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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 1  |  Page : 13-16

Oral health problems among geriatric population and its implication on general health: A cross-sectional survey


1 Department of Public Health Dentistry, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
2 Department of Public Health Dentistry, Government Dental College, Kottayam, Kerala, India
3 Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Mangalore, Karnataka, India

Date of Web Publication3-Jul-2017

Correspondence Address:
B K Sujatha
Department of Public Health Dentistry, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdrr.jdrr_26_17

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  Abstract 

Background: Aging is a natural process seen in all the individuals. The world is on the brink of a demographic milestone. Since the beginning of recorded history, young children have outnumbered their elders. In about 5 years' time, the number of people aged 65 or older will outnumber children under age 5. Driven by falling fertility rates and remarkable increases in life expectancy, population aging will continue, even accelerate the number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050, with most of the increase in developing countries. India being developing as well as a second highest populated country will be affected badly by both general as well as oral diseases which are noncommunicable in nature. Aim: The aim of the study was to assess oral health problems among geriatric population in a dental institution and its effect on general health. Objectives: The objectives of the study were (1) Common oral diseases/conditions among geriatric population and its prevalence and (2) implications of oral diseases/conditions on general health. Materials and Methods: A cross-sectional survey was conducted among 301 study participants of 65–74 years old from March 2016 to August 2016. A self-structured, pretested questionnaire was used to collect data on common oral health problems as well as systemic diseases along with demographic details. Data were compiled and statistically analyzed using Chi-square test and other descriptive statistics. Results: Out of 301 study participants, 42% were edentulous, 12% had denture-related problems, 16% had root caries, 22% had periodontal disease, and 8% were found to have precancerous lesions. Thirty percent of participants were found to have a combination of two or more oral diseases. Most common systemic diseases reported are malnutrition, hypertension, and diabetes. The implication of oral health on general health was found to be significant at P< 0.05. Conclusion: Oral diseases influence general health. Oral health is an integral part of general health.

Keywords: Geriatric, oral disease, systemic disease


How to cite this article:
Sujatha B K, Gomez MS, Mathew NS, Suresh J. Oral health problems among geriatric population and its implication on general health: A cross-sectional survey. J Dent Res Rev 2017;4:13-6

How to cite this URL:
Sujatha B K, Gomez MS, Mathew NS, Suresh J. Oral health problems among geriatric population and its implication on general health: A cross-sectional survey. J Dent Res Rev [serial online] 2017 [cited 2022 Jun 30];4:13-6. Available from: https://www.jdrr.org/text.asp?2017/4/1/13/209359


  Introduction Top


Aging is a natural process.[1] Since the beginning of recorded history, young children have outnumbered their elders. In 5 years' time, the number of people aged 65 or older will outnumber the children under age 5 due to decreasing fertility rates and remarkable increases in life expectancy. The number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050, with most of the increase in developing countries.[2] India being developing as well as a second highest populated country will be affected badly by both general as well as oral diseases which are noncommunicable in nature.[3] Oral health is an integral part of general health and can individually influence the overall well-being of an individual. Oral health-care delivery is very expensive, and to understand the oral health problems and its implications on general health of geriatric population, there is a need to understand common oral health problems in elderly population and its influence on general health.[4] Available literature reveals meager studies in India in the above-mentioned perspective. Hence, the present study has been chosen with an aim to assess oral health problems among geriatric population and its effect on general health in a dental institution in Bengaluru city.


  Materials and Methods Top


Study design

The present study is a cross-sectional survey conducted in Vydehi Institute of Medical and Dental Sciences, Bengaluru city.

Permission from authorities

Ethical clearance was obtained from the Institutional Review Board of Vydehi Group of Medical institutions. Required permission was obtained from the heads of medical and dental institutions.

Inclusion criteria

  • Subjects who gave consent
  • 65–74 year-old individuals
  • Subjects who are able to cooperate for the study.


Exclusion criteria

  • Subjects who have cognitive impairment
  • Subjects with reported psychological problems.


Methodology

Tool

A self-structured, pretested special format consisting of demographic details, information related to oral health and general health was used to collect data from 301 study participants after obtaining written informed consent from the participants/guardians. Sample size was calculated based on the available literature regarding the prevalence of dental caries (57.1%) by Shaheen et al. in the year 2015.[5]

Examinations

Oral examination was done to record oral health problems among study participants in the department of oral medicine and radiology using World Health Organization (WHO) 1997 pro forma.[6]

Data related to systemic diseases were collected from outpatient department of medical college through patient history or from the patient records. All the oral examinations were done by single examiner (BKS).

Duration of the study

This study was conducted from March 2016–August 2016.

After the data collection, it was compiled and subjected to statistical analysis using IBM Statistical Package for the Social Sciences (SPSS) version 21 (Chicago, IL, USA).

Statistical analysis

Chi-square test and other descriptive statistics were applied to record most common oral diseases and to understand its implication on general health.


  Results Top


[Graph 1] shows the distribution of study participants based on age.



Out of 301 participants in the present study, 83% were of 65–70 years old and 17% were 71–74 years of age group.

[Graph 2] shows the distribution of study participants based on gender.



In the present study out of 301 subjects, 65% were males and 35% were females.

[Table 1] shows the distribution of study subjects based on socioeconomic status.
Table 1: Distribution of study participants based on socioeconomic status

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In the present study, 60% (180) participants were belonging to middle class, 30% (90) were of lower class, and 10% (31) were found to be of upper socioeconomic class. Even though there was difference in the percentage of subjects belonging to different socioeconomic status, the results were not significant (P > 0.05).

[Table 2] shows the distribution of oral diseases/conditions among study participants.
Table 2: Distribution of oral diseases/conditions among study participants

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In the present study, edentulous was found in 42% (126) of the study participants, 22% (66) had periodontal disease, root caries was found in 16% (48) of study participants, 12% (36) had denture-related problems, and 8% (25) had precancerous lesions/conditions.

[Table 3] shows systemic diseases among study participants with oral diseases/conditions.
Table 3: Systemic diseases in study participants with oral diseases/conditions

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In the present study out of 126 (42%) edentulous participants, 112 (88%) were found to have malnutrition, 66 (22%) who had periodontal disease, 46 (70%) were diabetic. Results were significant at P&360; 0.05.


  Discussion Top


The aging phenomenon has transpired as a significant health/oral health issue of the present era. According to WHO, the global population is increasing at the annual rate of 1.7%, whereas the population of those over 65 years is increasing at a rate of 2.5%. Both the developed as well as the developing countries are expected to experience significant shifts in the age distribution of the population by 2050.[1]

There is a sudden blast of the “65 plus” population in the past decade, and India is no exception to that.[7] In the present study, edentulous was more prevalent, followed by periodontal disease and root caries and systemic diseases such as malnutrition and diabetes were more prevalent. These results are in accordance with the study conducted by Zhu and Hollis,[8] Nowjack-Raymer and Sheiham,[9] Lalla and Papapanou,[10] and Wolff.[11] There is an escalating demand for geriatric oral health care in all developing countries including India, as two-thirds of the world's elderly live in developing countries. Population that must receive attention from policymakers according to changing demands for social and health services including oral health services. Limited resources, rather than being aspiration to provide all treatment needed, should have a road map to answer the present and future geriatric oral health concerns in a most efficient manner in a developing country.

Aging is a biological and psychological process. A variety of age-related changes occur throughout the body which can affect the health care and treatment plans. Hence, provision of quality health and oral health care for older patients depends on health-care professionals who require training in the care of medically complex and cognitively impaired elders. Health-care professionals should be ready to manage age- and disease-related conditions of the aging population and also they must be prepared comprehensively to treat geriatric patients by paying attention to various parameters.

Finally, oral health care of elderly becomes complicated as they remain homebound and frail. The limited health-care access makes the situation a public health issue, as in future the geriatric population is going to increase which demands for more oral health-care services. To reduce the crisis, elder population should be made aware of importance of oral health and its implications on general health.

Health-care professionals should be trained in geriatric oral care in maintaining adequate oral health for elderly population. Free oral care or treatment should be given to elders in all the health centers. “Home dentistry or domiciliary dental care,” however it is yet an infrequent practice in India but can be a suitable option. Geriatric education should be included in undergraduate and postgraduate curricula and diploma courses. Finally, the effective policies should be made by the government regarding geriatric oral care.


  Conclusion Top


Oral health status of the geriatric population is generally deficient, with an elevated prevalence of edentulous, periodontal disease, and root caries. These are responsible for malnutrition, diabetes, and caridovascular diseases after diabetes.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Razak PA, Richard KM, Thankachan RP, Hafiz KA, Kumar KN, Sameer KM. Geriatric oral health: A review article. J Int Oral Health 2014;6:110-6.  Back to cited text no. 1
    
2.
Available from: https://www.nia.nih.gov/research/publication/global-health-and-aging/overview. [Last accessed on 2017 Mar 23].  Back to cited text no. 2
    
3.
Singh A, Purohit BM. Addressing geriatric oral health concerns through national oral health policy in India. Int J Health Policy Manag 2014;4:39-42.  Back to cited text no. 3
    
4.
Gil-Montoya JA, de Mello AL, Barrios R, Gonzalez-Moles MA, Bravo M. Oral health in the elderly patient and its impact on general well-being: A nonsystematic review. Clin Interv Aging 2015;10:461-7.  Back to cited text no. 4
    
5.
Shaheen SS, Kulkarni S, Doshi D, Reddy S, Reddy P. Oral health status and treatment need among institutionalized elderly in India. Indian J Dent Res 2015;26:493-9.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
World Health Organization. Oral Health Surveys: Basic Methods: Oral Health Unit. 4th ed. New Delhi: AITBS; 1997.  Back to cited text no. 6
    
7.
Panchbhai AS. Oral health care needs in the dependant elderly in India. Indian J Palliat Care 2012;18:19-26.  Back to cited text no. 7
  [Full text]  
8.
Zhu Y, Hollis JH. Tooth loss and its association with dietary intake and diet quality in American adults. J Dent 2014;42:1428-35.  Back to cited text no. 8
    
9.
Nowjack-Raymer RE, Sheiham A. Numbers of natural teeth, diet, and nutritional status in US adults. J Dent Res 2007;86:1171-5.  Back to cited text no. 9
    
10.
Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: A tale of two common interrelated diseases. Nat Rev Endocrinol 2011;7:738-48.  Back to cited text no. 10
    
11.
Wolff LF. Diabetes and periodontal disease. Am J Dent 2014;27:127-8.  Back to cited text no. 11
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]


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