Abstract
Objectives
To describe the oral health status and dental service use of older adults with complex
needs living within the community and aged residential care (ARC) facility settings,
and to determine associations between dental service utilization and sociodemographic
variables.
Design
Secondary analysis of 2 continuously recruited national cohorts.
Setting and Participants
Adults aged ≥65 years having standardized assessments between July 1, 2012, and May
31, 2018, within New Zealand and who provided consent.
Methods
All community-living older people with complex needs undergo a standardized assessment,
using the Home Care International Residential Assessment Instrument (interRAI-HC),
whereas all ARC facility residents undergo Long Term Care Facilities assessments (interRAI-LTCF).
Anonymized data from consenting participants were extracted. Cross-sectional analyses
of oral health status and dental service use variables employed logistic regression
models, whereas longitudinal analysis of factors influencing dental service utilization
employed binary generalized estimating equation models.
Results
Overall, 144,380 interRAI-HC assessments from 97,229 participants, and 195,549 interRAI-LTCF
assessments from 62,798 participants were eligible. At first assessment, their average
age was 81.9 years (range: 65-109 years) and 84.4 years (range: 65-110 years), respectively.
Approximately 65% of the participants wore dentures; 9% had broken, fragmented, loose,
or otherwise nonintact natural teeth; and 10% reported difficulties chewing. Overall,
only 25.3% of community-dwelling older adults and 17.5% of ARC residents had a dental
examination within the previous year. Stark inequalities were observed with, for example,
Māori participants having adjusted odds 3.14 [95% confidence interval (CI): 2.88,
3.42] and 2.08 (95% CI: 1.81, 2.39) of not having a dental examination in community
and ARC facility settings compared with their New Zealand European counterparts.
Conclusions and Implications
Heavy and unequal oral health burdens were observed among older adults with complex
needs, together with low dental service uptake. New Zealand needs an oral health policy
for older adults.
Keywords
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Article info
Publication history
Published online: July 28, 2020
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
