A prospective cohort study on factors related to dental care and continuation of care for older adults receiving home medical care.

Abstract

Information on the effects of dental treatment must be identified and factors that hinder the continuation of dental treatment must be identified to provide appropriate domiciliary dental care (DDC). This study aimed to clarify the treatment outcomes of DDC for older adults and the factors that impede the continuation of such care. This prospective study was conducted at a Japanese clinic specializing in dental care for older adults. The functional status, nutritional status, oral assessment, details of the dental treatment, and outcomes after 6months of older adults receiving DDC were surveyed. The Oral Health Assessment Tool (OHAT) was used for oral assessment. Cox proportional hazards analysis was used to analyze the factors at the first visit that were associated with treatment continuation. A total of 72 participants (mean age, 85.8 ± 6.9) were included. Twenty-three participants (31.9%) could not continue treatment after 6months. The most frequently performed procedures were oral care and dysphagia rehabilitation, followed by prosthetic treatment, then tooth extraction. The percentage of participants with teeth that required extraction after 6months and the total OHAT score decreased significantly. The Barthel Index, Mini Nutritional Assessment Short-Form, and rinsing ability were significantly associated with treatment continuation. Furthermore, instrumental activities of daily living (ADL) and the OHAT "tongue" sub-item were correlated with treatment continuation. In conclusion, DDC improved the oral health status of older adults after 6months. Factors that impeded treatment continuation were decreased ADL, decreased nutritional status, difficulty in rinsing, and changes in the tongue such as tongue coating.