Using subjective oral health status indicators to screen for dental care needs in older adults

A study was undertaken to assess the ability of a number of subjective oral health status indicators to identify community-dwelling older adults who need dental treatment. The indicators consisted of a single-item self-rating of treatment need, a 15-item psychosocial impact index and the 49-item Oral Health Impact Profile (OHIP). Data for the study were collected as part of an oral health survey of Canadians aged 50 years and over. The associations between these subjective indicators and clinically defined dental treatment needs were assessed using statistics for determining the predictive power of a diagnostic test. Although there were statistically significant associations between the subjective and clinical measures, values for statistics such as sensitivity, positive predictive values and positive likelihood ratios were low. Although the measures did not perform well as screening tests, they did identify a sub-group of individuals whose clinical conditions impacted significantly on daily life and who would probably benefit the most from dental treatment. In this respect, the subjective measures assessed here can themselves be interpreted as indicators of need which complement conventional clinical measures of needs for dental care.