NEW YORK, May 31 (Reuters Health) -- The dental health of nursing home residents is often neglected, suggests a small study published in a letter to the editors of The Lancet.
In their survey of residents in 48 nursing homes in the UK's West Hertfordshire, Debra Simons, of the Principal Health Centre in St. Albans, UK, and colleagues found that many had cavities, as well as high rates of plaque accumulation and gingivitis.
"It is surely a disgrace that the mouth, one of the most personal and intimate areas of the body, should be neglected in such a manner," write Simons and colleagues.
Although dental care can be difficult for elderly people who have diminished manual dexterity, impaired vision, or illness, the management of the surveyed homes admitted that there was no "systematic approach to arranging dental care."
"Dental care was sought only when residents or their relatives complained of acute dental problems such a pain or a broken denture," Simons and colleagues write.
And although 343 of the 1,041 residents surveyed said they needed assistance cleaning their teeth and dentures, only 94 reported that the staff helped them.
The researchers report that only 4% of the residents with dentures and 20% of those with their natural teeth saw a dentist in the previous 2 years.
US nursing home residents also have their share of oral health problems, but to attribute the cause to nursing home negligence may be simplistic, according to Dr. Stephen Shuman, of the University of Minnesota School of Dentistry in Saint Paul, Minnesota, and past president of the American Society of Geriatric Dentistry.
"We do have a fair body of evidence that suggests that the oral health of US nursing home residents is not particularly good," Shuman told Reuters Health. "But I don't think we can hang it all on problems with regulation or lack of organization. I think that people have a sense of what they need to do, I think they are just having trouble doing it."
Nursing home residents represent a high-risk population for cavities, because of factors such as disabilities that interfere with self-care, and the prescription of drugs that dry the mouth and predispose to cavities, Shuman pointed out.
"My sense is there is a lot of effort and concern about this now," Shuman said. The oral health of nursing home residents "is a matter that is receiving attention in this country. I think people are struggling with just how best to do it."
SOURCE: The Lancet 1999;353:1761.
