Discrepancy between need for prosthodontic treatment and complaints in an elderly edentulous population

Most reports indicate that about two-thirds of the elderly population have poor oral health but that only about one-third complain of a problem. The reason for this discrepancy has never been explained adequately. The objective of this study was to estimate the need for prosthodontic treatment in an edentulous elderly population, and to identify factors associated with complaints, needs for treatment, and the use of dentures. Interviews and examinations were conducted to determine the oral health and dental concerns among 269 residents of longterm care facilities in Vancouver. The need for prosthodontic treatment was considered under theoretical, clinical, and practical conditions, and related to various factors that might help to predict this need. During the interview, about half (54%) of the sample identified a problem, and 83% of the subjects were either using a denture with a major fault or were missing a denture. Seventeen percent of the sample would not benefit from treatment because of a severely resorbed residual ridge, while the presence of a complaint combined with a prosthodontic need indicated that about one-third (36%) would seek and benefit from treatment. The proportion of subjects with complaints was larger among the more educated subjects, and among those who had been recently to a dentist. It was not possible to predict the need for treatment from any of the socioeconomic factors considered. No significant association was observed between the need for treatment and the complaints, and many subjects seemed to be resigned to their discomfort or had unrealistic expectations from their dentures.