Oral health care behavior and frailty-related factors in a care-dependent older population

Abstract

ObjectivesTo assess, in older people with different levels of care-dependency 1) which frailty- and non-frailty related predisposing, enabling and need factors are associated with a) dental service use (DSU) frequency, b) changed DSU after the onset of care-dependency, c) brushing frequency, and d) changed brushing frequency since the onset of care-dependency; and 2) if unfavorable oral health care behavior is related to unfavorable oral health outcomes. MethodsBivariate analyses and multivariable logistic regression analyses were performed to evaluate data from 126 Dutch care-dependent people aged≥65 on oral and general health, psychological and social issues. ResultsLower DSU frequency was mainly related to non-frailty-related predisposing factors, especially being edentate (OR=3.75; CI: 1.20–11.71; p=0.023) and lower socioeconomic status (OR=1.74; CI: 0.97–3.14; p=0.065); lower DSU frequency since the onset of care-dependency to frailty-related enabling and need factors, especially ‘difficulty going to the dentist’ (OR=4.98; CI:1.85–13.36; p=0.001) and clinically assessed treatment need (OR=3.23; CI:1.24–8.42; p=0.016); lower brushing and changed (reduced) brushing frequency to frailty-related enabling factors, and, in case of reduced frequency, significantly to ‘not being capable of summoning the effort to brush’ (OR=8.28; CI: 1.44–47.56; p=0.018) and high care-dependency level (OR=4.14; CI: 1.05–16.36; p=0.043). Elders with lower and especially those with reduced DSU and brushing frequencies since the onset of care-dependency, had generally worse oral health outcomes and related quality of life. ConclusionsOral health care behavior, especially lower brushing and DSU frequency since the onset of care-dependency, is related to specific frailty-related factors in a care-dependent older population. Clinical significanceOral care-providers should be alert to the role of specific frailty-related factors, which are likely to reduce DSU and brushing frequency in the course of increasing frailty.