The impact of providing dental services to frail older adults: Perceptions of elders in adult day health centers*

Abstract

Very little is known about the oral health of, and access to, dental services among frail elders who live in the community and use an adult day health center (ADHC) for respite care. This pilot study evaluated the perceived oral health quality of life (OHQOL) of elders who used a mobile dental program in urban, suburban, and rural ADHC settings. Pre- and post-treatment interviews were conducted to evaluate OHQOL using the Geriatric Oral Health Assessment Index (GOHAI). ADHC records were used to obtain demographic, medical history and medication data. Following initial dental examinations and consent, dental treatment was provided at each ADHC. Of the 138 elders screened at three ADHCs, pre- and post-treatment data were obtained on 76 subjects following their treatment (mean four months later). The group's members were mostly female (64.5%) and Caucasian (71.6%). Their mean age was 76.8 (+/- 9.8), with an average of 12.4 teeth (34.2% edentulous); 67.7% were on Medicaid. On average they had 5.5 chronic diseases, hypertension being the most common (67.19%); 44.8% had a neurological disorder or dementia. GOHAI scores were generally high both pre- and post-treatment, reflecting high physical and psychosocial OHQOL and low levels of worry. GOHAI scores were correlated with chronic diseases; the more chronic diseases an individual had, the lower his or her total score pre- and post-treatment (r=-.24, r=-.26 respectively, p<.04). The more dental treatment needs an elder had, the lower his or her GOHAI (r=-.23, p<.05). Elders with more teeth reported higher GOHAI pre- and post-treatment (r=.36, r=.37 respectively, p<.002). Paired t-tests comparing pre- and post-treatment GOHAI scores revealed significant improvements in overall GOHAI (p<.001), and on two dimensions: physical (p<.005) and psychosocial (p<.002). The findings support the importance of providing on-site access to dental services in order to maintain the general OHQOL of frail elders, more specifically in the areas of physical and psychosocial well-being.

Oral health-related quality of life and prosthetic status of nursing home residents with or without dementia

“…In our recent study, however, comparable dental and prosthetic statuses and prevalence of dental treatment needs were observed among those with or without dementia, leading to similar OHRQoL. Similar levels of OHRQoL among demented and “healthy” elderly people have also been detected in previous studies 19,35…”

Dental hygiene education for nursing staff in a nursing home for older people

“…Therefore, the importance of adequate daily oral care needs to be increasingly emphasized. Poor dental status may also result in reduced quality of life and difficulties in maintaining an active social life (Walker & Kiyak 2007). Thus, it seems that more dental health education needs to be included in nursing curricula (Wårdh et al 1997, Nicol et al 2005.…”

“…Thus, perception of resistance is an important issue to overcome in dental hygiene education for nursing home staff. Furthermore, the importance of dental hygiene and its positive effects on general well-being need to be emphasized (Walker & Kiyak 2007).…”

Oral Health Perception in Institutionalized Elderly in Brazil: Psychosocial, Physical and Pain Aspects

“…Furthermore, literature studies have shown that the absence of teeth may have a negative influence on self-rated oral health [38][39][40], and that the elderly tend to improve in this area after rehabilitation [41][42][43][44].…”