'Not on the radar': dentists' perspectives on the oral health care of dependent older people.

OBJECTIVES: We explored the following research questions: (i) what challenges do dentists face when providing oral health care to dependent older adults; and (ii) to overcome those challenges, what recommendations would dentists providing care give those planning and implementing oral health policy and services for dependent older adults? BACKGROUND: The dentate older population is steadily increasing, and about half will end up in residential care, where dental caries rates over time are at least twice as great as those observed elsewhere. MATERIALS AND METHODS: A qualitative study was used, with semi-structured interviews conducted by a single interviewer. Dental examiners in a recent national survey of oral health in dependent older people in New Zealand were interviewed about their experiences and perspectives of that. RESULTS: The challenges participants identified stemmed from three areas - the patient, the care facility and the oral health sector. To address those challenges, the participants recommended actions at the patient, system and sector levels. Each of the challenges and recommendations had a number of subthemes. Overall, the dentists felt that it is a very complex situation urgently requiring policy development, cross-sectoral collaboration and upskilling of the dental profession, carers, the private sector and the State to ensure a care environment which supports achieving and maintaining oral health among frail elders. CONCLUSIONS: Urgent attention to frail older New Zealanders' oral health is needed. Such attention needs to focus on not only the narrow dental clinical preventive and therapeutic implications of those needs, but also on the broader health system and policy development challenges.

Listening to older adults: community consultation on a new dental service.

BACKGROUND: Increased life expectancy, retention of a natural dentition often heavily restored, and increasing risks of oral disease mean that older people have particular dental needs and yet uptake of care is low. A new health and wellbeing centre in south London offering student-delivered care has been built to serve the local community. Community views could informed the planning of acceptable care for older people. OBJECTIVE: To explore the views and expectations of older adults towards dental services and ascertain how a new dental centre may best provide dental care. RESEARCH DESIGN: This qualitative study used in-depth and triad interviews to explore the views of older people. Purposive sampling of local centres/groups for older adults was undertaken and all willing clients interviewed. Interviews were audio recorded, transcribed and analysed using Framework Methodology with emerging themes categorised according to Maxwell's six descriptors of quality. RESULTS: Nine sessions (five triad and four in-depth interviews) involving 17 older adults were conducted in local day centres. Barriers to dental care were largely related to fear, cost, transport, lack of perceived need and the attitude of clinicians. Outcomes related to acceptability featured highly in a dental service for older adults; the overarching principles of 'delivering mutual benefit' for students and older people, 'experiencing warm humanity' and 'restoring dignity and worth' were central to their views of quality care. The importance of clinicians, whether student or staff, delivering person centred care with warm humanity was dominant: comprising 'welcoming', 'valuing', 'listening' 'communicating' and 'caring' for older adults to enhance relationships and contributing to 'restoring dignity and worth'. CONCLUSION: Community engagement identified a willingness amongst older adults to utilise dental services where mutual benefit was perceived and, importantly, there were low barriers to care and a warm humanity was exhibited.

Executive directors' perceptions of oral health care of aging adults in long-term care settings.

PURPOSE: The objective of this study was to investigate knowledge and perceptions of executive directors of long-term care facilities in a large western state regarding oral health of residents, barriers to the provision of optimal oral health care and the collaborative practice role for dental hygienists. METHODS: A descriptive, exploratory online survey research design was utilized. A purposive sample of executive directors of long-term care facilities in a large western state certified for Medicare/Medicaid reimbursement was used. An online survey was developed to investigate perceptions and knowledge regarding oral health of long-term care residents, protocol for provision of, and barriers to optimal oral health care, and support for employment of dental hygienists in long-term care facilities. Statistics used for data analysis included frequency distributions, Spearman's rho correlation coefficient and the Mann-Whitney test. RESULTS: Executive directors in long-term care facilities included in the study perceived oral health as an important aspect of general health; however, a knowledge deficit was identified related to oral disease as an exacerbating factor to systemic disease. Financial concerns and low interest among residents/families were identified as major barriers to accessing care. Executive directors supported interprofessional practice of nurses working with dental hygienists to optimize oral health care of residents. No significant associations were found between demographics and facility characteristics. CONCLUSION: Awareness of the knowledge and perceptions of executive directors providing leadership in these facilities can provide avenues to creating needed change, which can foster improvement in the oral and overall health status of long-term care residents. Support for interprofessional work of nurses and dental hygienists can open a door for innovative practice that optimizes oral health care of long-term care facility residents through the application of shared expertise.

Barriers to dental services for older adults.

OBJECTIVE: To explore barriers to older adults' accessing dental care. METHODS: We performed oral exams on 184 community-dwelling older adults; those who needed dental care were contacted 6-12 weeks later to determine if they were able to access treatment. Those who could not access care were interviewed regarding barriers. RESULTS: Of those examined, 89% needed dental treatment. After 6 weeks, 52% had received treatment, 48% had not. Those unable to access treatment had fewer teeth, were more likely to be referred regarding dentures, and were less likely to have a dentist. Reasons cited for not accessing care among the 35 participants we interviewed included a lack of finances, transportation, or assistance in navigating dental service. CONCLUSIONS: Older adults have a high burden of oral disease and access barriers remain.

Care home managers' views of dental services for older people living in nursing and residential homes in inner city London.

OBJECTIVE: To investigate care home managers' views on the provision of dental care (current and future; urgent, check-up and follow-up) for their residents, barriers to care and the impact of policy changes, by type of home (nursing vs residential), with a view to informing the planning and provision of care. BASIC RESEARCH DESIGN: A cross sectional postal questionnaire survey and follow-up semi-structured interviews. SETTING: Care homes in South East London. PARTCIPANTS: All care home managers in three south east London boroughs. RESULTS: A 72% response rate (n=152) was achieved, 140 of which were designated as nursing and/or residential homes (92%). Almost all managers reported that the care homes had arrangements in place for residents to access some elements of dental care (99%, n=148). Reported barriers to care included residents' fear of treatment (53%), patients' limited mobility (45%) and waiting times for services (42%). Limited mobility (p=0.01) and transport issues (p=0.01) were more significant barriers for nursing homes, whereas fear (p=0.02) was more significant for residential homes. Access to a range of dental services and modes of service delivery were requested for the future; most notable were the demands for domiciliary services to be available to nursing homes and for residential homes to access local general dental practitioners to meet the needs of their residents. CONCLUSIONS: Managers report having arrangements in place for residents to access dental services; however, there was a clear view that future arrangements should be more appropriate to the needs and vulnerabilities of their residents.

Comparison of the OHIP-14 and GOHAI as measures of oral health among elderly in Lebanon.

BACKGROUND: The respective abilities of the GOHAI and OHIP-14 to discriminate between aged patients with different levels of oral diseases have rarely been studied in developing countries. The aim of this study was to compare the discriminative abilities of the OHIP-14 and the GOHAI in an elderly Lebanese population, and particularly to identify persons with different masticatory function. METHODS: A sample of elderly, aged 65 years or more, living independently was recruited in two primary care offices in Beirut, Lebanon. Data were collected by means of personal interview and clinical examination. The Arabic OHIP-14 and GOHAI questionnaires were used after cultural adaptation for use in Lebanon. The internal consistency, reproducibility and concurrent validity were verified. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile respectively and logistic regressions were conducted using socio-demographic, clinical and subjective explanatory variables. RESULTS: Two hundred and six participants were included; mean age was 72 years and 60% were women. Good psychometric properties were observed for both questionnaires for internal consistency (Cronbach's alpha>0.88), reproducibility (ICC>0.86) and concurrent validity. Strong correlations were found between GOHAI and OHIP-14 scores but a high prevalence of subjects with no impact was observed using the OHIP-14. Both questionnaires were able to discriminate between participants according to age, perception of temporomandibular joint (TMJ) pain or functional status as represented by the number of dental Functional Units (FU). GOHAI was more discriminant since it identified participants with high dental care needs: high numbers of decayed teeth, low numbers of teeth and socially deprived status. CONCLUSIONS: Lebanese elderly with high dental care needs and impaired oral health were identified more easily with the GOHAI. These results may guide the choice of dental indicators to use in a national geriatric survey.

Experiences and perceptions of oral health and oral health care among a sample of older New Zealanders.

BACKGROUND: Most research on older people's oral health has been quantitative. A need for more in-depth understanding of the oral health of that age group has pointed to a need for more qualitative investigations. OBJECTIVE: To explore experiences and perceptions of oral health and oral health care among an ethnically-mixed sample of older New Zealanders. METHODS: In-depth interviews were conducted with 24 older people in two communities in New Zealand's South Island. Thematic analysis of transcribed data was undertaken. RESULTS: Three main themes that emerged were: (1) the processes of negotiating a tension between cost and convenience of access; (2) the experiential constraining of oral health maintenance; and (3) trusting in dental professionals. These serve to organise processes such as normalising, justifying and social comparisons that create an equilibrium or tolerance and acceptance of what might otherwise be considered to be relatively poor oral health. CONCLUSIONS: We identified a number of shared experiences which affect older people's ability to maintain their oral health in the face of material and social barriers to oral health care. Because expectations were generally lower, there was greater concordance between experience and expectation, and people tended to be fairly satisfied with their oral health and the care they had received.

Preference for dentist's home visits among older people.

OBJECTIVES: To investigate factors associated with older people's preference for a dentist's home visit. METHODS: This is a report on 321 home-dwelling participants (mean age 81.6) in the population-based Geriatric Multidisciplinary Strategy for Good Care of the Elderly (GeMS) study, conducted in 2004-2005 in the city of Kuopio in eastern Finland. The information about sociodemographic and general health-related factors and the use of social and health services was collected by two study nurses using a structured interview. Each study subject was given a clinical oral examination and an interview about oral health and the use of dental health care services by one of two dentists. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Of the study subjects, 25.9% preferred a dentist's home visit. The preference for choosing a dentist's home visit was associated with a low score (≤24) in the Mini-Mental State Examination, OR 6.1 (CI: 2.9-13.6), and a low score (<8) on the scale of Instrumental Activities of Daily Living, OR 8.0 (CI: 3.6-18.6). It was also associated with living alone, OR 5.9 (CI: 2.7-13.0), and high use of home care services, OR 9.3 (CI: 4.6-19.0). CONCLUSIONS: The findings of this study emphasize the need to organize dentists' home visits in order to increase equality in the use of dental health care services among the older people with disabilities.

Perceptions of predoctoral dental education and practice patterns in special care dentistry.

The objective of this research project was to compare alumni perceptions of predoctoral dental education in the care and management of patients with complex needs to alumni practice patterns. Alumni from the University of the Pacific Arthur A. Dugoni School of Dentistry who graduated from 1997 to 2007 were surveyed regarding perceptions of their predoctoral education in the care of patients categorized and defined as medically compromised, frail elders, and developmentally disabled, as well as their practice patterns. Perceptions were rated on a Likert scale. Regression analyses were utilized. Three primary relationships were identified: 1) positive relationships emerged between perceptions of educational value, as students and practitioners, of the training they received compared to percentages of medically compromised patients they currently treat (p≤0.05); 2) after practice experience, 2003-07 graduates reported significantly higher value of their education in this area compared to 1997-2002 graduates; and 3) alumni who reported treating more patients with complex needs during school reported treating significantly more of these patients in practice (p≤0.05). We conclude that alumni who reported educational experiences as more valuable treat more patients with complex needs compared to those who valued them less. Alumni who reported having more opportunities to treat patients with complex needs as students treat a higher percentage of those patients than those reporting fewer. Even positive perceptions may underestimate the value of educational experiences as they relate to future practice.

Informing the debate on oral health care for older people: a qualitative study of older people's views on oral health and oral health care.

BACKGROUND: Older people represent a growing and diverse section of the population. As age increases, people are more likely to experience health and mobility problems and be at higher risk of developing oral disease. Nevertheless, few older people utilise primary oral healthcare services. It is therefore important to understand the value older people place on oral health and dental services to inform providers and planners of oral health care. This research was conducted as part of a study to identify potential ways of minimising barriers to oral health care in older people. OBJECTIVES: To explore perceptions of oral health and oral healthcare services amongst older people living in a socially deprived inner city area and how these are related to service utilisation. METHODS: A qualitative approach was utilised to explore the range of issues related to older people's perceptions of oral health and their views on health care. This involved a combination of focus groups and semi-structured individual interviews with older people and their carers. Data analysis was conducted using the Framework approach. RESULTS: * RESPONSE: Thirty-nine older people and/or their carers participated in focus groups. * Oral health perception: Oral health was associated with the presence of natural teeth, the absence of pain, practical/social functioning, preferably supported by positive assessment by a dentist. * Oral health life-course: Older people have a long and complex dental history. Past negative experiences with oral health care, especially in childhood, strongly influenced present attitudes towards dentistry and dental personnel. * Citizenship and right to health care: There was a strong perception that, as 'British citizens', older people should have a right to free health care and that the National Health Service (NHS) should support them in this phase of their life. CONCLUSIONS: The oral health life-course of older people is an important influence on their perceptions of oral health and dental attendance. They consider oral health of importance and place great emphasis on their citizenship and rights of access to state funded oral health care. This raises important issues for the funding and delivery of NHS oral health care for older people.

Oral health care issues in aged care facilities in Western Australia: resident and family caregiver views.

OBJECTIVE: To investigate resident and family perceptions and attitudes towards oral health care and access to dental services for aged care facility residents. METHOD: Focus groups and individual interviews with residents and family caregivers were conducted at aged care facilities in the Perth Metropolitan Area, Western Australia. RESULTS: There were 30 participants from twelve aged care facilities (21 residents and nine family caregivers). Five focus groups comprising both residents and family caregivers were conducted in addition to three face-to-face interviews with residents. Both groups considered oral health very important to overall health and quality of life. Family caregivers noted a lack of dental check-ups and specialised professional oral care, particularly in high-care facilities. Low care residents were more likely to have regular dental check-ups or dental treatment and off-site dental visits were straightforward due to their mobility and family member assistance. Family caregivers noted time limitations and lack of expertise in oral health care amongst staff in high-care facilities, and the challenges of maintaining oral care for residents with poor mobility or cognitive impairment. It was considered important that staff and management liaise with family caregivers and family members in provision of oral care. CONCLUSION: Regular oral care, assessment and treatment were considered limited, particularly for residents in high care. There is a need for comprehensive, ongoing oral health programmes involving appropriately trained and empathetic dental health professionals and staff to improve oral health care in Perth's aged care facilities.

Older peoples' perceptions of oral health: 'it's just not that simple'.

OBJECTIVES: Little is known about older persons' perceptions of oral health and oral health care. The purpose of this study was to explore the viewpoint of older adults' regarding their oral health care practices. METHODS: A qualitative interpretive methodology was employed comprising three analytic levels: coding of data into concepts, analysis of concepts into themes, followed by an in-depth analysis of relationships within concepts and between themes. In-depth individual interviews were conducted with 19 participants aged 65 to 87 years. RESULTS: Older people's decision to access oral health care involves complex and personally meaningful strategies. A dental visit surfaces hopes and fears based on past and present experiences. Mouth and teeth are not merely objects of dental care; they represent a person's social and relational self. Age-related changes challenge the relational self as represented in societal ideal images of youth and perfection (the perfect smile). This study highlights older peoples' resilience and determination when faced with the dilemmas in accessing oral health care--it costs, personally as well as financially. Contrary to the assumption that older peoples' oral health status is related to neglect, rather for many, it is the result of the intersection of their history with technological advances. CONCLUSIONS: These findings challenge oral health care practitioners to be sensitive to the contexts affecting their older client's oral health care status. They do not 'just go' to the dentist; they bring with them their past dental experiences and their hopes for the future. It matters how one is treated at this vulnerable time.

The prosthetic need WHO index: a comparison between self-perception and professional assessment in an elderly population.

The purpose of this study was to consider the criteria for establishing the need for prosthesis, by comparing the need perceived subjectively by a patient (self-perception) with that assessed by an examiner according to the WHO diagnosis criteria. The proposed domiciliary sample comprised 270 elderly (aged 60 years or older) residents in a municipality in southern Brazil. The interviews and oral examinations were conducted by two dentists following a period of training and calibration. The criteria used conformed to the WHO and FDI standards. Statistical treatment of data included bivariate and multivariate analysis using SPSS 10.0. Only five patients identified the need for a prosthesis when not identified by the examiner. In the case of 172 elderly subjects, there was agreement in the self-perceived and observed treatment needs. The need for prosthesis was found in 93 elderly subjects who did not perceive any need for prosthetic treatment. The multivariate analysis showed that the variables age, gender, residential area and form of service most sought after during their lives were significantly associated with a better self-perception of oral health. The professional criteria based on WHO guidelines differed from the self-perceived need. Elderly male subjects who lived in a rural area and were 70 years of age or more, who did not participate in third age groups, and who had not sought dental services for most of their lives were the least likely to perceive the need for prosthetic treatment, thereby underestimating their oral health needs.

Oral healthcare for older people: 'I can't afford not to go to the dentist, but can I afford it?'.

AIM: The purpose of this study was to examine challenges older people encounter in maintaining satisfactory oral health status. METHOD: This interpretive qualitative study involved 19 in-depth interviews with participants aged 65 to 87 years. Data were examined using a three-level analytic process. NVivo Qualitative Software assisted data management. RESULTS: Participants in this study didn't 'just go' to the dentist. Much effort went into solving the dilemmas and tensions of maintaining their oral health through a process of option balancing. Balancing personal and financial costs, they continually assessed their 'bottom line'. They negotiated issues of: dental cost versus service quality; basic treatment versus functionality and social appearance; future living costs versus current dental costs; and 'how long will it need to last' versus 'how long will I live'? CONCLUSION: Problems exist in the provision of affordable oral health care for the older population in Aotearoa New Zealand. They struggle to afford dental care. They receive little financial support to access oral healthcare services and are dependent on developing their own strategies to enable such care. Health professionals and policy decisionmakers' challenge is to bridge this gap.

Perceptions of oral health adequacy and access in Michigan nursing facilities.

OBJECTIVE: To determine practices and perceived access barriers (facility resources, attitudes and professional dental involvement) related to oral health by surveying directors of nursing (DONs) in Michigan nursing homes (NHs). BACKGROUND: DONs are crucial to NH practice and policy, so understanding their perceptions of oral health care is vital. METHODS: A 27-item questionnaire exploring aspects of oral health was mailed to all 402 Michigan NH. Descriptive statistics were calculated for response items. RESULTS: Facility response rate was 32% (n = 129). Sixty-three per cent of facilities had a written dental care plan primarily co-ordinated by nursing staff and social workers. Stationary dental equipment was available in 3% of facilities. Thirty-eight per cent stated an examination by a dentist was provided to new residents. Seventy-five per cent of residents identified as needing dental treatment were likely to receive it. Of the 28% of residents receiving dental treatment beyond an examination in the past year, 28% received emergent care. Over 50% of responding DONs indicated satisfaction with how oral hygiene needs were met in their facilities. The greatest perceived barriers were willingness of general and specialty dentists to treat residents at the nursing facility and/or their private offices as well as financial concerns of the resident and/or family. Generally, greater resources were available in urban facilities, but substantial barriers to care were uniformly perceived. CONCLUSION: Oral health policies and practices within Michigan NH vary, as measured by resources, attitudes, and the availability of professional care. Dental involvement in policy creation, provision of consultation, and service is limited.

Saúde bucal de idosos restritos ao domicílio: estudo descritivo de uma demanda interdisciplinar / Oral health of residence restricted elders: descriptive study of an interdisciplinary demand

No município de Londrina, a proporção de pessoas acima de 60 anos em 2002 era de 9,35%, enquanto que a média nacional, neste mesmo ano, foi de 8,52%. Do total dessa população, estima-se que 15% apresentam problemas de saúde que dificultam seu deslocamento para atendimento médico-odontológico. Somadas a essa dificuldade, a baixa renda familiar para a utilização dos serviços odontológicos privados e a falta de prioridade nos serviços públicos os coloca em uma condição de abandono. Foram selecionados 43 idosos, moradores do Conjunto Habitacional Ruy Viermond Carnascialli, e então submetidos a uma entrevista e exame clínico odontológico em seus domicílios. Foi observado que 79,1% referiram a última visita a um dentista há mais de cinco anos, e apenas 55,8% reconhecem a necessidade de um atendimento odontológico. No exame clínico, observou-se que 79,1% dos idosos já haviam perdido todos os seus dentes no arco superior e 65,1% no arco inferior, necessitando usar próteses. Quanto ao tempo de uso de uma mesma prótese, foi encontrada a média de 15 anos, sendo que ao considerar o estado geral de conservação, 67,8% das próteses superiores e 82,4% das inferiores tiveram indicação de substituição. O índice de dentes cariados, perdidos ou obturados encontrado foi de 29,7, com a média de 2,3 dentes hígidos presentes por idoso. Devido às precárias condições encontradas, serão necessários estudos considerando a restrição ao domicílio e suas implicações, como fatores de risco para a má condição e manutenção da saúde bucal em idosos.

In the city of Londrina, State of Paraná, Brazil, the proportion of people aged over 60 years in 2002 was of 9.35%, whereas the national average in the same year was 8.52%. Fifteen percent have health problems that hinder their search for health medical and dentalservices. Besides this difficulty, the low family income to afford private dental assistance and the lack of priority in public services place them in a condition of abandonment. Forty-three elders, selected in a convenience sample, were interviewed and underwent clinical dental exams in their homes. It was observed that 79.1% reported their last visit to a dentist more than 5 years ago, and barely 55.8% recognized theneed for dental treatment. In the clinical exam, 79.1% of the elders had already lost all teeth in the upper arch and 65.1% in the lower arch, and needed to use prosthesis. Concerning time of use of the same prosthesis, it was found an average of 15 years, and considering the general state of conservation, 67.8% of the upper prosthesis and 82.4% of the lower ones should be replaced. The index of decayed, lost or filled teeth was of 29.7, with an average of 2.3 teeth with no treatments or problems. Due to the precariousconditions found, more studies on the restraint to residence and its implications are needed, as risk factorsfor bad condition and maintenance of mouth health among elders.

The impact of providing dental services to frail older adults: perceptions of elders in adult day health centers.

Very little is known about the oral health of, and access to, dental services among frail elders who live in the community and use an adult day health center (ADHC) for respite care. This pilot study evaluated the perceived oral health quality of life (OHQOL) of elders who used a mobile dental program in urban, suburban, and rural ADHC settings. Pre- and post-treatment interviews were conducted to evaluate OHQOL using the Geriatric Oral Health Assessment Index (GOHAI). ADHC records were used to obtain demographic, medical history and medication data. Following initial dental examinations and consent, dental treatment was provided at each ADHC. Of the 138 elders screened at three ADHCs, pre- and post-treatment data were obtained on 76 subjects following their treatment (mean four months later). The group's members were mostly female (64.5%) and Caucasian (71.6%). Their mean age was 76.8 (+/- 9.8), with an average of 12.4 teeth (34.2% edentulous); 67.7% were on Medicaid. On average they had 5.5 chronic diseases, hypertension being the most common (67.19%); 44.8% had a neurological disorder or dementia. GOHAI scores were generally high both pre- and post-treatment, reflecting high physical and psychosocial OHQOL and low levels of worry. GOHAI scores were correlated with chronic diseases; the more chronic diseases an individual had, the lower his or her total score pre- and post-treatment (r=-.24, r=-.26 respectively, p<.04). The more dental treatment needs an elder had, the lower his or her GOHAI (r=-.23, p<.05). Elders with more teeth reported higher GOHAI pre- and post-treatment (r=.36, r=.37 respectively, p<.002). Paired t-tests comparing pre- and post-treatment GOHAI scores revealed significant improvements in overall GOHAI (p<.001), and on two dimensions: physical (p<.005) and psychosocial (p<.002). The findings support the importance of providing on-site access to dental services in order to maintain the general OHQOL of frail elders, more specifically in the areas of physical and psychosocial well-being.

What influences dental students to serve special care patients?

This study examines factors associated with graduating dental students' motivation to deliver services to special care patients. We investigated community context and student characteristics, which would influence potential behavior. Higher percentages of older adults and low-income residents in the community were positively correlated with interest in serving special care populations. Factors which correlated with individual student characteristics included having a father with at least a college education, a higher number of weeks spent in extramural clinical rotations, preparedness to provide care to disabled patients, and service orientation and socially conscious attitudes. Frail elderly and disabled persons have limited access to dental care, which is compounded by a shortage of skilled dental professionals who are willing to treat these populations. Our findings suggest that interest in special care dentistry is partly conditioned by the dental school's demographic and dental market context. This study is important to dental educators and policymakers because the challenge of providing care to the "special patient" will increase in the future.

[Geriatric dentistry: dental needs, problems, and expectations of residents of care homes]. / Stomatologia geriatryczna - potrzeby, problemy i oczekiwania stomatologiczne pensjonariuszy domów pomocy spolecznej.

PURPOSE: Elderly people deserve respect and the right to receive appropriate medical assistance. This work was undertaken to determine the stomatognathic status of residents of Care Homes, condition of their dental prostheses, their main dental problems, expectations and needs, with emphasis on aspects of prosthetic treatment and psychosocial status. MATERIAL AND METHODS: Altogether, 135 residents of the Care Homes were studied. It was found that the stomatognathic status of the residents was disappointing. The residents had problems with hygiene, their prosthetic appliances were in a poor condition, and they also experinced problems when using the prostheses. Prosthetic problems were noted in almost every resident of Care Homes. RESULTS: Expectations as to dental care cannot be fulfilled without changing the national health care system. A relationship between satisfaction in life and extent of prosthetic needs, condition of prosthetic appliances, and problems with their use was found. A positive life history plays an important role in past dental care. CONCLUSION: The psychosocial status of residents of Care Homes was poor.