Utility of State-Based Basic Screening Survey Reports for National Oral Health Surveillance in Older Adults

Abstract

Introduction: Untreated dental disease and resulting tooth loss can diminish quality of life for older adults by limiting food choices and discouraging social interaction. Before the Basic Screening Survey (BSS) for older adults, no clinical data were available to monitor the oral health of older adults in long-term care (LTC) facilities at the national level or older adults overall at the state level. Although BSS is widely used, no guidelines exist to ensure the validity, reliability, and comparability of survey information across states. We examined BSS content to help establish reporting guidelines and synthesized findings across states for older adults living in LTC.

Methods: We systematically reviewed BSS reports published from 2011-2019, assessing how oral health outcomes were measured and reported. For reports that included statewide estimates for LTC residents, we calculated the mean, median, and ranges of 3 preventable oral health conditions and 4 indicators of tooth loss.

Results: We found wide variation in reporting of sampling, screening, and statistical methods, as well as in indicators of tooth loss. Median prevalence of untreated tooth decay and edentulism (total tooth loss) among LTC adults in 11 states was almost twice that for community-dwelling adults in a national survey.

Conclusions: The substantial variation in BSS reporting highlights the potential benefits of adopting standardized guidance, which could improve the utility of BSS. Poor oral health outcomes among LTC residents underscore the importance of systematic monitoring of the oral health of this vulnerable population.

Figure 1

Process for identifying reports from the Basic Screening Survey (BSS) for older adults that met inclusion criteria. ASTDD, Association of State and Territorial Dental Directors.

Figure 2

Prevalence of oral health indicators among older adults in long-term care (LTC) facilities as reported in state basic screening surveys. Abbreviations: BSS, basic screening survey; NA, not applicable; NHANES, National Health and Nutrition Examination Survey; NR, not reported.