Oral health of community dwelling elders in Hong Kong

Abstract

Introduction: The world’s population is ageing and the elders are vulnerable to oral health problems. This project aimed to observe the oral health status of community dwelling elders in Hong Kong, investigate the oral health impact on their quality of life and nutritional status, and provide oral health education and preventive service. Methods: Community dwelling elders (65 or above) were recruited from five community centers. An interviewer-administered questionnaire was completed to collect information on their socio-demographic background and oral health perception/practice. Their oral health related quality of life (OHQoL) and nutritional status were measured by using the Geriatric Oral Health Assessment Index (GOHAI) and Mini-Nutritional Assessment (MNA), respectively. Their tooth and periodontal status, oral hygiene and soft tissues were examined. Individualized advice, oral health education and scaling were provided. Results: A total of 195 elders participated. Despite their sound knowledge on dental caries, their awareness of the causes and risk factors of periodontal diseases was low. Several misconceptions of oral health were common and their expectation towards oral health was low. Although 81% brush their teeth at least twice a day, over 75% did not perform interdental cleaning mainly due to unawareness of the necessity (32%) and lack of skills (42%). Their dental visits were treatment-driven and mainly for pain-relieving and emergency care. Only 19% were regular dental attendees. The mean (SD) DMFT was 8.9 (7.8). Over 60% had periodontal pockets; 6% were edentulous and 38% had fewer than 20 teeth. The mean (SD) total GOHAI score was 56.4 (8.0); 60% reported negative impact of oral health on their quality of life. The mean (SD) MNA score was 25.2 (2.9); 30% had malnutrition or were at risk. Multivariate analysis showed that tooth loss and untreated decayed teeth (DT) were significant determinants of poor OHQoL; older age, higher education level, and poorer OHQoL were significantly associated with higher risk of malnutrition (all p<0.05). Conclusions: Oral health problems are common among community dwelling elders in Hong Kong. Their oral health awareness and practice are yet to be improved. Tooth loss and unmet treatment need for dental caries significantly compromise elders’ quality of life, which in turn increases their risk for malnutrition. Outreach oral health education and service are well received by the community.