Homebound Seniors Need Tooth Love

Oral health of homebound elderly needs attention

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Oral health care may be difficult to access for homebound seniors. As a result, many homebound seniors may have serious dental health needs.

In a recent study, a team of dentists checked the oral health in a group of homebound elderly.

The results showed that the vast majority of patients were in a state of moderate to high urgency need of oral health care.

"Get regular dental check ups."

Rima Gluzman, DDS, MS, of the New York University (NYU) College of Dentistry, led a team of researchers to study the oral health needs of homebound elderly persons.

According to the authors, 13 percent of the US population is 65 and older, which is approximately 40.3 million people.

The American Academy of Home Care Physicians estimated that at least 2 million seniors were homebound in 2005.

The study authors suggested that homebound elderly persons have limited access to dental care, which can result in oral pain, infection, trouble eating and lower quality of life.

The Mount Sinai Visiting Doctors (MSVD) program sends primary care physicians into the homes of homebound seniors.

For this study, the NYU College of Dentistry partnered with the MSVD program to send dentists into the homes of 131 homebound seniors for oral health exams. The average age among the patients was 81.

The dentists used the Dental Utilization and Needs survey and Geriatric Oral Health Assessment Index to gauge the dental health of each patient.

The patients’ dental needs were rated as “low urgency,” “moderate urgency,” or “high urgency.”

Overall, 76 percent of the patients still had teeth and 24 percent no longer had any natural teeth. Patients with teeth had an average of 14.3 teeth remaining.

Among patients with teeth, 78.9 percent had at least one decayed tooth, and 35.7 percent had at least one root tip exposed.

The men in the study had almost twice the number of decayed teeth, and nearly triple the amount of decayed surfaces, compared with the women in the study.

The results showed that 40 percent of patients with teeth needed restorative care, like a filling, and 45.6 percent needed to have at least one tooth pulled.

Only 3.2 percent of the patients were labeled as “high urgency,” but 88.8 percent qualified as “moderate urgency.”

Red lesions were found in 41.1 percent of the patients. Lesions related to denture use were found in 13.7 percent of denture-wearing patients.

Among patients that needed dentures, 18 percent lacked appropriate denture coverage, and 28.1 percent needed replacement dentures.

Pain or discomfort was reported by 33.6 percent of the group. Chewing limitations were reported by 50.4 percent of the group.

The majority of patients, 93.5 percent, said they would be interested in having home-based oral health care.

The study authors concluded that the oral health status of homebound elderly was poor, and that their quality of life was affected by a lack of basic dental care.

“The elderly are often a forgotten population in the discussion of access to oral health care. We must find ways to implement care to this population as our nation ages, as poor oral health can have significant negative impact on overall quality of life,” Dana Fort, DDS, a practicing dentist in Chicago, told dailyRx in an email. Dr. Fort was not involved with this study.

This study will be published in the September/October issue of Special Care in Dentistry.

No outside funding sources were reported by the study authors. No conflicts of interest were found. 

Review Date: 
September 4, 2013
Last Updated:
September 5, 2013