Oral disease in the elderly in long‐term hospital care

Abstract

OBJECTIVE: To obtain baseline information on the prevalence of oral problems and disease in institutionalized elderly in a Scottish hospital. DESIGN: A cross-sectional clinical investigation with complementary microbiological studies as appropriate. SUBJECTS AND METHODS:A cohort of 147 elderly in five long-term care wards; collection of demographic data; clinical examination to determine: i) the dental, and denture status and associated lesions such as Candida-associated denture stomatitis and angular cheilitis, ii) oral mucosal disease; swabs as appropriate for microbiology. MAIN OUTCOME MEASURES: Dental status, root caries prevalence; denture status and hygiene, and associated disease; oral mucosal health. RESULTS Median period of institutionalization of I47 patients was 15 months and 65% were aged 80 years or more; the majority were significantly mentally impaired; 52% wore complete dentures, 9% were partially dentate, 19% possessed partial or incomplete dentures; 20% were neither dentate nor had dentures. Of 80 patients who verbalired their complaints, 35% complained of dry mouth and 45% had denture-related problems, principally discomfort. The commonest oral finding was a coated tongue (56%); angular cheilitis was present in 25%, and Candida-associated denture stomatitis in 19%; none had oral ulcers. CONCLUSIONS: There was considerable unmet dental need with significant oral disease and poor levels of oral and denture hygiene in this target group; both dental and medical professionals should act in concert t o deliver curative as well as preventative dental care for the elderly living in institutions to improve their quality of life.

Oral health status among long-term hospitalized adults: A cross sectional study.

“…Possible explanation might be that, on one hand only 12.6% from the participants were wearing dental dentures, and on the otherhand most of the participants received anti-inflamotary drugs, including antibiotics additionally to daily treatment of oral cavity with solutions of chlorhexidine 0.12% may positively effect gums health and affect periodontal status Angular cheilitis was found in our study in significant proportions similarly to the study of (Peltola et al2004) (14% vs. 19%). Nevertheless, these findings are lower than Samaranayake et al findings (Samaranayake et al, 1995). Most patients who suffer from angular cheilitis, according to our observation, were patients with nasogastric feeding device.…”

Oral health status among long-term hospitalized adults: A cross sectional study.

“…Possible explanation might be that, on one hand only 12.6% from the participants were wearing dental dentures, and on the otherhand most of the participants received anti-inflamotary drugs, including antibiotics additionally to daily treatment of oral cavity with solutions of chlorhexidine 0.12% may positively effect gums health and affect periodontal status Angular cheilitis was found in our study in significant proportions similarly to the study of (Peltola et al2004) (14% vs. 19%). Nevertheless, these findings are lower than Samaranayake et al findings (Samaranayake et al, 1995). Most patients who suffer from angular cheilitis, according to our observation, were patients with nasogastric feeding device.…”

The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents

“…It was assumed that these two scores were representing the xerostomia prevalence of the present study group. The figure of 52% is within the range of the figures of previous studies on prevalence of xerostomia in groups of institutionalized elderly people (35–63%) and somewhat higher than in groups of non-institutionalized elderly people (21–46%) [3–5, 35, 38]. …”

Variation in oral health parameters between older people with and without mental disorders

“…The prevalence of these symptoms in older adults varies between studies but relevant data in the older people who are mentally ill are very limited (Table ). The prevalence of dysgeusia (2.7%) in the nonmentally ill older group was within the limits reported in previous studies in elderly populations (0% to 12%) . Many factors have been associated with dysgeusia: general medical disease (infections, diabetes, hypothyroidism, Alzheimer's disease, Parkinson's disease, renal failure, neoplastic disease), drugs’ intake (antianxiety, antibacterials, antidepressants, antiepileptic, antihistamine, antinemic, antipsychotics, bronchodilators, hypnotics, antiarthritic, antipyretic, antilipidemics, antiparkinsonian, antithyroids), and also mental disorders .…”

“…The prevalence of subjective complaints of xerostomia is high in the elderly (8.4% to 62.9%; Table ) . The findings in this study are within these limits; 46.7% of the older people with mental disorders and 33.8% of the controls complained of mouth dryness.…”

Oral health status among long-term hospitalized adults: A cross sectional study.

“…Possible explanation might be that, on one hand only 12.6% from the participants were wearing dental dentures, and on the otherhand most of the participants received anti-inflamotary drugs, including antibiotics additionally to daily treatment of oral cavity with solutions of chlorhexidine 0.12% may positively effect gums health and affect periodontal status Angular cheilitis was found in our study in significant proportions similarly to the study of (Peltola et al2004) (14% vs. 19%). Nevertheless, these findings are lower than Samaranayake et al findings (Samaranayake et al, 1995). Most patients who suffer from angular cheilitis, according to our observation, were patients with nasogastric feeding device.…”

The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents

“…It was assumed that these two scores were representing the xerostomia prevalence of the present study group. The figure of 52% is within the range of the figures of previous studies on prevalence of xerostomia in groups of institutionalized elderly people (35–63%) and somewhat higher than in groups of non-institutionalized elderly people (21–46%) [3–5, 35, 38]. …”

Variation in oral health parameters between older people with and without mental disorders

“…The prevalence of these symptoms in older adults varies between studies but relevant data in the older people who are mentally ill are very limited (Table ). The prevalence of dysgeusia (2.7%) in the nonmentally ill older group was within the limits reported in previous studies in elderly populations (0% to 12%) . Many factors have been associated with dysgeusia: general medical disease (infections, diabetes, hypothyroidism, Alzheimer's disease, Parkinson's disease, renal failure, neoplastic disease), drugs’ intake (antianxiety, antibacterials, antidepressants, antiepileptic, antihistamine, antinemic, antipsychotics, bronchodilators, hypnotics, antiarthritic, antipyretic, antilipidemics, antiparkinsonian, antithyroids), and also mental disorders .…”

“…The prevalence of subjective complaints of xerostomia is high in the elderly (8.4% to 62.9%; Table ) . The findings in this study are within these limits; 46.7% of the older people with mental disorders and 33.8% of the controls complained of mouth dryness.…”

Oral health status among long-term hospitalized adults: A cross sectional study.

“…Possible explanation might be that, on one hand only 12.6% from the participants were wearing dental dentures, and on the otherhand most of the participants received anti-inflamotary drugs, including antibiotics additionally to daily treatment of oral cavity with solutions of chlorhexidine 0.12% may positively effect gums health and affect periodontal status Angular cheilitis was found in our study in significant proportions similarly to the study of (Peltola et al2004) (14% vs. 19%). Nevertheless, these findings are lower than Samaranayake et al findings (Samaranayake et al, 1995). Most patients who suffer from angular cheilitis, according to our observation, were patients with nasogastric feeding device.…”

The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents

“…It was assumed that these two scores were representing the xerostomia prevalence of the present study group. The figure of 52% is within the range of the figures of previous studies on prevalence of xerostomia in groups of institutionalized elderly people (35–63%) and somewhat higher than in groups of non-institutionalized elderly people (21–46%) [3–5, 35, 38]. …”

Variation in oral health parameters between older people with and without mental disorders

“…The prevalence of these symptoms in older adults varies between studies but relevant data in the older people who are mentally ill are very limited (Table ). The prevalence of dysgeusia (2.7%) in the nonmentally ill older group was within the limits reported in previous studies in elderly populations (0% to 12%) . Many factors have been associated with dysgeusia: general medical disease (infections, diabetes, hypothyroidism, Alzheimer's disease, Parkinson's disease, renal failure, neoplastic disease), drugs’ intake (antianxiety, antibacterials, antidepressants, antiepileptic, antihistamine, antinemic, antipsychotics, bronchodilators, hypnotics, antiarthritic, antipyretic, antilipidemics, antiparkinsonian, antithyroids), and also mental disorders .…”

“…The prevalence of subjective complaints of xerostomia is high in the elderly (8.4% to 62.9%; Table ) . The findings in this study are within these limits; 46.7% of the older people with mental disorders and 33.8% of the controls complained of mouth dryness.…”