Oral health status and treatment needs of elderly residents in a Singapore nursing home.

Dear Editor, The oral health of nursing home residents is an integral part of their total health. Good oral health facilitates effective chewing, contributes positively to speech, social confidence and is associated with better cognitive and functional capacity in older persons.1 Gum disease can exert a negative effect on diabetes, pneumonia, heart disease, high-density-lipoprotein cholesterol, serum iron, white blood cell count, fasting blood sugar, hypertension and other health markers.2,3 Upon admission to a local nursing home, residents are given a medical assessment and thereafter regularly monitored by medical practitioners. However, residents are generally not provided with any oral health assessment and only referred to dentists when they complain of dental symptoms. It has been over 15 years since any data on the oral health of nursing home residents in Singapore was published.4 A study conducted in 1991 suggested that oral health neglect was common and residents only had episodic dental care when they complained of pain. There were no preventive programmes and about 50% of subjects examined required urgent dental treatment. In November 2006, a team of 3 dentists (HPYT, MLW and ASMW) carried out a bedside oral health assessment for the residents of a 270-bedded local nursing home. They assessed the prevalence of edentulism, denture status, extent of tooth decay, oral hygiene and the dental treatment needs of the residents. Of the 265 residents, 184 residents participated in the study. Ninety-one (49.5%) were males and the mean age was 75 years (range, 29 to 100) years. None except 2 of the residents had any dental complaints. One complained of a painful molar due to advanced tooth decay and another complained of denture discomfort (the resident had angular cheilitis and an ulcerated bleeding denture-induced hyperplastic lesion on the buccal sulcus of the mandible). Edentulism was common. Seventy-five (41%) were completely edentulous and another 54 (29%) were completely edentulous in either the maxilla or mandible. Altogether 64 maxillary and 37 mandibular complete dentures were examined in this study (Table 1). Few of the partially dentate had partial maxillary (2 out of 50) or mandibular (4 out of 90) dentures. Complete dentures were assessed for retention, stability, extension, occlusion and hygiene. The results are reported Oral Health Status and Treatment Needs of Elderly Residents in a Singapore Nursing Home