Benefit related assessment of treatment need among institutionalised elderly people

It has been assumed that improved oral health leads to a better quality of life for elderly people. It is, however, difficult to assess the benefit of oral health care, especially dental treatment in terms of life quality. The normative assessment, based solely on clinical diagnosis, often leads to an overestimation of the true need for treatment, especially among the 'frail elderly', some of whom do not want treatment, either because there is no perceived need or expressed demand. Others are very ill, and some in such a poor mental condition that they can not express any demand for treatment, and would probably not benefit from treatment e.g. new dentures. The realistic treatment need is an attempt to assess the true need for treatment in relation to the benefit provided. It is a combination of the normative need, the self-perceived need, and the expressed demand for treatment, and takes into account the mental and physical state of the individual, as well as ethical considerations.