Objective and perceived oral health status of elderly nursing home residents: a local survey in southern France

Abstract

Objective: The aim of this study was to compare the perceived oral health of elderly persons and the clinical reality of their oral status.

Background: Persons aged over 60 have considerable need for oral health care; a need that increases over time. However, this population appears to be unaware of their state of oral health, and this may be a further obstacle to professional management. We thought it useful to examine the objective and the perceived oral health of these patients. Understanding what may influence their perception can help us to improve their management.

Methods: The data analyzed in this work are the findings of a field survey carried out in elderly nursing home residents. Their objective oral health was evaluated by using two variables: oral profile, determined by clinical examination, and the oral health index determined using the Oral Health Assessment Tool (OHAT). Perceived oral health was evaluated using the various categories and fields of the General Oral Health Assessment Index (GOHAI).

Results: Our clinical study showed a discrepancy between perceived oral health and the clinical reality: although a significant association can be demonstrated between the OHAT and the GOHAI, there are considerable variations. It also appeared that the number of teeth and total edentation considerably influence perceived oral health and that findings vary according to different situations.

Conclusion: Numerous factors influence elderly persons' perception of their true oral health. In order to improve our elders' quality of life, the necessary measures must be taken for the follow-up and regular monitoring of their oral health. At the same time, all possible means should be used and awareness should be raised to improve the health behavior and perception of patients and their entourage.

Keywords: aging; dental care need; dental health perception; oral health; quality of life.

Figure 1

(A) Objective oral health (OHAT) according to oral profile (n=114). (B) Perceived oral health (GOHAI) according to oral profile (n=94). Abbreviations: OHAI, General Oral Health Assessment Index; OHAT, Oral Health Assessment Tool; PFDR, p-value associated with exact Wilcoxon rank sum test after FDR-correction; PKW, p-value associated with Kruskal-Wallis test.

Figure 2

Boxplot representations of the three GOHAI subscores by oral profile. Note: Only significant pairwise comparisons after FDR-correction are added on the graphs. Abbreviations: FDR, false discovery rate; GOHAI, General Oral Health Assessment Index; OHAT, Oral Health Assessment Tool.

Figure 3

Perceived oral health (OHAT) according to oral profile (n=94). Abbreviations: GOHAI, General Oral Health Assessment Index; OHAT, Oral Health Assessment Tool.