Evaluation of Oral Health Status and the Need of Surgical and Therapeutical Preprosthodontic measures in the Elderly Living in Old People's Homes in Latvia

Introduction. Demographic evolution indicates enlargement of the older people proportion and increased life expectancy. The oral health is strongly associated with quality of life. In 1992 the main part of Latvian dental care was excluded from the list of the government paid health service. The rules N. 254 (2006) of the Cabinet of Ministers of the Republic of Latvia establish that customers from social old people's homes have to pay for dental care by themselves and the government will prepay only teeth extractions in cases of acute pain. Thereby, there appeared necessity to conduct comparative evaluation of clinical situation among populations of Latvia and other countries. Aim of the study. The aim of the study was to establish necessary types and ranges of surgical and therapeutical measures before prosthodontical teeth replacement among people who live in old people's homes; to conduct comparative analysis of clinical situation with corresponding groups of age in Latvian population. Materials and methods. There were examined 212 elderly people living in old people's homes of Kurzeme region of Latvia (randomly chosen). The indices of bad odour were established by HALIMETER. Caries incidence was assessed with DMFT index (D-decayed, M-missing, F-filling). This study was done in period from November of 2007 to February of 2009. Results. Out of all examined elderly people living in old people's homes 32.3% of men and 57.3% of women had complete teeth loss. Caries incidence ratio was 28.7 and 28.8, respectively. Untreated dental caries and filling rate were low (4.5; 2.6 and 0.6; 0.7) while the number of lost teeth was high (23.1 and 25.8). Out of the examined elderly 85.7% of men and 76.5% of women needed emergency surgical treatment (extraction of destroyed teeth). In 45.2% and 57.8% of cases were observed oral mucosal lesions, in 2.4% and 1.6% of cases were found oral precancerous conditions. In 14.3% and 18.8% of cases was noted pain in temporomandibular joints. 97.6% and 87.5% of old people's homes inhabitants needed prosthodontical teeth replacement. Conclusions. Oral health care measures for the elderly in old people's homes is insufficient, the ratio of decayed and missing teeth is high, oral hygiene mostly is unsatisfactory and many of them have halitosis. The elderly from old people's homes need vast surgical and therapeutical treatment prior to prosthetics and teeth replacement. The prevalent type of prosthodontics is complete removable dentures. There is need to develop the oral health care conception for the elderly living in old people's homes in Latvia.