Utilization of dental services in the adult Danish population 1975

Lack of information on the dental behavior of adults in Denmark has become a major problem in the national planning of dental services. The purpose of this study was to establish the pattern of utilization of dental services among adult Danes (aged 15 and above). A three-stage cluster sampling design covering the total adult population of Denmark was used to draw a representative sample comprising 1,600 persons. Household interviews by trained interviewers were carried out. Of the adults interviewed, 58% reported yearly dental visits the last 5 years, 32% had not seen a dentist or only when in pain, and 10% went irregularly. Differences according to place of living, age, sex, occupation and school dental care were found. 63% of those who had seen a dentist reported bad teeth or were edentulous with or without dentures. 10% reported fear, 9% had good teeth and 5% reported economic difficulties. The most frequent treatments at the latest dental visit were cleaning and filling for the regular patients and extractions and dentures for the nonregular patients. A multiple classification analysis revealed that the number of teeth was the strongest predictor for dental services, with the following predictors in descending order: age, occupation, place of living, economy, sex and school dental care. These variables could explain 58% of the variation in utilization.     

Oral conditions and need for dental treatment in an elderly population in Northern Norway

abstract Oral conditions and dental treatment needs were investigated in a group of persons aged 65–79. A sample comprising 280 persons was drawn systematically to cover all persons in this age category living in the county of Troms in Norway. 241 persons attended, leaving a participation-rate of 86. The participants were examined mainly in their homes by dentists in graduate training. Sixteen percent of the group were in constant need of assistance or care due to a poor general state of health. In all, 80% were edentulous: 72% of the men and 87% of the women. Ninety-two percent wore removable dentures, 5% had natural teeth only, and 14% had natural teeth combined with a denture. Furthermore, 4% had neither teeth nor dentures, while dentures in both jaws were found in 66%. The “objective” treatment needs were extensive and had mainly accumulated due to neglected care. Forty percent of the total group needed new complete dentures and 20% a more comprehensive correction of their dentures. By contrast only 30% intended to seek treatment in the near future. There seemed to be a definite need for a dental program to overcome or reduce the economic and other situational barriers.     

Tooth loss and dental caries in institutionalized elderly in Italy

An epidemiological survey of dental health status and needs was conducted in a group of 234 randomly selected institutionalized elderly people in Naples, Italy. The mean age of the patients was 81.4 yr, 71.4% were women and 28.6% men. A total of 140 (59.8%) people were totally edentulous; an additional 13.7% were edentulous in one jaw. A significant increase in prevalence of edentulousness with increasing age was recorded. 44.3% of the edentulous in both jaws wore complete dentures. The mean number of remaining sound teeth, decayed teeth and root remnants in the elderly with maxillary and mandibular natural teeth decreased with increasing age. Of the 94 dentate elderly, 29.8% had no need of dental treatment. Of all dentate patients 68.1% needed one or more dental extractions with a mean need of 3.9 per patient; 37.2% needed restorative treatment for one or more teeth with a mean need per patient of 2.9. Analysis of the results showed poor dental health in this target group and the necessity of improving the dental health services programs for the elderly living in institutions.     

Oral health status and need of dental treatment in the elderly Danish population

ABSTRACT Oral health and dental treatment needs were investigated in 560 elderly persons in the county of Vestsjælland (West Zealand) in Denmark. Of the population aged 65 and above in three typical communities in the county, 10 % were selected by random sampling and totaled 633 persons. Of these, 560 persons (88.5 %) were interviewed and examined in their homes. The final sample population was representative of the total Danish population in relation to sex and socioeconomic status for this specific age group. Oral health was generally poor. In all, 68.2 % of the population were edentulous (64.7 of the males, 70.7 % of the females), while the dentate persons had an average of 12 teeth; 3.6 % were totally edentulous and lacked dentures in both jaws, a further 5.5 % were totally edentulous and lacked a denture in one jaw, and 83.4 % had removable dentures. Only 3.4 % of the dentate and 28.2 % of the edentulous persons did not need any dental treatment. The total percentage of people needing treatment was 80. Prosthetic treatment was the main requirement, applying to 80 % of the group. In contrast with this, only 25 % of the interviewed subjects had a subjective need for treatment. Information and economic aids for dental treatment are obviously needed in the elderly Danish population.     

The use of dental services in a population in Northern Norway.

The utilization of dental services was studied by means of records from dentist's files, a method which permits gathering of detailed information with high reliability and validity. 53% of the adult population of 358 persons living in a coastal community in Northern Norway had visited a dentist during a period of two years. In the group of 13% who were considered to be regular treatment attenders, number of teeth, sex and socio-economical status were the most influential predictors of utilization. Among the 182 persons with 10 or more remaining teeth, 59% had made preventive and restorative dental visits, and in this group there was a dominating proportion of women, young people and people with high income and/or social class. In contrast, only six persons out of 61 with one to nine remaining teeth had made such visits. People in social class 3 were overrepresented among the 26% of the population who visited a dentist because of extractions or complete denture services. The treatment profile according to age showed that younger people used most of their treatment time on consultations, preventive measures and conservative treatments, while fixed and removable prosthetics constituted a major part of the treatment time among elderly people.     

Subjective need of removable denture treatment in Finnish adults

The aim of this study was to analyse the clinical dental health, use of dental services and socio-economic factors correlating with the subjective need for removable dentures in Finnish adults aged 30 years and older. A total of 2528 persons who had lost one or more natural teeth (wisdom teeth excluded) and who had not been provided with any dentures, were selected for this study. Subjects who had subjective need for prosthetic treatment had statistically significantly fewer teeth and fewer fillings, and more decayed teeth than others. Irregular users of dental services felt the need for a prosthesis more often than did regular users of those services. Irregular brushing of teeth was also associated with a greater need for prosthetic treatment. Men, older individuals and persons with less education and a smaller family income felt the need for prosthetic treatment more often than women, younger individuals and better educated persons. The factors differentiating between the two groups with and without a subjective prosthetic treatment need were analysed by discriminant analysis. The best differentiating factors were frequency of dental visits, caries score, frequency of brushing teeth, family income, number of fillings and sex.     

Dental visits, teeth remaining, and prosthetic appliances in a Norwegian urban population

Abstract Of a random sample (177 persons) of 35-year-old Oslo citizens, 117 subjects (66.1 %) attended a dental examination. Questionnaires were returned by mail from 28 of the non-respondents. The most common reason for not attending was “difficulty in finding time for an appointment.” About 89% of the respondents had visited a dentist regularly. Regular dental care seemed to be more common among people with a high level of education than among those with a low level of education. The most common treatment performed at the last dental visit was filling of cavities. The mean number of remaining teeth was 25.7. Females in the lower educational group had significantly less teeth than those in the higher educational group. No subjects were totally edentulous, but five persons had one edentulous jaw. Nine full or partial dentures were found. Twelve percent of the subjects had one or more fixed bridges, and 29.9% of the persons had one or more crown restorations. There seemed to be no differences between the sexes or educational levels in this respect.     

Perceived Need for Dental Care Among Dentate Older Individuals in Sri Lanka

The authors assessed the perceived need for dental care among 585 older individuals, of whom 235 received a clinical oral examination. Of the 235 participants, only 171 were dentate. The present analysis is limited to this group. Of these 171 dentate adults, 43 percent perceived a need for dental care. Of this sample section, 53 percent perceived a need for dentures. Age, perceived oral health status, presence of mobile teeth, three impact items of the Oral Health Impact Profile‐14 (OHIP‐14) scale—namely “had a painful aching in the mouth, had difficulty in eating and that the diet had been unsatisfactory due problems with teeth, mouth or dentures”–and the total OHIP‐14 score showed significant associations with perceived need for dental care in bi‐vartate analysis. Poor perceived oral health status emerged as the strongest predictor of perceived need for dental care in logistic regression.     

Oral hygiene and associated factors among frail older assisted living residents

The aim of this study was to determine the associations of older assisted living residents’ tooth brushing habits with health and nutritional status. We assessed the tooth brushing habits, nutritional status, oral health, use of dental services, and morbidity of 1,447 assisted living residents in the Helsinki metropolitan area of Finland. Of the residents, 17% did not clean or had not cleaned their teeth and/or dentures daily. Those not cleaning their teeth and/or dentures daily were more often male, less educated and had a mean length of stay in assisted living longer than those who cleaned their teeth and/or dentures daily. They were more often malnourished and dependent in ADLs. In addition they more often had poorer oral health and used fewer dental services. Poor tooth brushing habits indicate poor oral and subjective health. More attention should focus on the oral hygiene of frail older assisted living residents.     

Response from a disadvantaged, rural population to a subsidized dental program

abstract – The present report deals with the first part of an investigation concerning the dental treatment in a disadvantaged, rural population in Norway. A state-supported dental program was introduced, and the response of the recipients was recorded. In a community of 5,214 inhabitants (Nord-Odal) all persons (280) between 20–60 years of age receiving economic support under different welfare programs were sent a short questionnaire and an accompanying letter offering subsidized dental services. After a follow-up letter, remaining non-respondents were visited in their homes for collection of the questionnaires. Finally, completely or partially answered questionnaires totalled 265, representing 97 % of all recipients excluding 7 with residence outside the community. Of the respondents, 78 % agreed to participate in the program, 12 % refused, and 10 % were uncertain. In general, those who refused were most likely to be found in the oldest age group and among people with a minimum income. Persons wearing dentures in both jaws refused the program more frequently than did persons with 15 or more teeth. The most common reason for refusing participation was satisfaction with their present dental condition.     

Oral health of Singapore adults

In a study conducted by the Dental Division of the Ministry of Health in 1992, 3157 Singapore adults aged 20 to 65 years and over were interviewed on their knowledge, attitude and practice of dental care and given an examination. About 66% indicated they required dental treatment. Utilisation of dental services was low with 39% visiting the dentist at least once in 2 years. About 72% brushed their teeth morning and night. The dental examination showed that 79.2% had calculus, 92% needed prophylaxis and oral hygiene instruction and only 0.2% needed complex periodontal treatment. A large proportion (96.6%) of the sample was dentate. The mean DMFT was 10.7 and the mean number of decayed root for the dentate population was 0.2. The age-group 65 years and over had the highest percentage (63.6%) of persons wearing dentures and the age group 50-54 years had the highest percentage (54.2%) requiring dentures. This study has shown that oral health promotion for home and professional care should be stressed to the adult population, particularly the older age groups.     

Changing dentate status of adults, use of dental health services, and achievement of national dental health goals in Denmark by the year 2000

OBJECTIVES: This study analyzes the current profile of dentate status and use of dental health services among adults in Denmark at the turn of the millennium, assesses the impact on dentate status of sociodemographic factors and use of dental health services in adulthood and in childhood, and highlights the changes over time in dental health conditions among adults. Finally, the intention of the study was to evaluate the Danish dental health care system's level of achievement of the official goals for the year 2000 as formulated by the World Health Organization and the National Board of Health. The subjects of this study included a national representative sample of 16,690 Danish citizens aged 16 years and older (response rate=74.2%). A subsample (n=3,818) took part in a survey of dental care habits in childhood and prevalence of removable dentures; 66 percent of persons selected responded. METHODS: Personal interviews were used to collect information on dentate status, use of dental health services and living conditions; data on dental care habits in childhood and prevalence of removable dentures were collected by self-administered questionnaires. RESULTS: In all, 8 percent of interviewed persons were edentulous, while 80 percent had 20 or more natural teeth. At age 65-74 years, 27 percent were edentulous and 40 percent had 20 teeth or more; 58 percent wore removable dentures. Dentate status and prevalence of dentures were highly related to educational background and income, particularly for older age groups. Among persons interviewed, 80 percent paid regular dental visits and visits were most frequent among persons of high education and income. At age 35-44 years 95 percent had participated in regular dental care in childhood compared to 49 percent of 65-74-year-olds. Multivariate analyses revealed that sociobehavioral factors had significant effects on dentate status. CONCLUSIONS: Compared to similar studies carried out in 1987 and 1994, the present survey indicates a positive trend of improved dentate status in adult Danes in general and regular use of dental health services increased considerably over time. The WHO goals for better dental health by the year 2000 were achieved for 35-44-year-olds, whereas the goal of more people with functional dentitions at age 65 years or older was not achieved. It remains a challenge to the Danish dental health system to help even out the social inequalities in dental health.     

Oral candidosis in long-term hospital care: comparison of edentulous and dentate subjects

OBJECTIVE: To obtain information on the oral health status of the elderly living in a medicalized, geriatric institution.
DESIGN: A cross-sectional clinical investigation with complementary microbiological studies.
SUBJECTS AND METHODS: A cohort of 233 elderly in one long-term care ward; collection of demographic data; clinical examination to determine dental and prosthetic status and health of the oral mucosae; swabs for detection of mucosal and denture colonization by Condido; paraffin stimulated saliva for detection of colonization by mutans streptococci and lactobacilli.
MAIN OUTCOME MEASURES: Oral and denture hygiene; oral mucosal health; degree of colonization by Condida , mutans streptococci and lactobacilli.
RESULTS: Mean age of the 233 patients was 85.6 ± 6.9 years; 61% were totally dependent, 62.7% were wearing one or two complete dentures; 19.7% had natural teeth and no denture and 17.6% neither teeth nor denture. Of those wearing dentures 72% had denture stomatitis. Of those with natural teeth 72% were affected by active caries. Yeast counts were significantly correlated with the intensity of the erythema of the palatal mucosa, plaque score of the natural teeth, denture plaque score, and salivary counts of mutans streptococci and lactobacilli.
CONCLUSIONS: High oral yeast counts and frequent prevalence of oral candidosis in elderly subjects living in institutions are associated with poor oral hygiene and neglect of denture care.     

Self perceived oral health, oral treatment need and the use of oral health care of the adult population in Skåne, Sweden

The aim was to describe how the adult population in Sk?ne, Sweden, perceived their oral health, dental status, oral treatment need and use of oral health care. A questionnaire was sent to a randomly selected sample of 10 000 persons in Sk?ne, Sweden. The individuals were between 20 and 89 years old and registered as residents of the region during 2006. After excluding those no longer living in the region, 9 690 individuals remained. The response rate to the questionnaire was 63%, of which 57% were women and 43% men.A majority was satisfied with their teeth and with their teeth's appearance, 65% and 62% respectively. Of the respondents, 35% considered their dental health to be better than others in their age group. Symptoms associated with periodontitis were experienced by 40%. 7% were missing more than ten teeth while 7% had no dental fillings. 30% rated their need of dental treatment as high and most expected their treatment need to increase in the future. Most of the respondents, 60%, received their oral care at a private practice, whereas 13% did not see a dentist regularly for check-ups. More women than men perceived a high dental treatment need, 32% compared to 28%. CONCLUSIONS: A majority of the adult population in Sk?ne have a positive attitude towards their oral health. Most individuals had lost few teeth and removable dentures were uncommon.A third rated their dental treatment need as high and most expected their treatment need to increase in the future..     

Oral health conditions and denture treatment needs in institutionalized elderly people in Japan

Oral health conditions, including dental conditions, temporomandibular joint (TMJ) conditions, denture status, and oral hygiene status, were assessed on 1908 institutionalized elderly people 65 yr of age and older at 29 of the 30 existing institutions in the city of Kitakyushu, Japan. The percentage of edentulous people was 27% in the 65-74-yr-old group, and increased with age to 56% in the 85 yr and older group. In dentate persons, the mean number of remaining teeth and DF teeth were 13.4 and 8.6, 9.5 and 6.8, and 8.4 and 6.5 in the groups aged 65-74 yr old, 75-84 yr old, and 85 yr and older, respectively. 81% of all the persons examined had no unusual symptoms in their TMJ. A clicking sound was the most frequent symptom (17%). Hygiene of both their teeth and dentures was very poor. Of all the subjects, 36% needed new full and/or partial denture(s), and 41% needed only repair. When the institutionalized elderly people were compared according to their general health condition, no clear differences were observed in percentage of edentulousness, mean number of remaining teeth and DF teeth, and TMJ conditions. However, a higher level of both untreated teeth and denture treatment needs, and poorer oral hygiene, was found in elderly people having poor general health than was observed in those with better health.(ABSTRACT TRUNCATED AT 250 WORDS)     

Oral health in a long-term care institution equipped with a dental service

The oral health and medico-dental status of 250 mostly elderly residents of a long term care institution were assessed by examination and a review of medical records. In addition, attitudes to dental care, dental experiences, and demands for care were solicited from those who could participate in an interview. There were no dental complaints from 70% of those interviewed. The complaints most frequently reported were difficulties with mouth dryness, hygiene, and chewing. Natural teeth remained in at least one jaw in 30% of the 245 residents examined. Dental caries was present in 78% of this dentate group, with coronal and root lesions equally prevalent. Gingival bleeding was also common in this group and 29% had deep periodontal pockets. Nearly 50% of the mandibular dentures and 25% of the maxillary dentures examined were inadequate. Mandibular dysfunction occurred in 25% of the population and was more frequent in the dentate group. Oral mucosal pathoses were rare. No correlation was found between the systemic health and the oral health of the residents. There was a need to improve the oral hygiene of most of those examined. Less than 20% of the denture wearers would have benefitted from treatment and 10% of those with defective dentures were considered unsuitable for treatment. In contrast, 60% of those with natural teeth required restorations and 36% needed one or more teeth removed. Very few urgent needs were seen. An inter-examiner accumulative inconsistency of 11% was measured between the three examiners, and a third of the assessments made of periodontal status were contradictory.     

Distribution and evaluation of complete dentures in a population in Northern Norway

The frequency and distribution of complete dentures were studied in a population of 358 persons aged 20--69 living in a community in Northern Norway. Among the 83% who attended the investigation, 49% had a maxillary and 26% a mandibular denture. The occurrence of dentures increased with increasing age and with decreasing income and/or social class, while dentures were almost equally common in both sexes, when differences of age and income were taken into account. Of the participants between 50--69 years 39% had received their first maxillary denture at the age 17--24 years. In the age group 30--49 years the corresponding percentage was 20. Forty-four percent of the participants had maxillary dentures and 33% mandibular dentures which were older than 10 years. According to an index on the clinical evaluation of complete dentures as well as to the denture wearers' own opinion, the insufficiency of the dentures tended to increase with increasing age of the dentures. Sex, age, income and social class, however, were found to have only a minor effect on the age and the condition of the dentures as well as on the denture wearers' degree of satisfaction with their dentures. Persons who had natural mandibular teeth, tended to be less satisfied with their maxillary dentures than persons with complete dentures in both jaws.     

Teeth, tooth spaces, and prosthetic appliances in elderly men in Malmö, Sweden

Abstract A group of 483 men, all of whom were 68 or 69 yr old and had lived for a long time in the city of Malmö were examined with regard to number of teeth present, removable dentures, fixed bridges, and tooth spaces. 76.4% had one or more natural teeth remaining, 59.2% had removable dentures, and 0.2% were edentulous and without dentures. The mean number of teeth present in a fixed dentition calculated on dentate subjects was 16.21 ± 8.02, including teeth replaced by pontics and 15.0 ± 7.44 when natural teeth only were recorded. The number of bridges was high, 28.8% of natural dentate persons having bridgework. This cohort had fewer remaining teeth than in similar groups in other areas of Sweden, but more fixed bridges. 19.5% had open tooth spaces corresponding to one or more teeth in the visible parts of the dental arches. The availability of dentistry has been extremely good in Malmö and financial support for all types of dental care has been provided for all inhabitants since 1974. In spite of this, a low number of remaining teeth and many untreated tooth spaces in visible part of the dental arches were found, though on the other hand much fixed bridgework was found. It appears from the present study that the population tends to polarize into two groups, namely one group which takes advantage of the dental services and one which does not.     

Differentiating dental satisfaction in Finns by means of discriminant analyses

In March 1983 dental satisfaction was studied by interviews with a sample comprising 957 persons drawn to cover the total Finnish population aged 15 yr or over. 34% of the interviewees wore removable dentures of some kind. 78% of persons with only natural teeth and 56% of denture wearers were satisfied with their dentition (subjective estimation of dentition excellent or good). Among persons with only natural teeth the level of satisfaction differed significantly with respect to sex, age, toothbrushing frequency and the latest dental visit. Such a difference was not found among denture wearers. The time elapsed since the latest dental visit was the most important single variable in the discriminant analyses of the level of satisfaction both in the whole series and among persons with only natural teeth. Sex was the only variable in the discriminant analysis which related to satisfaction with dentition among denture wearers. The classification of dissatisfied persons, with and without removable dentures, was far from adequate. It was rarely possible to predict satisfaction with removable dentures using discriminant analysis. The results depict the complexity of the problem. More understanding is needed of the contributions of psychologic factors to patient behavior.