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Oral health in frail elderly

PhD ceremony:drs. A.R. Hoeksema
When:December 14, 2016
Supervisors:prof. dr. A. (Arjan) Vissink, prof. dr. G.M. (Gerry) Raghoebar, prof. dr. H.J.A. (Henny) Meijer
Co-supervisor:prof. dr. A. Visser
Where:Academy building RUG
Faculty:Medical Sciences / UMCG

Ageing points towards increasing health problems and rising costs for the society. One of these health problems is the deteriorating oral health in care dependent elderly. The latter is related to the high need for care on many levels in these elderly. The lack of attention for oral care can be considered a hidden health hazard as it has been shown that dental awareness and oral health significantly contribute to general health and quality of life (QoL).

The general aim of this PhD study was to assess the oral status and oral health of frail community living and indwelling elderly (>75 years) as well as to assess its impact on general health, frailty and QoL.

We found that elderly do not prioritize oral health, and we concluded that the oral health in frail elderly is in general bad. Dental visits are skipped as well as visits to the oral hygienist. A broad number of dental problems, including caries, broken teeth and gum disease, is measured in frail elderly with remaining teeth. In the group of edentulous elderly the fitting of prosthesis is regularly in a poor to bad state, and they report more oral complaints. Frailty levels in edentulous people are higher compared to elderly with their own teeth.

We classified elderly in subgroups of frailty: robust, frail and with complex care needs. The elderly with their own teeth and elderly with an overdenture or implants were found to be more robust and scored a higher QoL. Edentulous elderly scored a higher rate of frailty and used more medication.

In conclusion, in our opinion all elderly above the arbitrary age of 75 years should be screened on a regular basis, preferably once a year, for a check of their general health and oral health, their medication and frailty status. The result of this screening should underlie the specific oral care needs for a particular patient, preferably provided by general dentists and oral hygienists.