Prevalence of teeth and dentures among elderly in Norway receiving social care

Oral health status of institutionalized older adults receiving domiciliary dental care: A cross-sectional retrospective study

AIM

This study aimed to evaluate the oral health of care-dependent institutionalized older adults receiving domiciliary dental care.

METHODS AND RESULTS

Dental health records of institutionalized adults receiving regular domiciliary dental care were examined (observation period: 5 years). Relevant demographic and oral health information were extracted. Statistical analyses included descriptive and non-parametric tests (α = .05). Records of 398 nursing home residents (mean-age: 84.9 ± 6.4 years) were included. Average time spent by the residents in the institution was 2.8 ± 1.5 years. The mean number of teeth present and the overall DMF-T score was 14.7 ± 9.1 and 27.4 ± 6.2, respectively. The DMF-T score increased until the 3-year recall, with a significant increase in the number of decayed teeth (2-year: p = .013; 3-year: p = .010). An improvement in the residents' periodontal health was seen during the observation period but was not statistically significant.

CONCLUSION

The findings of this cross-sectional study confirmed that regular domiciliary dental care provision to institutionalized older adults helps maintain gingival and periodontal health. However, the incidence of dental caries might still be a problem that needs to be addressed with effective measures that improve the daily oral care provision to these older adults.

Effects of vitamin D status on oral health

Normal humans of all ages have the innate ability to produce vitamin D following sunlight exposure. Inadequate vitamin D status has shown to be associated with a wide variety of diseases, including oral health disorders. Insufficient sunlight exposure may accelerate some of these diseases, possibly due to impaired vitamin D synthesis. The beneficial effects of vitamin D on oral health are not only limited to the direct effects on the tooth mineralization, but are also exerted through the anti-inflammatory functions and the ability to stimulate the production of anti-microbial peptides. In this article, we will briefly discuss the genesis of various oral diseases due to inadequate vitamin D level in the body and elucidate the potential benefits of safe sunlight exposure for the maintenance of oral and general health.

Portuguese self-reported oral-hygiene habits and oral status

BACKGROUND

Good oral health is essential for good general health and quality of life. In Portugal, there are few studies on oral-health habits and the population's perceptions of this behaviour.

OBJECTIVE

The main purpose of this study was to characterise the Portuguese population's self-reported oral-health status, habits and perceptions, as well as their demands regarding national oral health-care services.

METHODS

A randomised group of 1,395 individuals, > 15 years of age, was selected as a representative sample of the Portuguese population. Face-to-face interviews were conducted, based on a structured questionnaire with closed and semi-closed questions. The data were submitted for statistical analysis using SPSS.

RESULTS AND DISCUSSION

A sample of 1,102 individuals answered the questionnaire. The great majority of the sample (97.6%) brushed their teeth daily, 70.3% had lost permanent teeth and 6.4% were edentulous. The loss of permanent teeth was statistically associated with poor oral-hygiene habits (P < 0.01). Moreover, 50.1% of the participants had experienced difficulty eating and/or drinking, 18% had felt ashamed of the appearance of their teeth and 69.3% had experienced toothache or gingival pain. A reduction in visits to a dentist in the previous 12 months was identified mainly for people from a lower social class (31.2%) and older people (29.4%).

CONCLUSION

Evidence suggests that oral diseases might be more prevalent in Portuguese adults than the European average. Efforts should be made to promote good oral-hygiene habits among older people and people from lower social classes.

Shortcomings of prosthodontic rehabilitation of patients living in long-term care facilities

Removable dentures are a non-invasive, cost-effective prosthodontic solution for the reduced dentition. Their intended purpose is the rehabilitation of harmonious oral function and aesthetics on a long-term basis. The prevalence of removable dentures among patients of advanced age is high and the quality of the dentures is often poor. The aim of this study was to find the most important shortcomings of removable dentures and address the main targets for improving the quality of prosthodontic rehabilitation. The records from dental check-ups in Austrian residential homes were analysed retrospectively. Dental anamnesis questionnaires and data from the clinical examinations of 105 denture wearers were analysed. The functional condition and retention of 192 dentures had been assessed, as well as the impact of the dentures on the intra-oral tissues. Insufficient denture retention was very common, particularly in the lower jaw (56·0%). Problems with the masticatory function were reported by 26.7% of the denture wearers, 11·4% were dissatisfied with the denture aesthetics, and 4·8% had difficulties with phonetics. Traumatic ulcers were found in 18·1%. Cracks, broken pieces (6·3%) or missing denture teeth (2·1%) were rare. It may be assumed that the findings of the present study also apply to a great percentage of community-dwelling seniors. The most important issues in prosthodontic rehabilitation with removable dentures are denture retention and masticatory function. Regular dental check-ups, denture adjustment and, when necessary, relining can maintain the primary denture quality and prevent damages of the oral tissues caused by ill-fitting dentures.

Development of a new model system to study microbial colonization on dentures

PURPOSE

Dentures are often colonized with a variety of microorganisms, including Candida albicans, that contribute to denture stomatitis. Several in vitro models have been previously established to study denture-related microbial colonization and evaluate treatment efficacy of denture cleansers; however, those models typically fail to appreciate the complex topology and heterogeneity of denture surfaces and lack effective ways to accurately measure microbial colonization. The purpose of this study was to study microbial colonization with a new model system based on real dentures, to more realistically mimic in vivo conditions.

MATERIALS AND METHODS

Scanning electron microscopy was used to observe topological structures among surfaces from different parts of the denture. Employing C. albicans as a model microorganism, we established microbial colonization on different denture surfaces. Moreover, we applied a modified MTT (3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide) colorimetric assay to quantify C. albicans colonization on dentures without the necessity of biofilm removal and to evaluate treatment efficacy of denture cleansers.

RESULTS

There were significant variations in topological structures among surfaces from different parts of the denture, with the unpolished side having the highest amounts of indentations and pores. The distinct denture surfaces support microbial colonization differently, with the unpolished side containing the highest level of microbial colonization and biofilm formation. Furthermore, the modified MTT colorimetric assay proved to be an accurate assay to measure biofilm formation on dentures and evaluate treatment efficacy of denture cleansers.

CONCLUSION

This new denture model system in conjunction with the MTT colorimetric assay is a valuable tool to study denture-related microbiology and treatment approaches.

Change in oral health status among the institutionalized Norwegian elderly over a period of 16 years

OBJECTIVE

To assess the oral health status of elderly residents living in nursing homes, and to determine whether there have been any changes between 1988 and 2004.

MATERIAL AND METHODS

The dental, periodontal, prosthetic, and oral mucosal status was recorded for 155 elderly long-term residents in five nursing homes. The results were compared with those of an identical cross-sectional study from 1988, using the same nursing homes, examination procedures, and evaluation criteria. The participation rate was 89.6%.

RESULTS

Edentulism was less frequent in 2004 (43%) than in 1988 (71%), and the mean number of teeth among the dentate participants had increased from 10.7 to 14.6. The proportion of subjects with decayed teeth increased from 55% in 1988 to 72% in 2004, and the mean DMFT (decayed, missing, and filled teeth) increased from 19.4 to 23.2. The frequency of subjects with periodontal pockets of 4 mm or more increased from 43% to 65% during the 16-year period. More participants had crowns or bridges. Of the denture-wearing subjects, more were affected by stomatitis in 2004 than in 1988; however, a decrease in the degree of severity was evident.

CONCLUSIONS

As more people retain their own teeth throughout life and the prevalence of oral diseases increases among the institutionalized elderly, their objective need for dental treatment is even greater than before. This underscores the necessity for developing effective and oral care programs for the elderly.

Oral hygiene and oral symptoms among the elderly in long-term care

Dental teams examined 1910 elderly adults living in long-term care settings (1358 institutionalized, 552 homebound) from all 19 counties in Norway to document oral hygiene, oral symptoms and ability to receive dental treatment. The Mucosal-Plaque Score (MPS) was used to assess oral status. The MPS was significantly better in women than in men, in individuals with dentures than in those with any remaining teeth, and in people who were homebound rather than those who lived in institutions. The MPS did not differ between age groups or geographic regions. According to the Treatment Ability Index, nearly a quarter of the sample was able to receive comprehensive dental care. Reports of "any oral symptom" and "eating/chewing problems" decreased with age and were most prevalent for individuals who had dentures. The MPS had only slight impact on oral symptoms, chewing ability and dry mouth (p > 0.05). Dry mouth was found in 16.9% and was most prevalent in individuals with dentures.

Dental caries among the elderly in Norway

OBJECTIVES

[corrected] To describe the occurrence of decayed teeth (DT), missing teeth (MT), filled teeth (FT), and the total sum score DMFT in elderly Norwegian pensioners, 67 years or more.

BASIC PROCEDURES

A representative sample of 582 elderly Norwegians (12.5% receiving social care) participated in a nationwide study (46% men and 54% women). In all, 394 (68%) still had some of their own teeth. A standardized clinical examination was performed by one of the authors (BMH) using well-defined criteria.

MAIN FINDINGS

Mean DT was 0.46, FT was 8.4, and DMFT was 25.4. Mean number of root remnants was 0.11. Mean DT, FT, DMFT, and root remnants for the dentate participants were 0.67, 12.4, 24.1, and 0.17, respectively. Men had significantly higher DT than women. DT decreased with increasing age. Only small differences were found in the prevalence of dentate individuals with caries between gender, age groups, geographical regions, and residence in areas of varying population density.

CONCLUSION

It seems that caries is a minor problem in the Norwegian elderly population. Age and the number of remaining teeth do not have a decisive role in the development of caries. Further, there are no differences in these respects between geographical areas in Norway.