Oral health in a long-term care institution equipped with a dental service

The oral health and medico-dental status of 250 mostly elderly residents of a long term care institution were assessed by examination and a review of medical records. In addition, attitudes to dental care, dental experiences, and demands for care were solicited from those who could participate in an interview. There were no dental complaints from 70% of those interviewed. The complaints most frequently reported were difficulties with mouth dryness, hygiene, and chewing. Natural teeth remained in at least one jaw in 30% of the 245 residents examined. Dental caries was present in 78% of this dentate group, with coronal and root lesions equally prevalent. Gingival bleeding was also common in this group and 29% had deep periodontal pockets. Nearly 50% of the mandibular dentures and 25% of the maxillary dentures examined were inadequate. Mandibular dysfunction occurred in 25% of the population and was more frequent in the dentate group. Oral mucosal pathoses were rare. No correlation was found between the systemic health and the oral health of the residents. There was a need to improve the oral hygiene of most of those examined. Less than 20% of the denture wearers would have benefitted from treatment and 10% of those with defective dentures were considered unsuitable for treatment. In contrast, 60% of those with natural teeth required restorations and 36% needed one or more teeth removed. Very few urgent needs were seen. An inter-examiner accumulative inconsistency of 11% was measured between the three examiners, and a third of the assessments made of periodontal status were contradictory.