Dental health and treatment needs in institutionalized psychiatric patients in Italy

Abstract The caries prevalence, oral hygiene status, periodontal health and the treatment needs were assessed in a group of institutionalized psychiatric patients in Catanzaro, Italy. Of the total sample of 297 subjects, 165 (55.6%) were males, the mean age was 55.1 yr, the great majority (90.6%) was able to care for themselves, on average they had been institutionalized for 12.9 yr, and almost two-thirds were schizophrenic (65%). They did not receive any assistance in daily oral hygiene procedures, only 7.4% had visited a dentist and exclusively for emergency care. A total of 33 (11.1%) patients were edentulous, and the multiple logistic regression analysis showed a highly significant increase of edentulousness with increasing age (P < 0.001). No caries-free subjects were found and among the dentate the DMFT and DMFS scores for all age groups were respectively 15.5 and 88.6. The stepwise linear regression analysis showed that the mean DMFT index increased with age (t = 6.86; P < 0.00l), and in the partly or totally helpless patients it was significantly higher than in the self-sufficient patients (1=2.78; P= 0.006). Of the 264 dentate subjects, only 25 (9.5%) had no need of dental treatment: 213 (80.7%) required extractions with a mean number per person of 6.3 and the need for conservative dental care was recorded in 154 (58.3%) patients with a mean need for patient of 2.8. Mean OH1-S score was 4.2 and the stepwise linear regression analysis showed that it increased with age (t = 5.73; P < 0.01) and with the length of institutionalization (t =3.42; P < 0.001). Only 0.9% of the entire sample was found with healthy periodontal tissue; bleeding on probing or a higher score was found in 4.6% of examined sextants; calculus in 10.1%; shallow pockets and deep pockets in 19.6%. and 64.8% of all sextants. The results of the multiple logistic regression analysis indicated that the number of subjects with deep pockets as highest score increased with increasing age (P < 0.001), and with the increasing length of institutionalization (P=0.005). The findings of this study demonstrate high caries prevalence, poor oral hygiene and periodontal health, and extensive unmet needs for dental treatment. More coordinated efforts between the social and dental care sector must be maintained to serve adequately the need of this disadvantaged group.     

Oral health and treatment needs among patients in psychiatric institutions for the elderly

Abstract – The purpose of the study was to assess oral health and treatment needs among elderly in psychiatric institutions in a Danish county. The study serves as baseline for the evaluation of a newly established oral health care program in the county. The study population comprised the residents in eight institutions ( n = 407). Two thirds of the residents were edentulous, 34% of the dentate had one or more root remnants, and 55% had untreated decay. The dentate with regular dental visiting habits had significantly less untreated decay than the irregular users. The oral hygiene was poor, but was not related to whether or not the elderly were assisted in daily oral hygiene. The evaluation of the program will show to what extent treatment takes place, and whether or not oral hygiene improves.     

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 status and treatment requirements of hospitalized psychiatric patients in Bangalore city: a comparative study

The purpose of the present study was to describe the oral health status and treatment requirements and to study the association between dental caries and mental illness in a group of hospitalized psychiatric patients.A total of 326 psychiatric patients were examined and compared with 156 normal persons of comparable age and sex. 75.5% of the psychiatric patients exhibited caries experience with significantly higher DMFT and DMFS compared to the 66% in controls. Stepwise regression analysis demonstrated that DMFT was related to age, type of the ward and duration of mental illness. Periodontal diseases were significantly higher among psychiatric patients than controls. Higher proportion of psychiatric patients were suffering from TMJ disorders. Further, extensive dental treatment requirements were observed among these patients.     

Oral health status and treatment needs in long-term medicine patients in a Copenhagen hospital department

Oral health and dental treatment needs were investigated in 50 randomly selected long-term medicine patients admitted to The Glostrup Hospital, University of Copenhagen, Glostrup, Denmark. All the patients were clinically and radiologically examined. Oral health generally was poor. Two-thirds (66%) of the patients were totally edentulous, 24 % partially edentulous. Only 10 % were dentate with no dentures. The number of remaining teeth per patient averaged 4.7, that of caries destructed teeth 1.4. All 17 patients with remaining teeth had periodontal disease, and 13 of them suffered from caries. Alveolar ridge atrophy, periapical inflammation, root remnants, impacted teeth and oral mucosal lesions were demonstrated in, respectively, 80, 22, 24, 8, and 26% of the group. In total 82 % of the patients needed some kind of treatment, mainly prosthetic and oral surgery. The estimated total treatment time per patient averaged 165 min.     

Periodontal status and treatment needs among Spanish hospitalized psychiatric patients

The purpose of this study was to evaluate the periodontal status and treatment needs (by CPITN) of 565 patients hospitalized in a psychiatric facility in Seville, Spain. The results of this study showed that 31.7% of the patients were edentulous and that 68.3%% were dentate. Of the dentate subjects, 8.5% were found to have a healthy periodontium, 14.2% had bleeding on probing, 43.8% had calculus, 24.6% had shallow pockets, and 8.9% had deep pockets. The results of the study also showed that the severity of periodontal disease increased significantly with age and the length of time of hospitalization. The need for oral hygiene instruction among the dentate population was determined to be 91.5%, and the need for treatment (oral prophylaxis and scaling) was 77.3%. These findings suggest that hospitalized psychiatric patients in Spain are in dire need of preventive dentistry .     

Dental health among institutionalized psychiatric patients in Spain

This study assessed the dental health of an institutionalized psychiatric population in Spain. The study population was composed of 347 males and 2A8 females with a mean age of 58.0. The mean length of hospitalization was 26.1 years. The largest proportion of the patients (62%) was diagnosed as having schizophrenia. All subjects were taking psychotropic drugs, with a mean number of 2.1 medications. The sample was examined according to the WHO dental criteria. The DMFT index demonstrated the mean number of carious teeth to be 7.9; missing teeth, 17.0; and filled teeth, 0.0. The DMFT index increased significantly with the patient's age and length of hospitalization. Female and demented patients had significantly higher DMFT scores. These findings suggest that institutionalized patients with mental illness in Spain have extensive untreated dental disease.     

Oral health status and needs for dental treatment in geriatric patients in a Danish district hospital

Oral health status and dental treatment needs were investigated in 50 randomly selected patients in the geriatric department of a Danish district hospital. All the participants were examined clinically and radiologically. Oral health status was generally poor. Ten participants required no dental treatment. The remaining 40 participants needed some kind of treatment, mainly prosthetic and surgical. The 40 participants requiring treatment were all asked whether or not they wanted the proposed treatment. Only 18 were interested. The participants were divided into three groups according to their medical status. 28 participants had a poor medical status. It was estimated that these patients once having left the hospital would never be able to visit a dentist on their own initiative, and therefore should be treated institutionally.     

Oral health status and treatment needs of children attending special schools in South India: a comparative study

The aim of this study was to assess and compare oral health status and treatment needs of children with special healthcare needs (SHCN) between the ages of 5 and 15, with a matched group of healthy children, in Udupi District of South India. A cross‐sectional study of 265 children with SHCN was compared to 310 healthy children to assess differences in periodontal status, dentition status, treatment needs, and dentofacial anomalies using the WHO criteria. Chi‐square, t‐test, and Z‐tests were performed to compare different variables. p≤ 0.05 was considered statistically significant. A significantly higher prevalence of caries (89.1%), malocclusion, and poorer periodontal status was observed among children with SHCN compared to the healthy control group. Improving the oral health of these children will require maintaining good oral hygiene practices, which can be achieved with appropriate target‐based oral health approaches.     

Oral health status of institutionalized geriatric residents in Metro Manila

A study was done on geriatric residents from three institutions in Metro Manila namely La Verna I and II, a retirement home of Sisters of Franciscan Immaculate Concepcion; Hospicio de San Jose, a catholic welfare institution for the very young as well as for the very old; and Golden Acres, a government institution that takes care of indigent old/elderly people. A total of 176 geriatric residents were examined, majority are from Golden Acres with 121, followed by Hospicio de San Jose with 30 and lastly La Verna I and II with 25. In general, the oral health status of geriatric residents is very poor especially at Golden Acres and Hospicio de San Jose. Since all the resident sisters in La Verna I and II are highly educated, their oral health status is fair to good. The more prevalent medical problems the geriatric residents had are: Cataract (54); Hypertension/Cardiac Disorders (46); Rheumatoid Arthritis (30); Respiratory Diseases (29); Blood Diseases (28); Diabetes Mellitus (14); Skin Diseases (10); Impaired Hearing (13); Neurologic Problems (19); and Psychological Problems (2).     

Periodontal status and treatment needs of 12-15 year old institutionalized mentally handicapped school children in Ibadan, Nigeria.

Mentally handicapped children are known, to have poor periodontal health. But previous studies lack conformity due to the use of different indices by the different authors. Twenty-five institutionalized mentally handicapped school children in Ibadan, Nigeria were studied with the aim of assessing their periodontal health and per treatment needs using the CPITN which is known to be simple and has international uniformity. The result showed that none of the children had healthy periodontium and all the children will need oral hygiene care with a significant percentage (8%) requiring complex periodontal care. The need for comprehensive preventive dental program is discussed since the hallmark of management of the children is prevention.     

Oral status and nutrition in the institutionalized elderly.

OBJECTIVES: To evaluate, in an elderly population, whether poor oral status might be a contributing factor to the development of undernutrition and might be associated with less eating pleasure, more subjective eating difficulty and increased mashed food consumption. METHODS: An oral examination and an evaluation of masticatory capacity were performed on 120 institutionalized elderly subjects. The nutritional assessment included serum albumin concentration, the Mini Nutritional Assessment and a questionnaire on eating habits. RESULTS: Edentulous subjects without dentures or with only one complete denture had significantly lower MNA scores than edentulous subjects with two complete dentures (p < 0.05). Edentulous subjects with two complete dentures more frequently reported taking pleasure from eating (p = 0.05), and had less frequent difficulties with hard foods (p = 0.01) than edentulous subjects without dentures or with only one complete denture. Mashed food consumption (p < 0.01) was also reported more frequently in edentulous subjects without dentures or with only one complete denture. Subjects with two complete dentures had similar or better MNA scores as dentate subjects with relatively few remaining teeth (10.4 +/- 7.8 teeth). About half of the subjects (53%) could not perform the masticatory test. These subjects had lower MNA scores (p = 0.001) and a larger proportion ate mashed food (p < 0.001) compared to those who were able to perform the test. CONCLUSIONS: Poor oral status (edentulous without dentures or with only one complete denture) increased difficulty in eating hard foods, increased mashed food consumption and decreased eating pleasure. It seemed also to put institutionalized subjects at higher risk of undernutrition.     

Oral health status and treatment needs in a disadvantaged, rural population in Norway

ABSTRACT Oral health and dental treatment needs were investigated in 216 disadvantaged, rural dwellers aged 20 to 60 years. Oral health was generally poor. One-third of the group was edentulous, while the dentulous persons had an average of 13 remaining teeth. Every second dentulous person had one or more residual roots. DMF teeth averaged 28.1, Gingival Index 1.59, and Oral Hygiene Index 2.87. Two-thirds of the group wore some removable denture, and every second denture was found to have major defects. According to described criteria, 96 % of the group needed some treatment. Prosthetic treatment was the most frequent requirement and applied to 69 % of the group. The estimated total treatment time per individual averaged 255 minutes. The time estimates varied markedly with age and treatment pattern.     

Dental status and treatment needs among institutionalized mentally subnormal persons in Norway

ABSTRACT Dental status and treatment needs were studied in a random sample comprising 353 mentally subnormal persons. The sample was drawn to represent institutionalized mentally subnormal persons in Norway aged 5–45. The overall dental health was poor, primarily due to inadequate and fragmentary treatment facilities. Whereas the dental condition of children below 15 years of age was acceptable, as measured by the DMFT index, tooth loss increased rapidly with advancing age. Nearly every second dentulous person needed some conservation, and every tenth needed extraction of one or more teeth. One-third of the patients needed treatment requiring general anesthesia. It was concluded that a new system for the investigation of treatment requirements should be developed. This system must be based on diagnostic and social criteria, and should serve as a guideline for the planning and delivery of dental services to the various subgroups of mentally subnormal persons.