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Yang, Moon, Han, Lee, and Chung: Oral health status and treatment need of institutionalized elderly patients
ORIGINAL ARTICLE

J Korean Acad Prosthodont 2008;46(5):455-469.

Published online: NaN December 2008

DOI: https://doi.org/10.4047/jkap.2008.46.5.455

Oral health status and treatment need of institutionalized elderly patients

Soon-Bong Yang, DDS, MSD1, Hong-Suk Moon, MSD, DDS, PhD2, Dong-Hoo Han, MSD, DDS, PhD3, Ho-Yong Lee, MSD, DDS, PhD3, Moon-Kyu Chung, MSD, DDS, PhD3,

1Graduate student, Department of Medical Science, Graduate School, Yonsei University, Korea

2Associate professor, Department of Prosthodontics, College of Dentistry, Yonsei University, Korea

3Professor, Department of Prosthodontics, College of Dentistry, Yonsei University, Korea

Corresponding Author: Moon-Kyu Jung Department of Prosthodontics, Dental Hospital, Yonsei University, 134 Sinchon-dong, Seodaemun-gu, Seoul, 120-749, Korea Tel.: +82 2 2228 8720 E-mail: mkjung@yuhs.ac

Received 29 April 200817 July 2008       Accepted 25 August 2008

Copyright © 2008 The Korean Academy of Prosthodontics

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Statement of problems

In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions.

Purpose

The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs.

Material and methods

The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea.

Results and conclusion

The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients. (J Kor Acad Prosthodont 2008;46:455-69).

Keywords: Oral health status, Treatment need, Institutionalized elderly, Occluding pairs, Caregiver

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Fig. 1.
Distribution of DMFT index by aged groups.
jkap-46-455f1.tif
Fig. 2.
Distribution of number of residual tooth by aged groups.
jkap-46-455f2.tif
Fig. 3.
Distribution of number of fixed partial denture by aged groups.
jkap-46-455f3.tif
Fig. 4.
Distribution of percentage of people wearing removable partial denture by aged groups.
jkap-46-455f4.tif
Fig. 5.
Distribution of percentage of people wearing complete denture by aged groups.
jkap-46-455f5.tif
Fig. 6.
Distribution of percentage of people needing complete denture by aged groups.
jkap-46-455f6.tif
Fig. 7.
Distribution of number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth by aged groups.
jkap-46-455f7.tif
Table I.
Distribution of the elderly in Experimental group (Institutions) and Control group (D dental clinic) by gender (unit: number)
    Male Female Total
Experimental group (Institutions) A 8 (18.6%) 35(81.4%) 43
B 1 (5.9%) 16(94.1%) 17
C 13 (18.8%) 56 (81.2%) 69
D 0 (0%) 2 (100%) 2
E 7 (14.3%) 42 (85.7%) 49
F 20 (15.3%) 111 (84.7%) 131
G 18 (31.6%) 39 (68.4%) 57
H 11 (22.9%) 37 (77.1%) 48
I 15 (27.3%) 40 (72.7%) 55
J 12 (41.4%) 17 (58.6%) 29
K 8 (17.4%) 38 (82.6%) 46
L 15 (30.6%) 34 (69.4%) 49
M 5 (10.6%) 42 (89.4%) 47
N 16 (15.4%) 88 (84.6%) 104
O 1 (8.3%) 11 (91.7%) 12
Total 150 (19.8%) 608 (80.2%) 758
Control group (D dental clinic) D 103 (48.6%) 109(51.4%) 212
Table II.
Mean values of DMFT index by aged groups (unit: number)
Aged groups Experimental group (Institutions) Control group (D dental clinic)
65≤Age≤74 19.93 ± 8.70 15.02 ± 9.01
75≤Age≤84 22.90 ± 7.27 21.68 ± 8.46
85≤Age 24.70 ± 5.74 24.00 ± 5.20
Table III.
Mean values of number of residual tooth by aged groups (unit: number)
Aged groups Experimental group (Institutions) Control group (D dental clinic)
65≤Age≤74 Mx 5.36 ± 5.25 9.06 ± 4.76
Mn 6.44 ± 5.16 9.84 ± 4.20
Total 11.80 ± 9.80 18.85 ± 8.21
75≤Age≤84 Mx 3.58 ± 4.57 5.30 ± 5.33
Mn 4.58 ± 4.74 6.88 ± 5.31
Total 8.16 ± 8.62 12.13 ± 10.24
85≤Age Mx 2.13 ± 3.61 1.67 ± 3.08
Mn 2.88 ± 4.07 3.00 ± 4.09
Total 5.01 ± 7.12 4.67 ± 6.56
Table IV.
Mean values of number of fixed partial denture by aged groups (unit: number)
Aged groups   Experimental group (Institutions) Control group (D dental clinic)
65≤Age≤74 Mx 1.48 ± 2.74 3.04 ± 3.73
Mn 2.11 ± 3.46 3.20 ± 3.73
Total 3.58 ± 5.11 6.09 ± 6.32
75≤Age≤84 Mx 1.38 ± 2.86 3.30 ± 4.21
Mn 1.91 ± 3.41 3.25 ± 3.67
Total 3.28 ± 5.12 6.55 ± 7.23
85≤Age Mx 0.72 ± 2.22 0.67 ± 2.00
Mn 0.93 ± 2.41 0
Total 1.65 ± 3.88 0.67 ± 2.00
Table V.
Percentage of people wearing removable partial denture by aged groups (unit: %)
Aged groups   Experimental group (Institutions) Control group (D dental clinic)
65≤Age≤74 Mx 4.14 7.97
Mn 9.47 10.43
Total 13.61 18.40
75≤Age≤84 Mx 8.95 5.00
Mn 13.27 20.00
Total 21.91 25.00
85≤Age Mx 4.94 11.11
Mn 8.23 11.11
Total 13.17 22.22
Table VI.
Percentage of people wearing complete denture by aged groups (unit: %)
Aged groups   Experimental group (Institutions) Control group (D dental clinic)
65<Age<74 Mx 11.83 13.50
Mn 4.14 6.13
Total 15.98 19.63
75<Age<84 Mx 22.22 37.50
Mn 11.73 22.50
Total 33.95 60.00
85<Age Mx 27.16 55.56
Mn 15.94 33.33
Total 43.10 88.89
Table VII.
Percentage of people needing complete denture by aged groups (unit: %)
Aged groups   Experimental group (Institutions) Control group (D dental clinic)
65<Age<74 Mx 20.71 9.20
Mn 17.75 1.84
Total 38.46 11.04
75<Age<84 Mx 24.69 17.50
Mn 20.99 2.50
Total 45.68 20.00
85<Age Mx 34.98 22.22
Mn 29.63 11.11
Total 64.61 33.33
Table VIII.
Mean values of number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teet by aged groups (unit: number)
Number of valued teeth and dental
prostheses in shortened dental arch concept		 Aged groups Experimental group (Institutions) Control group (D dental clinic)
  65<Age<74 12.32 ± 7.76 18.33 ± 3.24
  75<Age<84 12.18 ± 7.88 18.03 ± 4.73
  85<Age 9.70 ± 8.36 14.89 ± 7.69
Number of occluding
pairs of teeth		 Aged groups Experimental group (Institutions) Control group (D dental clinic)
  65<Age<74 5.28 ± 4.30 8.78 ± 2.04
  75<Age<84 5.16 ± 4.41 8.83 ± 2.58
  85<Age 3.93 ± 4.43 7.00 ± 4.30
Table IX.
Summary of number of valued teeth and dental prostheses in shortened dental arch concept, number of occluding pairs of teeth in relation of professional treatment need (unit: number, %)
  Experimental group (Institutions) Control group (D dental clinic)
  Value = 0 Mean Value = max Value = 0 Mean Value = max
NSDAC 16.35% 11.5 32.58%∗ 0.94% 18.13 64.60%∗
NOP 34.56% 4.84 32.18%∗∗ 2.83% 8.71 64.60%∗∗

∗: percentage that NSDAC is 20.

∗∗: percentage that NOP is 10.

Table X.
Summary of values in relation of removable prostheses (unit: number, %)
  Experimental group (Institutions) Control group (D dental clinic)
  Maxilla Mandible Total Maxilla Mandible Total
Edentulism (%) 51.90 35.60 29.50∗ 21.20 12.70 9.90∗
NRT>20 (%) - - 14.90 - - 44.33
RPD (%) 6.46 10.68 3.03∗∗ 7.54 12.26 2.35∗∗
Single RPD (%) 3.43 7.51 10.94 5.18 9.43 14.62
CD (%) 21.10 10.81 9.23∗∗∗ 19.81 10.37 8.96∗∗∗
Single CD (%) 3.43 0.52 3.95 11.30 1.41 12.73
Patient without denture in fully edentulism (%) - - 55.35 - - 9.52

∗: edentulous state on maxilla and mandible.

∗∗: removable partial denture on maxilla and mandible.

∗∗∗: complete denture on maxilla and mandible.

Table XI.
Data of Oral Health Research of year 2000 in Republic of Korea by aged groups (unit: number, %)
Aged groups   DMFT index Number of residual tooth∗ Percentage of people wearing removable partial denture Percentage of people wearing complete denture Percentage of people needing complete denture
65<Age<74 Mx - - 11.68 21.73 5.07
Mn - - 12.43 14.80 3.91
Total 11.94 18.67∗ - - -
75<Age Mx - - 10.67 33.41 16.13
Mn - - 9.97 24.74 14.31
Total 14.91 15.53∗ - - -

∗: estimated value by number of average missing permanent teeth in Oral Health Research of year 2000 in Republic of Korea.

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