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Dental health of community-living older people attending secondary healthcare: a cross-sectional comparison between those with and without diagnosed mental illness

Published online by Cambridge University Press:  15 December 2009

Nitin Purandare ,
Eva Woods ,
Sue Butler ,
Julie Morris ,
Martin Vernon ,
James Fraser McCord  and
Alistair Burns
Nitin Purandare*
Affiliation:
University of Manchester and Manchester Mental Health and Social Care Trust, Old Age Psychiatry, Manchester, U.K.
Eva Woods
Affiliation:
University of Manchester and School of Dentistry, Manchester, U.K.
Sue Butler
Affiliation:
University of Manchester and Manchester Mental Health and Social Care Trust, Old Age Psychiatry, Manchester, U.K.
Julie Morris
Affiliation:
Medical Statistics, University Hospital of South Manchester NHS Trust, Manchester, U.K.
Martin Vernon
Affiliation:
Geriatric Medicine, University Hospital of South Manchester NHS Trust, Manchester, U.K.
James Fraser McCord
Affiliation:
University of Manchester and School of Dentistry, Manchester, U.K.
Alistair Burns
Affiliation:
University of Manchester and Manchester Mental Health and Social Care Trust, Old Age Psychiatry, Manchester, U.K.
*
Correspondence should be addressed to: Dr. Nitin Purandare, Psychiatry Research Group, School of Community Based Medicine, The University of Manchester, Room 3.319, University Place (3rd Floor East), Oxford Road, Manchester M13 9PL, U.K. Phone: +44 (0)161 3067916; Fax: +44 (0)161 3067945. Email: nitin.purandare@manchester.ac.uk.
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Abstract

Background: Mental illness and cognitive impairment are risk factors for poor dental health.

Methods: We conducted a cross-sectional study to compare the dental health of older patients attending out-patient clinics and day hospitals of old age psychiatry services (the psychiatry group, n = 103) with those attending general/geriatric medical services (the medical group; n = 99). Those living in care homes, and those with diagnosed mental illness (in the medical group) were excluded. A registered mental health nurse assessed mental and general health using validated and previously published instruments. A registered dentist made an independent assessment of dental health (examination to assess oral pathology, status of remaining teeth, and dentures) and made an overall judgment about whether the patient needed any dental treatment (a “normative” need).

Results: The normative need for dental treatment was significantly higher among the psychiatry group compared to the medical group (85% vs 52%; p<0.001); even after taking account of the effect of age, gender, teeth status, physical comorbidity, cognition, depressive symptoms, and overall mental and social health [adjusted odds ratio, OR (95% confidence interval): 4.32 (2.09, 8.91)]. The presence of any natural remaining teeth [OR: 4.44 (2.10, 9.42)] and Barthel Index [OR: 0.96 (0.93, 0.99)] were the two other independent predictors of the need for treatment.

Conclusion: Dental problems are common in community-living older people, especially those with some natural remaining teeth and those with mental illness. There is a need to develop integrated mental health and dental care services for older people with emphasis on prevention of dental problems.

Keywords

dentaloraldentistagedmentalcognitioncommunityneed
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 3 , May 2010 , pp. 417 - 425
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Adult Dental Health Survey (1998). Oral Health in the United Kingdom. London: Office of National Statistics.Google Scholar
Antoun, J. S., Adsett, L. A., Goldsmith, S. M. and Thomson, W. M. (2008). The oral health of older people: general dental practitioners’ beliefs and treatment experience. Special Care in Dentistry, 28, 2–7.CrossRefGoogle ScholarPubMed
Burns, A. et al. (1999). Health of the Nation Outcome Scales for Elderly People (HoNOS 65+). British Journal of Psychiatry, 174, 424–427.CrossRefGoogle ScholarPubMed
Burvill, P. W., Mowry, B. and Hall, W. D. (1990). Quantification of physical illness in psychiatric research in the elderly. International Journal of Geriatric Psychiatry, 5, 161–170.CrossRefGoogle Scholar
Chalmers, J. M., Kingsford Smith, D. and Carter, K. D. (1998). A multi disciplinary dental program for community-living adults with chronic mental illness. Special Care in Dentistry, 18, 194–201.CrossRefGoogle Scholar
Community Periodontal Index of Treatment Needs (CPITN) Probe (1987). Extracts of the Third Edition of “Oral Health Surveys – Basic Methods”. Geneva: World Health Organization.Google Scholar
Dicks, J. L. (1995). Outpatient dental services for individuals with mental illness: a program description. Special Care in Dentistry, 15, 239–242.CrossRefGoogle ScholarPubMed
Dolan, T. A., Atchison, K. and Huynh, T. N. (2005). Access to dental care among older adults in the United States. Journal of Dental Education, 69, 961–974.CrossRefGoogle ScholarPubMed
Drake, C. W., Beck, J. D. and Strauss, R. P. (1990). The accuracy of oral self-perceptions in a dentate older population. Special Care in Dentistry, 10, 16–20.CrossRefGoogle Scholar
Fabiano, J. A., Waldrop, D. P., Nochajski, T. H., Davis, E. L. and Goldberg, L. J. (2005). Understanding dental students’ knowledge and perceptions of older people: toward a new model of geriatric dental education. Journal of Dental Education, 69, 419–433.CrossRefGoogle Scholar
Fenwick, J. E., Batchelor, P. A. and Samarawickrama, D. Y. (1998). Reasons for referral of very elderly patients to the community dental service in rural England and the implications for developing oral health care services. Gerontology, 15, 67–72.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Holm-Pedersen, P. et al. (2005). Dental caries, periodontal disease, and cardiac arrhythmias in community-dwelling older persons aged 80 and older; is there a link? Journal of the American Geriatrics Society, 53, 430–437.CrossRefGoogle ScholarPubMed
Lane, E. A. and Gallagher, J. E. (2006). Role of the single assessment process in the care of older people. How will primary dental care practitioners be involved? Primary Dental Care, 13, 130–134.CrossRefGoogle ScholarPubMed
Loesche, W. J. et al. (1998a). Assessing the relationship between dental disease and CHD in elderly U. S. veterans. Journal of the American Dental Association, 129, 301–311.CrossRefGoogle Scholar
Mahoney, F. L. and Barthel, D. W. (1965). Functional evaluation: the Barthel index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
McGrath, C. and Bedi, R. (1998). A study of the impact of oral health on the quality of life of older people in the UK: findings from a national survey. Gerodontology, 15, 93–98.CrossRefGoogle ScholarPubMed
McGrath, C., Bedi, R. and Dhawan, N. (1999). Factors influencing older people's self reported use of dental services in the United Kingdom. Gerodontology, 16, 97–102.CrossRefGoogle Scholar
Merelie, D. L. and Heyman, B. (1992). Dental needs of the elderly in residential care in Newcastle-upon-Tyne and the role of formal carers. Community Dentistry and Oral Eidemiology, 20, 106–111.CrossRefGoogle ScholarPubMed
Morris, A. J., Steele, J. and White, D. A. (2001). The oral cleanliness and periodontal health of UK adults in 1998. British Dental Journal, 191, 186–192.CrossRefGoogle ScholarPubMed
Nuttall, N. M. et al. (2001). Dental attendance in 1998 and implications for the future. British Dental Journal, 190, 177–182.CrossRefGoogle ScholarPubMed
Pearson, N. K., Gibson, B. J., Davis, D. M., Gelbier, S. and Robinson, P. G. (2007). The effect of a domiciliary denture service on oral health-related quality of life: a randomised controlled trial. British Dental Journal, 203, E3, doi: 10.1038/bdj.2007.569.CrossRefGoogle ScholarPubMed
Office of National Statistics/Government Actuary's Department (2006). National Population Projections 2004-based. Available at: http://www.gad.gov.uk/Documents/Demography/Projections/National_Population_Projections_2004_Based_Report.pdf.Google Scholar
Robinson, P. G., Nadanovsky, P. and Sheiham, A. (1998). Can questionnaires replace clinical surveys to assess dental treatment needs of adults? Journal of Public Health Dentistry, 58, 250–253.CrossRefGoogle ScholarPubMed
Sahyoun, N. R., Lin, C. L. and Krau, E. (2003). Nutritional status of the older adult is associated with dentition status. Journal of the American Dietetic Association, 103, 61–66.CrossRefGoogle ScholarPubMed
Sheiham, A. et al. (2002). The relationship between oral health status and body mass index among older people: a national survey of older people in Great Britain. British Dental Journal, 192, 703–706.CrossRefGoogle ScholarPubMed
Steele, J. G. and Ayatollahi, S. M. T. (1996). Major clinical findings from a dental survey of elderly people in three different English communities. British Dental Journal, 180, 17–23.CrossRefGoogle ScholarPubMed
Steele, J. G., Sheiham, A., Marcenes, W., Fay, N. and Walls, A. W. (2001). Clinical and behavioural risk indicators for root caries in older people. Gerodontology, 18, 95–101.CrossRefGoogle ScholarPubMed
Stewart, R. and Hirani, V. (2007). Dental health and cognitive impairment in an English national survey population. Journal of the American Geriatrics Society, 55, 1410–1414.CrossRefGoogle Scholar
Terpenning, M. S. et al. (2001). Aspiration pneumonia: dental and oral risk factors in an older veteran population. Journal of the American Geriatrics Society, 49, 557–563.CrossRefGoogle Scholar
Vered, Y. and Sgan-Cohen, H. D. (2003). Self-perceived and clinically diagnosed dental and periodontal health status among young adults and their implications for epidemiological surveys. BioMed Central Oral Health, 3, 3.CrossRefGoogle ScholarPubMed
World Health Organization (1992). International Classification of Diseases, ICD-10. Geneva: World Health Organization.Google Scholar
Wu, B., Plassman, B. L., Liang, J. and Wei, L. (2007). Cognitive function and dental care utilization among community-dwelling older adults. American Journal of Public Health, 97, 2216–2221.CrossRefGoogle ScholarPubMed
Yesavage, J. A. et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar