December 2009

Objective To identify the socio-economic, demographic and behavioural determinants of dental treatment needs of those aged 65 and over in the Republic of Ireland. Design The treatment needs data is based on detailed clinical oral examinations in the NSAOH carried out between October 2000 and June 2002. To determine factors influencing treatment needs, three measures are used: a dichotomous variable expressing the need for any dental treatment, a dichotomous variable expressing the need for dentures, and a dichotomous variable expressing a Community Periodontal Index of Treatment Need (CPITN) score of three or greater representing a need for periodontal treatment. Methods Factors such as age, gender, dental services eligibility status, fluoridation, employment status, educational attainment, anxiety about dental visits, frequency of brushing, and attendance patterns were regressed on a dichotomous version of prevalence of Decayed Missing Filled Surfaces, DMFS including the visual component, and CPITN scores. Associations were estimated using multivariate logistic regression and expressed as odds ratios (OR) with 95% confidence intervals (CI). Goodness of fit was evaluated by estimating sensitivity, specificity, positive/negative predictive values and accuracy. Results Being female, smoking, frequent snacking and anxiety about dental visits increased the odds of having a periodontal treatment need. Having primary education only, and being a smoker increased the odds of having a need for any treatment including dentures, whereas being female, regular usage of dental services, and access to fully fluoridated water supplies reduced the odds. Conclusions Socio-economic factors such as lower levels of educational attainment, demographic factors such as age and gender and not having access to fully fluoridated water supplies, and behavioural factors such as smoking, frequent snacking, anxiety about dental visits, influence above average treatment needs amongst the elderly in the Republic of Ireland. Keywords: Elderly, logistic regression, need for care, resource allocation, targeted approach.