Does non-institutionalized elders have a better oral health status compared to institutionalized ones? A systematic review and meta-analysis

Abstract

This systematic review compared the oral health status between institutionalized and non-institutionalized elders. The following electronic databases were searched: PubMed (Medline), Scopus, Web of Science, Lilacs and Cochrane Library, in a comprehensive and unrestricted manner. Electronic searches retrieved 1687 articles, which were analyzed with regards to respective eligibility criteria. After reading titles and abstracts, five studies were included and analyzed with respect their methodological quality. Oral status of institutionalized and non-institutionalized elderly was compared through meta-analysis. Included articles involved a cross-sectional design, which investigated 1936 individuals aged 60 years and over, being 999 Institutionalized and 937 non-institutionalized elders. Studies have investigated the prevalence of edentulous individuals, the dental caries experience and the periodontal status. Meta-analysis revealed that institutionalized elderly have greater prevalence of edentulous (OR = 2.28, 95%CI = 1.68-3.07) and higher number of decayed teeth (MD = 0.88, 95%CI = 0.71-1.05) and missed teeth (MD = 4.58, 95%CI = 1.89-7.27). Poor periodontal status did not differ significantly between groups. Compared to non-institutionalized, institutionalized elders have worse dental caries experience.

Masticatory function in nursing home residents: Correlation with the nutritional status and oral health–related quality of life

“…DMFT of the participants of our study and the worse oral health condition of nursing home residents compared with community-dwelling elders, 3 institutionalised elders need more access to oral health care.…”

“…4 As a result, due to difficulty in accessing oral health services, 4 living in a nursing home results in a poor oral health status, mainly regarding the absence of teeth and dentures. 3,4 Tooth loss, when not replaced by dentures, compromises mastication. 5,6 Considering that chewing and swallowing are the first stages of food digestion, 7 edentulism 8 and the absence of prosthetic rehabilitation 9 may affect food and nutrient intake.…”

“…The minimum sample size (303 participants) of this study was determined considering a response rate of 50%, a confidence interval of 95%, a design effect of 1.5 and statistical power of 80%, based on a previous study. 3 Therefore, 344 elderly were included, being 204 residents of 10 nursing homes in Piracicaba, and 140 elders living in seven nursing homes in João Pessoa.…”

“…Older adults require attention, and the reduction in the availability of family members to provide elderly care results in the transition of the elderly from the community to nursing homes, a process called institutionalisation 2 . A systematic review and meta‐analysis 3 summarised that nursing home residents have a higher number of decayed and missing teeth and a higher prevalence of edentulism than community‐dwelling elders. Moreover, elderly people residing in nursing homes present a lower use of dentures.…”

“…Moreover, elderly people residing in nursing homes present a lower use of dentures. 4 As a result, due to difficulty in accessing oral health services, 4 living in a nursing home results in a poor oral health status, mainly regarding the absence of teeth and dentures 3,4 …”