Dental needs and dental service use patterns of an elderly edentulous population

Abstract

This study was undertaken to examine an elderly edentulous population to evaluate current dental needs and dental service use rates as well as to determine whether trends toward a reversal of this group's poor dental care habits are present. Of the 443 elderly individuals screened in the current study, 168 were determined to be edentulous in both dental arches. This means that 38% of the elderly population examined would at some time require dental services either to maintain their edentulous arches and related intraoral structures in a state of health or to fabricate new or maintain existing complete prostheses in a properly functioning condition. This figure is 12% lower than 1974 statistics, which indicated that 50% of the nation's elderly population were edentulous. 2 A larger population would have to be surveyed to determine if this trend toward declining edentulousness is a national phenomenon or simply characteristic of the current population sample. Despite the lower proportion of edentulous individuals within the study population, some disturbing results were obtained. Although 92% of the population had complete dentures that they claimed were worn most or all of their waking hours, over 90% of these dentures were evaluated by examiners as requiring significant refinement (26%) or remake (69%). In addition, 58% of this group of individuals felt that they did not or were not sure whether they required current dental treatment; 58% also felt that the fit of their dentures was excellent or good. These figures demonstrated that only slightly more than half the study population was aware that their dentures were in need of corrective treatment. Evaluation of results comparing actual and perceived dental treatment needs among all denture fit groups (excellent to poor) showed that the number of individuals indicating the need for dental treatment increased as the denture fit rating declined (Table V). This was especially true for subjects who rated their denture fit as fair or poor: 50% and 94% of individuals, respectively, felt that current dental treatment was needed, in contrast to approximately 20% of subjects in the excellent and good denture fit groups. Such results indicate that as individuals gave poorer fit ratings to their dentures, more perceived a need for corrective dental treatment. A trend also appeared in the relationship between denture fit group and subject complaints about functional problems with their dentures. Complaints of soreness, esthetics, and difficulty in speaking and chewing with dentures increased with a decline in denture fit rating. Masticatory difficulty was the most frequently voiced complaint. This trend was consistent with results that indicated the poorer denture fit rating groups complained more about their dentures, perceived a greater need for dental treatment, and presented opinions about their dentures closer to those of the dental examiners than subjects claiming better denture fit. This study demonstrated that approximately 61% of the elderly edentulous population had not visited a dentist in at least 1 year. Although 35% had seen a dentist during the year preceding the study, only 9% went on a nonemergency basis. These figures are in general agreement with those from the National Center for Health Statistics report of 1971, which indicated that only 8.4% of the edentulous population 65 years of age and over had visited a dentist during the year prior to the survey. 2 These visits were not designated nonemergency or emergency, so specific comparison of the figures is not possible. Subjects' perceived need for dental treatment at the time of the study appeared to have a bearing on the frequency with which they sought regular dental care during the year preceding the study. Fifteen percent of individuals who felt they needed dental treatment sought regular dental treatment, with at least one dental office visit, as compared with only 6% of those who felt they were not in need of dental care or were unsure. In addition, almost twice as many individuals perceiving a need for dental treatment sought emergency dental care, in contrast to those who were unaware of dental care needs. Approximately 70% who claimed no need for or were unsure of a need for dental treatment did not see a dentist for at least 1 year, compared with 49% of those expressing a need for dental care. In addition, most subjects in the present study felt that they did not need dental care at the time of the study survey. This was in contrast to the actual dental needs of the population as determined by the study's dental examiners. This information leads to a belief that attitudes of edentulous individuals toward dental care and information disseminated to this population about the need for regular dental treatment are substandard and need to be improved.