Oral Health Status of the Elderly in New England

Abstract

The New England Elders Dental Study (NEEDS) reports the prevalence, extent and severity of oral diseases and conditions among a representative sample of community-dwelling elders age 70 and older residing throughout the six New England states. In-home, full-mouth examinations were conducted by four calibrated dentists who used National Institute of Dental Research (NIDR) standardized disease measures plus additional diagnostic codes on all tooth surfaces. Only 37.6% of elders age 70 and older were edentulous, while dentate elders had a mean number of teeth per person ranging from 21.5 to 17.9 across age and gender cohorts. The prevalence of untreated coronal decay in elders with teeth was 28% in female elders and 34% in male elders. More than 90% of all elders with teeth had coronal fillings and 22% exhibited untreated root caries. Periodontal destruction was substantial, with 66% of dentate elders exhibiting moderate periodontal pockets (4-6 mm) while 21% exhibited severe periodontal pocketing (> 6 mm). Comparisons with national surveys suggest that periodontal disease prevalence and severity appear to have been underestimated in previous national studies of the elderly. Because of aging and tooth retention trends, the periodontal disease problem of the elderly may be increasing in the face of dentists' tendency to underdiagnose the periodontal diseases, legal constraints on dental hygienists to independently treat them, and inadequate funding for conservative nonsurgical therapies.

Oral health and peripheral arterial disease

“…Alternatively, a common risk factor such as genetic predisposition to inflammation (proinflammatory trait) leading to increased risk of periodontal disease and atherosclerosis might also explain the association. 7,12,17 Tooth loss and atherosclerosis share several common risk factors, which could be partially responsible for the association between tooth loss and PAD. 12,17 In this study, we adjusted for these common risk factors, and the homogeneity in socioeconomic status and health-related behavior among these health professionals would further minimize the effect from other unmeasured factors.…”

“…Because of the high prevalence of tooth loss, these findings could have a significant public health impact. [7][8][9] Chronic infection with inflammation and change in diet have been proposed as 2 pathways linking tooth loss and CVD. 10 Peripheral arterial disease (PAD) of the legs is a state of insufficient tissue perfusion to meet metabolic demand.…”

Quality of written prescriptions and master impressions for fixed and removable prosthodontics: a comparative study

“…[1][2][3] From April 2001 to March 2002, in excess of £300 million was spent on various items of prosthodontic treatment for partially dentate patients on the National Health Service in England and Wales. 4 Data on the cost of similar treatments provided under private schemes is not available.…”

Nutrition and health risks in the elderly: the nutrition screening initiative.

“…[1][2][3] Although the majority of persons aged 70 years and older are reported to be in good to excellent health4,5 it is estimated that 85% of noninstitutionalized older persons have one or more chronic conditions that could improve with proper nutrition '2 and that up to half have clinically identifiable problems that require nutrition intervention. 15,6 The detection of nutritional risk among the elderly and referral as needed to appropriate nutrition services and resources are key concems of the Nutrition Screening Initiative. "7 The Initiative, a national effort supported by more than 25 professional organizations, is committed to the identification of nutritional problems in older persons and to improved de- England Elders Dental Study who completed a telephone survey, a home visit, or both.…”

“…"7 The Initiative, a national effort supported by more than 25 professional organizations, is committed to the identification of nutritional problems in older persons and to improved de- England Elders Dental Study who completed a telephone survey, a home visit, or both. 15 The dental study provided an examination of oral health status in a stratified random sample of Medicare beneficiaries aged 70 years or older in the six New England states. During in-home dental examination visits, trained interviewers measured subjects' height and weight and conducted 24-hour dietary recalls with the subjects or their designated proxies.…”