Impact of dental care on oral health-related quality of life and treatment goals among elderly adults.

BACKGROUND: General dental care can effectively control disease and restore damaged tissue, yet little is known about its impact on patients' subjective oral health, namely treatment goals and oral health-related quality of life (OHRQoL). This study aimed to evaluate change in both aspects of subjective oral health among elderly adults receiving publicly-funded, general dental care. METHODS: We conducted a prospective, single-group intervention study of adults aged 75+ years receiving care through the South Australian Dental Service (SADS). Before receiving dental care, subjects completed the Oral Health Impact Profile (OHIP-14) questionnaire which evaluates OHRQoL. In this questionnaire, subjects rated the extent to which they had attained a self-nominated oral health goal. Dentists provided standard-of-care treatment and six months later the OHIP-14 and goal attainment questions were re-administered. RESULTS: Among the 253 adults studied, overall improvements in OHRQoL were observed (p < 0.05), although the effect was dependent on pre-treatment goal: mean OHIP-14 scores did not change significantly for subjects whose goal was less pain/discomfort while significant improvements were observed for subjects with other treatment goals. In contrast, mean goal attainment ratings improved significantly (P < 0.05), regardless of treatment goal categories. CONCLUSIONS: Dental care was associated with improvements in subjective oral health, although different patterns of improvement were observed for OHRQoL compared with goal attainment ratings.

Does dental care improve the oral health of older adults?

OBJECTIVE: To assess the relationship between self-perceived change in oral health status and the provision of dental treatment in an older adult population. DESIGN: A longitudinal study with data collection at baseline and after three years. Information on change in oral health was obtained by interviews with study subjects and information on dental treatment over three years was obtained from subjects' dentists. SUBJECTS: Nine hundred and seven subjects took part at baseline and 611 at follow-up. Of the latter, 495 reported at least one dental visit during the three-year observation period and dental treatment information was available for 408. Outcome measures Global transition judgements and change scores derived from four oral health indexes were used to assess change in oral health status. RESULTS: Over the three-year period, one-tenth of subjects reported that their oral health had improved and one-fifth that it had deteriorated. Those who improved made significantly more dental visits and received significantly more dental services that those who deteriorated or did not change (P<0.0001). They also received a broader range of diagnostic, preventive and therapeutic services. The association between change and dental service provision remained after controlling for other potential determinants of oral health. CONCLUSION: The study suggests that improvements in the oral health of older adults depend upon access to comprehensive dental treatments which can address fully their clinical and self-perceived needs.

Making a comprehensive diagnosis in a comprehensive care curriculum.

Comprehensive care models in dental education encourage students to deliver patient-centered care. But to deliver effective comprehensive care, a clinician must first make a comprehensive diagnosis. Students of general dentistry are taught to make one or more diagnoses as defined by the dental specialties, and to direct patient care accordingly. Without a comprehensive diagnosis, patients may receive fragmented, poorly prioritized care that is inappropriate to their overall oral health. This paper presents a simple diagnostic classification that can be used to make a comprehensive diagnosis with which to guide the student of general dentistry in planning comprehensive care.

Team training at an outreach dental unit.

A cohort of eighty nine undergraduate dental students worked for one year on two clinics completing a total of 3901 days work. Most of this time (63%) was spent at a site with shared nursing support, but despite this another site with dedicated nursing support produced approximately the same output. Students and nurses preferred working as a team rather than sharing; 98% of the students completed a questionnaire on the role of dental nurses and the majority identified chairside assistance as being the most important contribution to the increased throughput of patients.

Reduction of tooth loss associated with periodontal treatment.

Comparing tooth loss for populations comprising subjects with periodontal disease has been limited by broad and different definitions of disease severity. Numeric scores for periodontal disease severity and risk were used to enhance the precision of comparing tooth loss for two populations. Both populations received routine dental care, but only one received comprehensive periodontal treatment. The analysis provides evidence that adding periodontal treatment to routine dental care is associated with less tooth loss and more patients who do not lose any teeth. Furthermore, it may be possible to nearly eliminate tooth loss associated with periodontal disease.