Dental Care Often Neglected
in Nursing Homes
NEW YORK (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 U.K.'s West Hertfordshire, Debra Simons, of the
Principal Health Centre in St. Albans, U.K., 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 percent of the
residents with dentures and 20 percent of those
with their natural teeth saw a dentist in the
previous two years.
U.S. 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 U.S. 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.