Comparison of oral health among older people with and without dementia.

Older people with dementia are very dependent on nursing, and caregivers are frequently confronted with oral-care-resistant behaviour which may lead to shortcomings in oral health. OBJECTIVE: To compare oral hygiene and health status of institutionalised older people suffering, or not, from dementia. BASIC RESEARCH DESIGN: Prospective cohort study (single-blind). CLINICAL SETTING: Institutionalised older population in south-west Germany. PARTICIPANTS: Ninety-three, allocated to two groups: dementia (n = 57) and non-dementia (n = 36) based on a mini mental state examination. MAIN OUTCOME MEASURES: Target variables were plaque control record (PCR), gingival bleeding index (GBI), community periodontal index of treatment needs (CPITN), and denture hygiene index (DHI). Differences between the dementia and non-dementia groups were evaluated by univariate testing of all target variables. RESULTS: Univariate analysis revealed the amount of plaque in the dementia group was significantly higher than in the non-dementia group (p = 0.004). Mean CPITN of participants in the dementia group was significantly worse than those of participants in the non-dementia group (p < 0.001). All participants in the dementia group had periodontitis in at least one of the sextants, compared with 74% in the non-dementia group (p < 0.001). For DHI (p = 0.198) and GBI (p = 0.275) no differences were found between the groups. CONCLUSIONS: Some aspects of oral hygiene and health seem to be worse for the institutionalised older people with dementia. Permanent specially adapted intervention for residents suffering from dementia in long-term care homes, and training for caregivers, is desirable to maintain life-long oral hygiene and health.