The oral health of individuals with dementia in nursing homes

OBJECTIVE: To determine if moderate to severe dementia has an effect on the oral health of individuals resident in nursing homes. BACKGROUND: A significant proportion of the elderly population lives in nursing homes and suffers from varying degrees of dementia. Dementia might affect an individual's ability to implement oral care. Previous work in this area has focused on individuals with mild dementia living in the community setting. MATERIAL AND METHODS: Two matched cohorts of subjects resident in four nursing homes in Cheshire were recruited (n=135). One cohort's subjects were deemed to have no or mild dementia, whereas the other cohort's subjects were deemed to have moderate to severe dementia. Oral parameters were scored, including Decayed, Missing, Filled Teeth (DMFT) scoring, dental deposit scoring, denture assessment and the noting of any other pathology. RESULTS: There was a statistically significant difference in the relative level of dementia of the subjects between the two cohorts (p<0.01, Student's t-test). The DMFT scores were similar for both groups. The mean number (+/-SD) of decayed and missing teeth for the no/mild dementia group was 1.11 (+/-3.42) and 28.22 (+/-6.64), whilst that of the moderate/severe dementia cohort was 0.80 (+/-1.87) and 27.28 (+/-7.73), respectively. Eleven per cent of the moderate/severe dementia cohort wore an upper denture alone as compared with 16% in the no/mild dementia group. CONCLUSION: For individuals resident in nursing homes, moderate to severe dementia might have a deleterious effect on oral health. Further work in this area is required.