Oral health in hospitalized and nonhospitalized community-dwelling elderly patients

Abstract

Objective. The purpose of this study was to compare hospitalized and nonhospitalized home-dwelling elderly patients in a single community with respect to oral health and general health and to study risk factors for edentulousness in these patients. The study hypothesis was that hospitalized elderly patients would have poorer oral health than nonhospitalized elderly patients. Study design. Oral health status was examined according to the World Health Organization’s guidelines for 181 hospitalized patients (mean age, 81.9 ± 5.8 years) in a geriatric ward and for 254 home-living patients (mean age, 76.9 ± 5.6 years). Data regarding the patients ́ diseases and medications came from hospital records and doctors ́ prescriptions and were categorized on the basis of the International Classification of Diseases. Differences between the hospitalized and nonhospitalized patients, between genders, between age groups, and between the various disease and medication groups were analyzed. Logistic regression was used to analyze the effects of study variables on edentulousness. Results. The mean number of teeth was 10.3 ± 7.6 in the hospitalized patients and 16.3 ± 7.4 in the nonhospitalized patients ( P < .001). The mean number of decayed teeth was 1.3 ± 2.2 in the hospitalized patients and 0.6 ± 0.9 in the nonhospitalized patients ( P < .01). All dentate patients had poor periodontal health. Community Periodontal Index scores were between 2 and 4 in 94.8% of the hospitalized patients and 98.6% of the nonhospitalized patients. Edentulousness was observed in 66.3% of the hospitalized patients and 42.1% of the nonhospitalized patients ( P < .001). In both groups, female gender (odds ratio, 2.0; CI, 1.3-3.1) and age between 80 and 89 years (odds ratio, 2.5; CI, 1.5-4.4) were the strongest risk factors for edentulousness. The number of drugs used daily also correlated significantly with the loss of teeth ( P < .05). In the nonhospitalized patients, edentulousness correlated significantly with cardiovascular diseases and drugs taken daily ( P < .01), whereas in the hospitalized patients such an association was not found. Conclusions. The results of this study confirmed our hypothesis that hospitalized elderly patients who had many concomitant diseases and used many drugs daily had worse dental health than nonhospitalized home-dwelling elderly patients. The nature of a patient’s illness was not a significant factor in this respect. Female gender and age between 80 and 89 years were the strongest factors for edentulousness in both patient groups. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:437-43)