Number of teeth in relation to oral health behaviour in dentate elderly patients in Lithuania

Aim: To describe oral self‐care practices and the use of dental services among dentate elderly patients attending public dental service in Kédainiai, Lithuania, and relate these parameters to the number of remaining teeth. Design: Cross‐sectional questionnaire study. Setting: Two public dental offices in Kédainiai, Lithuania. Participants: Dentate patients aged 60+. Methods: A self‐administered questionnaire covering oral hygiene practices, use of sugar, utilisation of dental services, and number of teeth. Age, gender, and education served as background factors. Results: In all, 174 dentate elderly people responded, their mean age being 69.2 years (CI 95% 68.2–70.2) and mean number of teeth reported 16.2 (CI 95% 15.4–17.1). Of these respondents, 30% reported that they brushed their teeth twice daily and 57% that they always used fluoridated tooth paste. Having 21+ teeth was strongly associated (p < 0.001) with these habits, with brushing in the evening, and with enrolment in higher education, but not with gender. After controlling for various self‐care and background factors, frequent tooth brushing remained as the only significant factor in the logistic regression model (OR 2.0, CI 95% 1.2–3.3, p = 0.01) to explain subjects’ retention of 21+ teeth. Conclusions: Elderly Lithuanians’ oral self‐care is far from meeting recommendations. To preserve their natural teeth, dentate elderly people should improve their oral self‐care practices, in particular as regards tooth brushing. To reach that goal, all efforts by the community and dental profession are welcomed.     

Correlates of dental visits among community‐residing Latino elders: a public health alert

doi:10.1111/j.1741‐2358.2009.00335.x
Correlates of dental visits among community‐residing Latino elders: a public health alert Objectives: To examine oral service utilisation in a probability sample of community‐residing Latino elders. Background: Older Latinos are at a potential increased risk of oral diseases, given their higher prevalence of co‐morbidities and lower rate of dental service utilisation. Methods: A prevalence survey was conducted among a random sample of Latino (largely Puerto Rican) elders (n = 205; mean age = 75.8; SD ± 5.3) in New York City during 2001–2002. A systematic random sample was drawn from the Centers for Medicare and Medicaid Services Beneficiary tape files. Current use of oral health services and self‐reported health conditions was obtained. Functional and cognitive impairment were assessed. Results: Less than half of the sample reported a dental visit in the previous year. The average time since the last dental visit was 54 months (SD ± 84.5). Last year dental visit compliers were more likely to be unmarried, living alone, with higher levels of education, fewer health conditions and less impairment with activities of daily living. In multivariate analyses, problem‐oriented behaviour, Medicaid beneficiary, education, living alone, chronic health conditions and mobility impairment explained 14% of the ‘time since last dental visit’ variance. Conclusions: Given that socio‐demographic and level of functioning determinants appear to influence the frequency of dental visits, a multilevel approach to oral health promotion is imperative.     

Effects of functional training of dysphagia to prevent pneumonia for patients on tube feeding

Objective: The purpose of this study was to evaluate the effects of functional training on outbreak frequency of pneumonia for the elderly dysphagia patients who were being tube fed. Methods: Subjects were divided into two groups; one group (n = 10) received oral care (i.e. non‐training group) and the other group (n = 11) received functional training of dysphagia in addition to oral care (i.e. training group). The dental health team treated subjects once a week for 3 years (1999–2001). The frequency of pneumonia outbreaks and changes in activities of daily living scale (ADL) were evaluated for each year. Result: It was recognised that the frequency of pneumonia in the training group decreased year by year (p < 0.05). Cognitive items in ADL improved in two subjects of the training group. No statistical differences were recognised in the non‐training group. Conclusion: It was suggested that once‐a‐week functional training of dysphagia with professional oral care might be effective in preventing pneumonia for elderly people who were being tube fed.     

Understanding the ‘epidemic’ of complete tooth loss among older New Zealanders

doi:10.1111/j.1741‐2358.2009.00306.x
Understanding the ‘epidemic’ of complete tooth loss among older New Zealanders Objective: The aim of this study was to obtain a deeper understanding of the social factors driving New Zealand’s historic ‘epidemic of edentulism’ and how they operated. Method: In‐depth, semi‐structured interviews with 31 older New Zealanders were analysed using applied grounded theory. Results: Universal factors present in the data were: (a) the way in which New Zealand society accepted and indeed encouraged edentulism without stigma for those who had a ‘sub‐optimal’ natural dentition; (b) how the predominant patterns of dental care utilisation (symptomatic and extraction‐based) were often strongly influenced by economic and social disadvantage; and (c) the way in which lay and professional worldviews relating to ‘calcium theory’ and dental caries were fundamental in decisions relating to the transition to edentulism. Major influences were rural isolation, the importance of professional authority and how patient‐initiated transitions to edentulism were ultimately facilitated by an accommodating profession. Conclusion: The combined effects of geography, economics, the dental care system and the professional culture of the day, in the context of contemporary (flawed) understandings of oral disease, appear to have been the key drivers. These were supported (in turn) by a widespread acceptance by the profession and society alike of the extraction/denture philosophy in dealing with oral disease.     

Undergraduate teaching in gerodontology in Leipzig and Zürich – a comparison of different approaches

Objective: To evaluate undergraduate students’ attitude towards the clinical components of the Leipzig (LPEG) and Zürich (ZPEG) Programmes of Education in Gerodontology. Background: Undergraduate student education is the seedbed for conscientious professionals. Extramural clinical education contributes to the formation of positive attitudes. Students in Zürich participate in three clinical activities (in‐house gerodontology clinic, extramural acute geriatrics ward, mobile dental service), in Leipzig they visit a long‐term care facility on six occasions within 4 years. Methods: A structured questionnaire with 10 items was administered to students in Leipzig [n = 34, 70.6% female, mean age 25.8 (SD 3.04) years] at the beginning and after completion of gerodontology training and to students in Zürich [n = 33, 48.5% female, mean age 27.0 (SD 3.28) years] on three occasions after clinical training. Students indicated the degree of their agreement with seven statements presented using a 5‐point scale. A choice of responses which characterised the course was offered for assessment. Results: Close collaboration with dental tutors, while self‐treating patients in the mobile dental service (mobiDent^?) attracted the most positive responses. Ratings from students completing their training in Leipzig were less favourable than their initial responses. Conclusion: The lack of a dental service and Leipzig students’ inability to offer treatment in the presence of disease was associated with frustrations. Practical training should go beyond dental examinations at a long‐term care facility and include the opportunity for dental treatment. Personnel and equipment required for mobile treatment exceed resources available at most German dental schools.     

Oral health and treatment needs of the long-term hospitalised elderly

Objectives: To determine the oral health and treatment needs of the long‐term hospitalised elderly. Setting: The Laakso long‐term hospital, Helsinki, Finland. Design: A cross‐sectional study with clinical oral examinations. Subjects: All long‐term patients (n = 260) aged 60 and older. Main outcome measures: Edentulousness, presence and hygiene of dentures, mucosal findings, number of teeth, functioning teeth and tooth remnants, level of dental hygiene, and need for operative treatment. Results: Subjects’ mean age was 83.3 years (SD = 8.1); 42% were edentulous, 45% of women and 33% of men (p = 0.12). With no gender difference, 41% had removable dentures, but one in four were considered to be in need of repair or replacement. Denture hygiene was good in 19%, moderate in 44%, and poor in 37%, and for men worse than for women (p = 0.02). Stomatitis was found in 25%, and angular cheilitis in 28% of the denture wearers. The dentate subjects had on average 12.4 (SD = 8.6) teeth with a clear difference by age (p = 0.03), but no difference by gender. Dental hygiene was considered poor. Of the dentate subjects, 37% were in need of restorations, 51% of periodontal therapy and 42% of extractions. Conclusions: Oral cleanliness should be improved with regards to dentures and teeth. More attention should be focused on dental care of the long‐term hospitalised elderly.     

Provision of dental care in aged care facilities,NSW, Australia – Part 1 as perceived by the Directors of Nursing (care providers)

doi: 10.1111/j.1741‐2358.2012.00670.x Provision of dental care in aged care facilities, NSW, Australia – Part 1 as perceived by the Directors of Nursing (care providers) Objective: To ascertain the Directors of Nursing (DONs) perception of the provision of dental care and the difficulties in oral health maintenance for residents in New South Wales (NSW) aged care facilities (ACFs). Background: There were no specific figures relating to DONs’ perceptions of oral health needs and dental care nor obstructions to dental care of residents. Materials and methods: A total of 414 questionnaires, encoded for confidentiality, were posted to all DONs of ACFs in NSW and the data analysed. Results: Questionnaires were returned from 255 ACFs (response rate 61.6%) representing 16 861 residents with a male‐to‐female ratio of 1:3.45. Of these residents, 48% had a dental assessment on admission by qualified dental staff. In 74.2% of facilities, no regular visits by dental staff took place, and 58.6% considered the perceived unwillingness of dental professionals to visit residents a barrier to good oral health. DONs reported that 53.6% of residents had dentures only, while 18.3% had natural teeth only. The most frequent difficulties reported by staff were residents’ use of abusive language (78.2%) and residents refusing to open mouth (60.9%). Conclusion: Lack of involvement of dental professionals in admission assessment and in ongoing programmes was of concern to DONs in ACFs.     

Derivation of the short form of the Oral Health Impact Profile in Spanish (OHIP-EE-14)

doi: 10.1111/j.1741‐2358.2012.00613.x
Derivation of the short form of the Oral Health Impact Profile in Spanish (OHIP‐EE‐14) Background and Objective: The Oral Health Impact Profile is the most frequently used and validated of the Oral Health Quality of Life instruments. Several short versions have been developed; and a validation of the OHIP‐49 in Spanish has been published. The objective was to develop the short version of the Oral Health Impact Profile in Spanish (OHIP‐EE‐14). Methods: Cross‐sectional study. One hundred and thirty‐one persons aged ≥60 years attending a social centre for the elderly, residents of a nursing home and persons seeking dental care at a dental school in Mexico City were interviewed and examined. The validity of each of the 49 questions was evaluated, and, to construct the short version, 14 items were selected. The perceived need for dental treatment, number of teeth, presence of coronal caries, root caries, presence of dental plaque and utilisation of removable prosthesis were measured. Internal consistency, repeatability and discriminant validity were calculated. Results: The OHIP‐EE‐14 was reliable (Cronbach’s‐α = 0.918, ICC = 0.825). Significant associations were found between OHIP‐EE‐14 and the number of teeth and perceived need for dental treatment. Conclusions: The OHIP‐EE‐14 is a reliable and valid instrument and can be used in subjects aged 60 years and over from Mexico City.     

The perceived effectiveness of continuing care and group support in the long-term self-help treatment of obesity

Objective : Obesity is increasingly considered a chronic disease requiring continuing care, but professional long‐term treatment for most patients is not available. This study examined treatment recipients’ perception of the effectiveness of different components of a group self‐help, continuing‐care treatment program for obesity. Research Methods and Procedures : Members (n = 120) and volunteer leaders (n = 66) of a self‐help, continuing‐care treatment program of previously demonstrated effectiveness (mean treatment duration, 40.6 months; mean weight lost, 14.1 kg) rated how helpful and effective they found the various therapeutic strategies used by this program. The strategies examined were continuing care, group support, behavior therapy, motivational enhancement strategies involving positive reinforcement, and motivational enhancement strategies involving punishment. Results : The single most highly valued aspect of treatment was the provision of continuing care, followed by group support. Greater success at achieving one's goal weight was associated with perceptions of greater effectiveness of the program's strategies overall (r = 0.219, p < 0.005), of continuing care (r = 0.225, p < 0.005), and of positive reinforcement strategies (r = 0.223, p < 0.01). Participants who had successfully attained their goal weight perceived behavior therapy strategies as more effective than did participants who had not reached their goal weight [t (170) = 2.93, p < 0.005]. Discussion : The high ratings given to continuing care and group support strategies indicate the acceptability of supportive self‐help treatment for obesity administered over the long term. The findings suggest that continuing care and group support should be made available to participants in the self‐help treatment of obesity.     

First-time dental care and the most recent dental treatment in relation to utilisation of dental services among dentate elderly patients in Lithuania

Objectives: To describe the initial dental treatments of Lithuanian dentate elderly patients and the content of the most recent treatment in relation to their dentist‐visiting behaviour. Materials and methods: A cross‐sectional questionnaire study was carried out at two public dental offices in Kédainiai, Lithuania, among dentate patients aged 60+ years. A self‐administered questionnaire covered first‐time dental care, the most recent dental treatment, check‐up behaviour, interval since the most recent dental visit, and number of teeth. Age, gender and education served as background information. Statistical evaluation was by chi‐squared test, anova and logistic regression for odds ratio (OR). Results: In all, 174 dentate elderly responded, mean age being 69.2 (SD = 6.6) years. The mean age at the first visit was 16.3 years [95% confidence interval (CI) 14.9–17.6]. Regular dental check‐ups were reported by 30%, and 36% had visited a dentist within the past 12 months. As to the content of the most recent treatment, 78% of the elderly reported filling therapy, 50% endodontics, 48% tooth extraction, 21% radiography, 10% cleaning or scaling and 6% polishing of fillings. Those going for check‐ups were more likely to report diagnostic (OR 1.9; 95% CI 1.1–2.8; p = 0.01) and preventive (OR 4.8; 95% CI 2.5–9.0; p = 0.002) treatment when analysed by a logistic regression model, controlling for age, gender, education and number of teeth. Conclusions: Check‐up‐orientated utilisation of dental services should be encouraged among the Lithuanian elderly. Dentists and health officials should place greater emphasis on prevention.     

Oral health of institutionalised elderly: a qualitative study of health caregivers’ perceptions in Brazil

doi: 10.1111/j.1741‐2358.2010.00366.x
Oral health of institutionalised elderly: a qualitative study of health caregivers’ perceptions in Brazil Objective: The aim of this study was to qualitatively explore caregivers’ perceptions of oral health care and factors influencing their work in a public long‐term care institution for the elderly in Goiania, Brazil. Method: Data were collected from a sample of 10 caregivers using personal in‐depth interviews and observation. Results: Caregivers were mainly nurses’ aides without training in oral health care. Oral health was associated with access to dental treatment, oral hygiene and use of dentures. Edentulousness, use of inappropriate dentures and appetite loss were perceived as negative images. Procedures used for oral hygiene were toothbrushing, mouth cleaning with a gauze and using a mouthwash. Conflicting priorities in routine care, lack of caregivers’ knowledge and the co‐operation of the elderly were the main obstacles to satisfactory oral care. Conclusion: Oral health care of the elderly was perceived as a burden by caregivers, and did not follow a standard protocol. Caregivers’ knowledge and perceptions reinforce the need for education and training in oral health issues.     

Informing the debate on oral health care for older people: a qualitative study of older people’s views on oral health and oral health care

doi: 10.1111/j.1741‐2358.2009.00274.x
Informing the debate on oral health care for older people: a qualitative study of older people’s views on oral health and oral health care Background: Older people represent a growing and diverse section of the population. As age increases, people are more likely to experience health and mobility problems and be at higher risk of developing oral disease. Nevertheless, few older people utilise primary oral healthcare services. It is therefore important to understand the value older people place on oral health and dental services to inform providers and planners of oral health care. This research was conducted as part of a study to identify potential ways of minimising barriers to oral health care in older people. Objectives: To explore perceptions of oral health and oral healthcare services amongst older people living in a socially deprived inner city area and how these are related to service utilisation. Methods: A qualitative approach was utilised to explore the range of issues related to older people’s perceptions of oral health and their views on health care. This involved a combination of focus groups and semi‐structured individual interviews with older people and their carers. Data analysis was conducted using the Framework approach. Results:

• ? Response: Thirty‐nine older people and/or their carers participated in focus groups.
• ? Oral health perception: Oral health was associated with the presence of natural teeth, the absence of pain, practical/social functioning, preferably supported by positive assessment by a dentist.
• ? Oral health life‐course: Older people have a long and complex dental history. Past negative experiences with oral health care, especially in childhood, strongly influenced present attitudes towards dentistry and dental personnel.
• ? Citizenship and right to health care: There was a strong perception that, as ‘British citizens’, older people should have a right to free health care and that the National Health Service (NHS) should support them in this phase of their life.

Conclusions: The oral health life‐course of older people is an important influence on their perceptions of oral health and dental attendance. They consider oral health of importance and place great emphasis on their citizenship and rights of access to state funded oral health care. This raises important issues for the funding and delivery of NHS oral health care for older people.     

Oral health care in long‐term care facilities for elderly people in southern Brazil: a conceptual framework

doi:10.1111/j.1741‐2358.2009.00280.x
Oral health care in long‐term care facilities for elderly people in southern Brazil: a conceptual framework Objective: To present a theoretical model for understanding oral health care for the elderly in the context of long‐term care institutions (LTCI). Methods: Open‐ended individual interviews were conducted with the elderly residing in LTCI, their carers, nursing technicians and nurses, directors of care, dental surgeons and managers of public health services. A grounded theory methodological approach was adopted for data collection and analysis. Results: The emerging core category revealed a basic social process: ‘Promoting oral health care for the elderly based on the context of LTCI’. This process was composed of two contradicting yet correlated aspects: the oral health care does not minimise the poor oral epidemiological condition, and at the same time, there was a continued improvement in the oral care expressed by better care practices. These aspects were related to the: attribution of meaning to oral health, social determination of oral health, the ageing process, interactions established in the oral health care practices, oral health care management in LTCI, inclusion of oral health care into the political–organisational dimension and possibility of conjecturing better oral health care practices. Conclusion: The core concept of ‘Promotion of oral health care for elderly people based on the context of LTCI’ is capable of explaining the variations in the structure and process of LTCI, as well as in helping to understand the meaning of the oral health care practices for the institutionalised elderly.     

Implant overdentures for edentulous elders: study of patient preference

Background: Studies show that elders wearing implant overdentures have improved nutrition and quality of life. However, upfront costs of this therapy are high, and the income of elderly edentulous populations is low. Objectives: This study was designed (i) to measure the preferences of edentulous patients for mandibular two‐implant overdentures using Willingness‐To‐Pay (WTP) and Willingness‐To‐Accept (WTA), (ii) to assess the effect of long‐term financing on WTP and (iii) to assess the desired role of health care plans in financing dental prostheses. Methods: Edentulous elders (68–79 years; n = 36) wearing maxillary dentures and either a mandibular conventional denture (CD, n = 13) or a two‐implant overdenture with ball attachments (IOD, n = 23) participated in this study. All had received their prostheses 2 years previously, as part of a randomised clinical trial. A three‐part questionnaire was completed during a 20‐min interview with a trained researcher. Results: Forty‐six per cent (6/13) of the CD wearers and 70% (16/23) of the IOD wearers were willing to pay three times more than the current cost of conventional dentures for implant prostheses. These percentages were increased to 77% (CD) and 96% (IOD) if participants could pay for implant overdentures in monthly instalments. Eighty‐six per cent (31/36) of all participants in both groups (21/23 IOD; 10/13 CD) thought that the government should cover at least some of the cost of implant overdentures. Conclusions: This study shows that, the majority of elderly edentate individuals who have not experienced mandibular two‐implant overdenture therapy are willing to pay the cost, particularly when payment can be made in monthly instalments.     

Obesity and the Use of Health Care Services

Objective: This study investigated differences in the use of health care services and associated costs between obese and nonobese patients. Research Methods and Procedures: New adult patients (N = 509) were randomly assigned to primary care physicians at a university medical center. Their use of medical services and related charges was monitored for 1 year. Data collected included sociodemographics, self‐reported health status using the Medical Outcomes Study Short Form‐36, evaluation for depression using the Beck Depression Index, and measured height and weight to calculate BMI. Results: Obese patients included a significantly higher percentage of women and had higher mean age, lower mean education, lower mean health status, and higher mean Beck Depression Index scores. Obese patients had a significantly higher mean number of visits to both primary care (p = 0.0005) and specialty care clinics (p = 0.0006), and a higher mean number of diagnostic services (p < 0.0001). Obese patients also had significantly higher primary care (p = 0.0058), specialty clinic (p = 0.0062), emergency department (p = 0.0484), hospitalization (p = 0.0485), diagnostic services (p = 0.0021), and total charges (p = 0.0033). Controlling for health status, depression, age, education, income, and sex, obesity was significantly related to the use of primary care (p = 0.0364) and diagnostic services (p = 0.0075). There was no statistically significant relationship between obesity and medical expenditures in any of the five categories or for total charges. Discussion: Obesity is a chronic condition requiring long‐term management, with an emphasis on prevention. If this critical health issue is not appropriately addressed, the prevalence of obesity and obesity‐related diseases will continue to grow, resulting in escalating use of health care services.     

Oral health promotion among older persons and their care providers in a nursing home facility

Objectives: To assess oral health status and oral health‐related quality of life (OHRQoL) of residents in an extended care facility and to assess the care providers’ oral health attitudes and knowledge. Methods: Participants included 137 residents (58.1% female, age range 32–94 years, 91% African–American) and 22 care providers. Residents received an oral examination and completed the Oral Health Impact Profile (OHIP‐14), an OHRQoL questionnaire. Care providers completed an oral health knowledge (OHK) questionnaire before and after the on‐site geriatric oral health education and training programme. Results: Oral examinations showed that 58% of the residents had extensive oral health needs. On the OHIP‐14, the mean severity was 9.2 (SD = 12.0), extent (number of items rated as ‘fairly often’ or ‘often’) was 1.2 (SD = 2.6) and prevalence (participants rating at least one item at least ‘fairly often’) was 37.8%. Most prevalent negative impact items were about ‘oral pain’, ‘appearance’ and ‘self‐consciousness’. Regarding OHK, caregivers’ knowledge improved following instruction from 65% correct on the pre‐test to 90% correct on the post‐test (p < 0.05). Subsequent to the eight in‐service workshops, providers reported that physical limitations, fear of getting bitten and time constraints were barriers to providing oral hygiene to their residents. Conclusion: Examination data showed a high level of dental needs among the majority of residents, accompanied by significantly reduced OHRQoL. Although care providers’ OHK improved following the geriatric service programme, they reported specific barriers regarding their provision of oral hygiene care to the residents.     

A pilot study on the effect of advance care planning implementation on healthcare utilisation and satisfaction in patients with advanced heart failure

BackgroundPatients with advanced heart failure may benefit from palliative care, including advance care planning (ACP). ACP, which can include referral back to the general practitioner (GP), may prevent unbeneficial hospital admissions and interventional/surgical procedures that are not in accordance with the patient’s personal goals of care.AimTo implement ACP in patients with advanced heart failure and explore the effect of ACP on healthcare utilisation as well as the satisfaction of patients and cardiologists.MethodsIn this pilot study, we enrolled 30 patients with New York Heart Association class III/IV heart failure who had had at least one unplanned hospital admission in the previous year because of heart failure. A structured ACP conversation was held and documented by the treating physician. Primary outcome was the number of visits to the emergency department and/or admissions within 3 months after the ACP conversation. Secondary endpoints were the satisfaction of patients and cardiologists as established by using a five-point Likert scale.ResultsMedian age of the patients was 81 years (range 33–94). Twenty-seven ACP documents could be analysed (90%). Twenty-one patients (78%) did not want to be readmitted to the hospital and subsequently none of them were readmitted during follow-up. Twenty-two patients (81%) discontinued all hospital care. All patients who died during follow-up (n = 12, 40%) died at home. Most patients and cardiologists indicated that they would recommend the intervention to others (80% and 92% respectively).ConclusionACP, and subsequent out-of-hospital care by the GP, was shown to be applicable in the present study of patients with advanced heart failure and evident palliative care needs. Patients and cardiologists were satisfied with this intervention.     

Barriers to provision of dental care in long-term care facilities: the confrontation with ageing and death

Objective: The aim of the study was to reveal barriers to providing dental care for residents in long‐term care (LTC) facilities. Design: Participants were selected randomly from the dentist register in Berlin and Saxony, Germany. The sample consisted of 60 self‐employed and 60 employed dentists, a further 60 dentists worked in their own dental practice but also part‐time in an LTC facility. In semi‐structured interviews a questionnaire with 36 statements concerning working conditions, administration and cost, insecurity concerning treatment decisions as well as confrontation with ageing and death was employed. Subsequently, the study participants were asked to rank the four dimensions concerning their impact on the decision against providing dental care in an LTC facility. Results: The random sample was representative in age and gender for the dental register in Berlin and Saxony. Fifty‐six per cent of the participants (63% of the men and 51% of the women; 52% of the self‐employed, 60% of the employed and 56% of the consultant dentists) indicated unfavourable working conditions as biggest obstacle in providing dental care in an LTC‐facility. Thirty‐two per cent of participants rated administration and cost, 7% the insecurity in treatment decisions as major hindrance. Only 5% of the participants rated the confrontation with age and death as substantial barrier. There were no age and gender differences. Dentists in Berlin seemed more concerned about administration and cost of a consultancy activity and less secure in their therapy decisions than the colleagues from Saxony (p < 0.001). Dentists who work partly in LTC facilities were the least concerned about the confrontation with ageing and death (not significant), employed dentist showed the least secure in their treatment decisions (p > 0.001). Conclusion: It can be concluded that the awareness of infra‐structural and financial aspects in providing dental care in LTC facilities should be raised with health politicians and that these aspects should be considered when inaugurating or re‐structuring the consultancy services to LTC facilities. Further it would be desirable to establish more postgraduate training programmes to increase clinical and ethical competence in the area of gerodontology.     

Analysis of socio-demographic and systemic health factors and the normative conditions of oral health care in a population of the Brazilian elderly

doi: 10.1111/j.1741‐2358.2010.00446.x
Analysis of socio‐demographic and systemic health factors and the normative conditions of oral health care in a population of the Brazilian elderly Objective: To investigate the association of socio‐demographic and systemic health factors according to the normative conditions of oral health care (dental caries, edentulism, periodontal disease and oral mucosal lesion) in elderly individuals. Material and methods: A cross‐sectional study was carried out in a group of elderly with access to community health care (n = 200). The normative conditions of oral health were then investigated according to the WHO and the SB Brazil criteria. Bivariate analyses were evaluated by the chi‐square test and Fisher’s exact test. An estimation of prevalence for the covariates was performed using Poisson’s regression models. Results: The prevalence of edentulism and oral mucosal lesions was detected in 58% and 21.5% of elderly patients, respectively. In the dentate subjects, the prevalence of dental caries and periodontal disease was 51.2% and 20.8%, respectively. Older men and individuals from lower‐income groups exhibited a higher prevalence of dental caries. Elderly women, illiterate individuals, and individuals over the age of 65 years exhibited a higher prevalence of edentulism. Elderly 60–64 years old and those who are employed had a significant association with periodontal disease. Conclusion: Socio‐demographic factors were associated with some notable oral diseases in the elderly.