Search

Objectives: To describe the oral health-related quality-of-life in homebound elderly dependent on moderate and substantial supportive care for daily living., Materials and Methods: A total of 302 selected persons in three counties in Sweden over 65 years of age and in need of daily support from society participated in the study. Half of the participants had moderate needs of support, defined as supportive care of 15-50 h per month and half had substantial needs of supportive care, i.e. 3-times a day with a night overview. An oral examination was performed and structured questions were asked about general health and living conditions, medication, oral care routines and quality-of-life, using the instrument GOHAI (Geriatric Oral Health Assessment Instrument)., Results: Cardiovascular disease was common and an average of seven prescription drugs was used. More than half of the participants had dentures. The strongest correlation with GOHAI was the total number of teeth. There was a significant difference between individuals with moderate and substantial needs according to GOHAI, irrespective of gender. More elderly people with substantial needs of support had low GOHAI values. Decayed teeth, DT/T, root remnants and dry mouth were negatively correlated to GOHAI among individuals with substantial needs., Conclusions: This study found that elderly homebound individuals with substantial needs of supportive care had a lower quality-of-life than elderly homebound individuals with moderate needs of supportive care, although both medical and odontological variables were similar in the groups.

Objectives: Elderly people with disabilities have an increased risk of developing oral diseases as compared with the healthy elderly. The aim of this study was to investigate oral hygiene habits, clinical variables related to oral self-care and caries risk in elderly individuals living at home with moderate and substantial needs of home care., Methods: A random sample of 151 elderly people with moderate needs and 151 with substantial needs of home care were examined. Data concerning general health, social conditions and oral hygiene habits were collected using a questionnaire. Data showing the prevalence of caries, plaque scores and gingival bleeding were obtained through clinical examinations., Results: Elderly subjects with substantial needs of home nursing had more active caries (P < 0.01) and more often gingival bleeding (P < 0.05), as compared with elderly people with moderate needs. Forty-nine per cent of the elderly with moderate needs performed acceptable self-care, as compared with 25% of the individuals with substantial needs. Good self-care was associated with women, low plaque scores, less bleeding and less caries. Factors increasing the risk of having caries were low saliva secretion, high plaque scores and a large number of fillings, while having a dentist and good oral hygiene habits increased the chance of not developing caries., Conclusions: Good oral hygiene habits were associated with less prevalence of plaque and oral disease in the elderly irrespective of extent of needs of home nursing. However, the elderly with moderate needs more often performed good self-care, indicating that the possibilities of strengthening self-care and learning new routines are better when functions are less affected., (© 2011 John Wiley & Sons A/S.)

Using osseointegrated implants to replace teeth is a routine procedure today. This study investigated oral status, oral hygiene habits, and patient satisfaction in elderly with dental implants who were dependent on substantial support for daily living. Twenty-six persons over the age of 65 who were dependent on supportive care were examined. Data collected included the number of teeth and implants, plaque scores, bleeding on probing, and oral hygiene habits. Self-perceived knowledge about managing their implants and satisfaction with the implants was recorded. Subjects had a total of 148 natural teeth and 144 implants. Only a few signs of oral disease were found and the tissues around implants were healthier than around natural teeth. No correlations between oral hygiene habits and plaque scores or bleeding were found. A majority of the subjects were satisfied with their implants. Dental implants have satisfactory function even in individuals who are elderly and have substantial needs for supportive care., (© 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.)

In 1999 a new law in Sweden granted people receiving a certain level of supportive care from the community the right to receive a free, in-home oral health assessment. Subsequent appraisal has disclosed that far from all eligible people, especially those living at home, have undergone such an assessment. Of fundamental importance to the success of this scheme is the active involvement of case managers in identifying those who are eligible for assessment. The aim of this study was to investigate case managers' knowledge of and attitudes to the oral health of their clients and the initiatives they take to ensure that dependent elderly and disabled persons living at home have access to oral health care. In qualitative in-depth interviews, 24 case managers from three Swedish counties were questioned about their perceptions of oral health care for their clients. The transcribed text was analysed by manifest and latent qualitative content analysis. The manifest analysis was based on the three content areas knowledge, attitudes and initiatives. During this process a theme emerged which disclosed the case managers' perceptions of their role in oral health care among elderly and disabled persons, a latent analysis. The case managers' age, education, experience and breadth of responsibilities varied. Their knowledge of the 1999 law was limited. In general there were no procedures in place to ensure that the oral assessments were undertaken and that records were kept. The case managers considered that they should not be responsible, although they could not suggest a more appropriate instance. The potential role of regular oral health assessment in prevention of oral diseases was not discussed at all in the interviews. The current systems for monitoring oral health are tailored primarily to institutionalised care. In future many more dependent people will continue to live at home with support from community home care assistants and relatives. It is important that oral health care activities, as well as research, are modified accordingly.