotion of inflammatory and infectious processes at a systemic level, potentially worsening the clinical picture of subjects with comorbidities [14].…”

Oral Health Status and the Impact on Oral Health-Related Quality of Life among the Institutionalized Elderly Population: A Cross-Sectional Study in an Area of Southern Italy

“…However, GOHAI has already been successfully used to evaluate OHRQoL among the elderly diagnosed with dementia [ 29 ] and Alzheimer’s disease [ 56 ]. Moreover, further attention is needed to improve the oral health status of the elderly with dementia, since higher level of plaque, coronal and root caries, retained gingival, and periodontal disease are highly common in these patients [ 57 ]. Fourth, the impact of edentulism on daily oral function and social interactions has significant plausibility and the relevant proportion of edentulous individuals that did not wear any type of prosthesis could have affected the study results.…”

Periodontal Disease in an Ageing Population: Key Considerations in Diagnosis and Management for the Dental Healthcare Professional

“…Aggression, refusing oral care or abusive language is more common in older adults who are cognitively impaired. 51 If adequate tooth brushing is not possible, it is reasonable to explore alternative options such as the use of mouthwashes and sponges etc., however, it is worth noting that the evidence for the effectiveness of chlorhexidine in reducing dental plaque relates only to its use as an adjunct, rather than alternative to brushing. 52…”

“…Aggression, refusing oral care or abusive language is more common in older adults who are cognitively impaired. 51 If adequate tooth brushing is not possible, it is reasonable to explore alternative options such as the use of mouthwashes and sponges etc., however, it is worth noting that the evidence for the effectiveness of chlorhexidine in reducing dental plaque relates only to its use as an adjunct, rather than alternative to brushing. 52 Treatment challenges of a reduced periodontium, managing recession, root caries and hypersensitivity the degree of periodontal destruction can present a number of challenges including gingival recession, dentine hypersensitivity, tooth mobility, root caries and poor aesthetics.…”