Dental findings in geriatric populations with diverse medical backgrounds

Objective: To determine whether there is a difference in the oral/dental health in older persons with different life styles and medical status. Study design: Survey (cross-sectional study) included four groups: (1) subjects (n=123) living in a residential retirement home or community dwelling; (2) subjects (n=218) seeking dental treatment at a Veterans Affairs Dental Outpatient Clinic; (3) subjects (n=132) resident in a VA long-term care facility; and (4) subjects (n=81) recently admitted to a VA acute care ward with a diagnosis of cerebral vascular accident or other neurologic problem. Each subject answered questions on medical and dental health and dietary preferences in a comprehensive interview. They were given a comprehensive dental examination that included measurements of stimulated salivary flow and minor salivary gland output. Results: The data from groups 2 and 3 confirmed previous reports that independent living subjects have better oral/dental health than dependent living subjects. The data from groups 1 and 4, obtained from geriatric populations on the opposite ends of the medical health/disease continuum provide new information that suggests that good medical health and good oral/dental health are linked. The subjects in group 1 were very healthy as judged by their longevity; 54% were ≥80 years and they had low reported prevalence of medical disease. Only 6% were edentulous and the dentate persons were missing 4.5 teeth. In contrast, over 50% of the patients in group 4 were <70 years; they had an edentulous rate of 49% and among the dentate persons had an average 12 missing and 5 decayed teeth. Conclusions: The medically healthy persons had excellent dental health whereas the sickest persons were either edentulous or had many missing teeth.