Short-Term Effects of a Deterioration of General Health on the Oral He

Anna-Luisa Klotz,¹ Melania Zajac,¹ Judith Ehret,¹ Samuel Kilian,² Peter Rammelsberg,¹ Andreas Zenthöfer¹

¹University of Heidelberg, Dental School, Department of Prosthetic Dentistry, Heidelberg 69120, Germany; ²University of Heidelberg, Institute of Medical Biometry and Informatics, Heidelberg 69120, Germany

Correspondence: Anna-Luisa Klotz
University of Heidelberg, Im Neuenheimer Feld 400, Heidelberg 69120, Germany
Tel +49 6221 566082
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Purpose: The purpose of this study was to identify how changes to general health might affect the oral health of nursing-home residents over a six-month period.
Materials and Methods: The study was conducted in nine nursing homes in Germany. Sociodemographic and general data were collected at baseline and after six months. Complete baseline and follow-up data were available for 114 participants. The Clinical Dementia Rating (CDR) and the Global Deterioration Scale (GDS) were used to identify the presence and, if applicable, severity of dementia among participants. The Apraxia Screen of TULIA (AST) was used to identify motor impairment. A comprehensive dental examination of each participant was also performed. The examination included the documentation of dental and denture status and the number of decayed, missing and filled teeth (DMF-T). In addition, dental and denture hygiene were quantitatively assessed using the Plaque Index (PI) and the Denture Hygiene Index (DHI), respectively. Global dental treatment needs were evaluated by use of the Oral Health Assessment Tool (OHAT). Univariate and multivariate linear regression models were compiled to analyse possible factors affecting the dependent target variables.
Results: During the study period, denture hygiene among the study population worsened by an average of 15%. The regression models detected that a more advanced age (in years) was associated with a less pronounced deterioration of denture hygiene as measured by use of the DHI (−0.806 per additional year of age; p = 0.030). Furthermore, an increase in the level of care needed (coefficient (C): −1.948; p = 0.002) and a more poorly graded assessment of general health compared with the value at baseline (C: 1.054; p = 0.026) were both associated with a deterioration of oral health as evaluated by use of the OHAT. In addition to these results, an increase in care needs was also associated with a deterioration of dental health as evaluated by use of the DMF-T (C: 0.966; p = 0.013).
Conclusion: In the short term, a deterioration of general health, including an increase in care needs, seems to be the predominant factor associated with a more pronounced deterioration of oral health among nursing-home residents.

Keywords: oral health, oral hygiene, caries, older people, nursing home