Impaired cognitive function is a risk indicator for dental caries
DUNEDIN, New Zealand: There is higher prevalence of cognitive and physical impairments among older people that can adversely affect their oral self-care and make the provision of oral care difficult, according to researchers at the University of Otago. In a world first, the researchers surveyed the oral health of people living in aged residential care, and they found those with dementia and older men in general to have more teeth affected by caries. They have consequently highlighted the need for increased attention regarding the oral health of older New Zealanders.
Of the 987 people examined in the study—which was representative of the more than 14,000 New Zealanders living in aged care—about half had severely impaired cognitive function and more than a third required fillings or extractions. Those with severely impaired cognitive function had higher rates of dental caries. These patients also had higher oral debris scores, reflecting poorer daily oral hygiene.
Poor oral health is one of the “geriatric giants” and a “major clinical and public health problem which is going to get worse” according to lead author Prof. Murray Thomson, Head of the Department of Oral Sciences at the university.
“Neither the aged care sector nor the dental profession, in most countries, is prepared. Not only do we have more and more older people every year, but more and more people are entering old age with their own teeth, rather than full dentures, as was the situation just a couple of decades ago. In some ways, dentistry has been a victim of its success—we have long emphasised the idea of ‘teeth for life’ without much thought to what happens towards the end of life,” explained Thomson.
“It’s a very complex situation involving a lot of players—the aged care sector, the Ministry of Health, the dental profession, and the public. An encouraging sign is the inclusion of oral health in New Zealand’s Healthy Ageing Strategy. That’s a starting point, but there is a lot of work to be done,” Thomson concluded.
However, the researchers also found that even the most cognitively impaired participants were able to be examined fairly easily, indicating that regular, routine removal of oral debris by carers should be manageable.
The study, titled “Oral status, cognitive function and dependency among New Zealand nursing home residents”, was published online in Gerodontology on 23 April 2018 ahead of inclusion in an issue.