Dental Health Among Homebound Elderly

Abstract

Currently, little is known about the oral health status, perceived oral health needs, or the extent of dental utilization among community-dwelling, functionally dependent elderly. The purpose of this study was to describe the dental health of functionally dependent elderly living at home and receiving community-based support services. The functional limitations experienced by these elderly living at home are comparable to functional limitations experienced by institutionalized elderly and these limitations impact on oral hygiene and access to dental care. Oral examinations and questionnaires were completed on 50 clients of an urban social service agency. Subjects had a mean of 8.8 teeth/person, with 44 percent completely edentulous. Two subgroups identified from the questionnaire--those who perceived themselves homebound (n = 30) and those who did not (n = 20), did not differ by age, gender, education level, or race. Respondents reported being homebound an average of 4.5 (+/- 2.9) years. The mean decayed, filled teeth for the perceived homebound group was 5.1, and 7.3 for the group that did not perceive themselves as homebound, with both groups averaging less than of one tooth/person with active root decay. Health care and social policy agendas must address the changing scope of oral health needs and limited access to dental care experienced by an aging population retaining more of their natural dentition.

Aging and Oral Health

“…The microorganisms that cause pneumonia are commonly found in significantly high concentrations in the dental plaque of people with gum disease. Many studies havedemonstrated that poor oral hygiene in older adults is a major risk factor forpneumonia, in particular a strain called "aspiration pneumonia", which is causedby bacteria-laden saliva accidentally entering the windpipe and travelling to the lungs [5].…”

“…Inflammation is a major risk factor for heart disease, and the bacterial accumulations associated with periodontal disease can increase inflammation levels throughout the entire body [3][4][5][6].…”

“…The researchers concluded that poor dental health, combined with diminished ability to communicate, can cause weight loss, dehydration and infirmity [8]. In addition to helping prevent the conditions listed above, good oral health and hygiene have been associated in less direct ways with the prevention of other diseasesi.e osteoporosis and rheumatoid arthiritis in different ways [5].…”

“…RA and periodontitis are both common chronic inflammatoryconditions. Researchers have concluded that non-surgical periodontal therapyhad a beneficial effect on the signs and symptoms of RA, regardless of themedications being used to treat the condition [2][3][4][5][6][7][8]. Good oral health is essential to healthy aging.…”

Oral status of residents of long-term care facilities in Kentucky.

“…Stating that other segments of the elderly population are more clearly identified, Saunders and Friedman assert that there is a need for regular oral care for persons with disabilities. Strayer (1993) was also interested in the oral health of the homebound elderly, especially those that considered themselves homebound due to limitations in ADL. He stated that, while the oral health of the institutionalized elderly has been reported to be poor, little information was available on the dental health of the homebound.…”