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Dental health of community-living older people attending secondary healthcare: a cross-sectional comparison between those with and without diagnosed mental illness

Published online by Cambridge University Press:  15 December 2009

Nitin Purandare ,
Eva Woods ,
Sue Butler ,
Julie Morris ,
Martin Vernon ,
James Fraser McCord  and
Alistair Burns
Nitin Purandare*
Affiliation:
University of Manchester and Manchester Mental Health and Social Care Trust, Old Age Psychiatry, Manchester, U.K.
Eva Woods
Affiliation:
University of Manchester and School of Dentistry, Manchester, U.K.
Sue Butler
Affiliation:
University of Manchester and Manchester Mental Health and Social Care Trust, Old Age Psychiatry, Manchester, U.K.
Julie Morris
Affiliation:
Medical Statistics, University Hospital of South Manchester NHS Trust, Manchester, U.K.
Martin Vernon
Affiliation:
Geriatric Medicine, University Hospital of South Manchester NHS Trust, Manchester, U.K.
James Fraser McCord
Affiliation:
University of Manchester and School of Dentistry, Manchester, U.K.
Alistair Burns
Affiliation:
University of Manchester and Manchester Mental Health and Social Care Trust, Old Age Psychiatry, Manchester, U.K.
*
Correspondence should be addressed to: Dr. Nitin Purandare, Psychiatry Research Group, School of Community Based Medicine, The University of Manchester, Room 3.319, University Place (3rd Floor East), Oxford Road, Manchester M13 9PL, U.K. Phone: +44 (0)161 3067916; Fax: +44 (0)161 3067945. Email: [email protected].
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Abstract

Background: Mental illness and cognitive impairment are risk factors for poor dental health.

Methods: We conducted a cross-sectional study to compare the dental health of older patients attending out-patient clinics and day hospitals of old age psychiatry services (the psychiatry group, n = 103) with those attending general/geriatric medical services (the medical group; n = 99). Those living in care homes, and those with diagnosed mental illness (in the medical group) were excluded. A registered mental health nurse assessed mental and general health using validated and previously published instruments. A registered dentist made an independent assessment of dental health (examination to assess oral pathology, status of remaining teeth, and dentures) and made an overall judgment about whether the patient needed any dental treatment (a “normative” need).

Results: The normative need for dental treatment was significantly higher among the psychiatry group compared to the medical group (85% vs 52%; p<0.001); even after taking account of the effect of age, gender, teeth status, physical comorbidity, cognition, depressive symptoms, and overall mental and social health [adjusted odds ratio, OR (95% confidence interval): 4.32 (2.09, 8.91)]. The presence of any natural remaining teeth [OR: 4.44 (2.10, 9.42)] and Barthel Index [OR: 0.96 (0.93, 0.99)] were the two other independent predictors of the need for treatment.

Conclusion: Dental problems are common in community-living older people, especially those with some natural remaining teeth and those with mental illness. There is a need to develop integrated mental health and dental care services for older people with emphasis on prevention of dental problems.

Keywords

dentaloraldentistagedmentalcognitioncommunityneed
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 3 , May 2010 , pp. 417 - 425
Copyright
Copyright © International Psychogeriatric Association 2009

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