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Oral Health Status in Alzheimer's Disease Patients: A Descriptive Study in an Italian Population
Giovanni D'Alessandro1, Tommaso Costi2, Nadia Alkhamis3
1Department of Biomedical and Neuromotor Sciences Dental School, Alma Mater Studiorum, Universita di Bologna Bologna, Italy, Phone: +390512088150,
Aim:
To evaluate the oral health status in Alzheimer's disease (AD) patients.
Materials And Methods:
A descriptive study was performed on 120 AD patients (60 institutionalized in a public institute and 60 attended a daytime center), from September 2013 to January 2014. About 103 subjects formed the control group. The following medical and dental data were collected: dementia severity, pharmacological therapy, physical status (American Society of Anesthesiologists [ASA]), decayed (D), filled (F), and remaining natural teeth (T), DF/T ratio, community periodontal index (CPI), and gingival index (GI). A t-test for independent samples and the Spearman's correlation test were used to evaluate all variables. The significance level was set at 0.05.
Results:
Statistically more AD patients (91.7%) were under pharmacological therapy and their physical status was more severe (ASA 2, ASA 3) compared with control subjects (p < 0.001). Moreover, they presented numbers of D, CPI, and GI significantly higher (p ≤ 0.005). In the institutionalized subgroup, statistically more moderate and severe AD cases were detected and more patients were edentulous (p < 0.001). Noninstitutionalized patients presented DF/T ratio, CPI, and GI significantly lower (p ≤ 0.024). A significant weak negative correlation (r = -0.121 to -0.372) between epidemiologic indices and AD severity was observed.
Conclusion:
Alzheimer's disease patients show a low oral health status that decreases progressively as the disease severity aggravates. Therefore, further studies are necessary to investigate oral health care interventions for AD patients.
Clinical Significance:
It would be beneficial to introduce trained professional figures in specialized elderly institutions for regular follow-up visits and professional oral hygiene procedures. This task has to be coordinated with the treating physician, family members, and/or caregivers. Knowing that the severity of AD has a negative effect on the oral health status and the type of institutionalization exacerbates it.