March 2014

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. Key words: older people, dementia, oral health, hygiene