Factors influencing oral health in long term care facilities

Abstract

In a stratified random sample of 41 long term care (LTC) facilities in Vancouver, 653 residents were chosen to investigate oral health needs and demands for treatment. All of the 603 dentists in the same area were questioned to assess their interest in attending the residents of the institutions. The information from each source was reviewed to identify factors influencing the oral health services to this predominantly elderly and medically compromised population. The majority (60%) of the residents were edentulous and they made infrequent demands on dentists. Two-thirds of those interviewed said that there was nothing wrong with their mouths, but most of those who were aware of a problem wanted it treated, preferably within the institution. They complained about loose or uncomfortable dentures most frequently, and many were dissatisfied with previous dental treatment. The oral mucosal lesions seen on examination were usually symptomless and associated with poor hygiene, while structurally defective dentures and deep carious lesions were not uncommon. The responding 334 dentists indicated that they enjoyed treating elderly patients, 19% had attended an LTC facility, usually to provide an emergency service, and 37% were willing to provide this service if asked. Interest, however, in the service was curtailed by pressures from private practice, concerns about inadequate training and the small demand and poor conditions in the facilities. Although the demand for treatment was not extensive from the residents, they did have problems that were not receiving care.

The concept of validity in sociodental indicators and oral health‐related quality‐of‐life measures

“…concurrent validity) or future (i.e. More often than not, patients and respondents to SDIs when compared with clinicians and researchers see the need for health care and treatment quite differently (31), which confirms yet again the need for input from nonexperts when developing psychometric instruments. The instrument is valid when the response elicited (e.g.…”

Oral hygiene of elderly people in long‐term care institutions – a cross‐sectional study

“…Previous international studies have shown poor oral hygiene and oral health among housebound [3][4][5] and institutionalised older people [6][7][8][9][10][11] . This is even more important for people of an advanced age.…”

The impact of frailty on oral care behavior of older people: a qualitative study

“…However, despite extensive research on barriers to dental service-use [7,12-17] and oral hygiene-related behavior [18-21] in which barriers have been associated with impaired mobility, impaired activities of daily living, low energy, depression, and lack of social support, it remains unclear how frailty in its many forms influences the oral care of older people. For example, it is not clear whether service-use and toothbrushing are disturbed more by impaired mobility, dexterity, or low morale, or, as some [22,23] suggest, by a lack of time and energy caused by more pressing general health problems. Nor do we know what motivates frail people to apply oral care despite physical and cognitive impairments, or why there are discrepancies between perceived treatment need and service-use.…”