Dental caries and the need for treatment among institutionalized elderly

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Abstract
The main purpose for the study was to determine the occurrence of untreated dental decay, and to assess the expressed demand for operative caries therapy among dentate institutionalized elderly in Denmark. The study population comprised all dentate elderly in eight nursing homes (n = 126) and in five hospital long-term care facilities (n = 75). In both groups of elderly 70% had untreated decay. The mean number of surfaces with untreated decay among the elderly in nursing homes (NH) and in hospital long-term care facilities (LTC) was respectively 9.7 and 7.5. The predominant factors influencing the occurrence of untreated decay were the use of dental services and the degree of helplessness. Regular use of dental services reduced the amount of untreated decay among the NH elderly, and the totally helpless LTC elderly had more decay than those able to manage alone. Half of the NH residents who had decay did not want treatment or were not able to express their demand for treatment due to poor mental or physical health. The realistic need for traditional operative filling therapy is discussed and it is concluded that the goal of an oral health care program for NH elderly should be to meet not only the demand for such treatment but also the need for emergency treatment and non-operative caries treatment.