No abstract

No abstract

In order to determine the influence of culture, individual idiosyncrasy, social and economic conditions as well as the importance of past and current dental care on oral health, the oral conditions of 610 patients in seven old age homes were evaluated in four countries: USA, Peru, Argentina and Israel. The patients included in this study were examined by clinicians who had undergone training and calibration sessions. The seven institutions surveyed have a large range of physical facilities, economic levels, and a variety of quantity and quality among medical, dental and ancillary staff. There were marked differences as to philosophy of treatment and scope for the dental care of the residents. A subjective impression by the examiners is that old age home administrators do not regard the dental needs of the residents to be among their higher priorities. Dental care is considered expensive and requires special equipment and exclusive physical space on the institutional premises. Of the 610 residents 419 were women and 191 men, with an average age of 80 years. The mean number of years of schooling was six. Sixty-two percent of the examinees were widowed, 21% were married, 1% single, 2% divorced, and 5% of unknown or undeclared status. The main orodontal characteristic of the population surveyed was partial or full eduentulousness. Of the total population (610 examinees) only three patients possessed a full complement of natural, unrestored teeth. Twelve examinees had 28 unit dentition, partly natural teeth and partly restored with plastic fillings, fixed prostheses, crowns or pontics. Three hundred and one patients (49%) of the examined population were totally edentulous, 249 (41%) wore sets of complete dentures and 52 (8%) did not wear any prosthetic restoration or replacement.

This paper demonstrated that 38% of the 610 examinees at seven institutions in four countries have soft tissue lesions. Seventy to eighty percent of the detected lesions were of the erythematous type. This incidence was found at institutions with and without attending dentists, in denture and non-denture users, in dependent and independent patients. Tissue lesions in denture wearers were four times as many as in non-denture wearers. The percentage of inflammatory lesions in both denture and non-denture wearers was considerably higher at institutions with no attending dental personnel when compared with those with dental care facilities. Where patients depended on the staff and/or their relatives for their personal hygiene, a sharp increase in pathological findings was seen when compared to independent dwellers. The nursing staff and the relatives know very little about the oral problems of the elderly residents. There was no uniform policy about telling patients when to wear their removable dentures and patients did not always follow instructions when they were given. Many patients sleep with their upper denture while the lower one is removed for the night. Patients sometimes sleep in the dentures and sometimes remove one or both dentures for varying periods of time. The high percentage of soft tissue lesions and erratic denture wearing habits point to neglect and insufficient oral care toward the geriatric population studied.