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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 9  |  Issue : 1  |  Page : 22-25

An evaluation of prosthetic status and treatment needs among institutionalized elderly individuals of Delhi, India


1 Department of Public Health Dentistry, Manav Rachna Dental College, Faridabad, Haryana, India
2 Department of Public Health Dentistry, NIMS Dental College, Jaipur, Rajasthan, India
3 Department of Public Health Dentistry, Subharti Dental College, Meerut, Uttar Pradesh, India
4 Department of Public Health Dentistry, Baba Jaswant Singh Dental College, Ludhiana, Punjab, India

Date of Web Publication6-Mar-2017

Correspondence Address:
Nisha Yadav
H No. 21, Sec-15. (2), Huda Colony, Gurgaon, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-4003.201635

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  Abstract 

Context: Oral health is essential for elderly person's general health and well-being. The most common oral problem in elderly is tooth loss which results due to periodontal diseases and caries. Prosthetic status is very important as it is related to dietary intake and maintaining nutritional status. Hence, to promote the oral health of the elderly, we need to know their prosthetic status and need. Aims: The aim of this study is to find the prosthetic status and need of 65–74 years old elderly residing in old age homes of Delhi, India. Settings and Design: A cross-sectional study was conducted among a total of 464 residents of 20 old age homes of Delhi, India. Material and Methods: Residents with age group of 64–75 were included in the study. The prosthetic status with treatment need was recorded using the World Health Organization Oral Health Assessment Form (1997). Statistical Analysis Used: Chi-square test and t-test were used to find significance of variables. P < 0.05 was considered significant. Results: Full removable dentures were worn by 7.30% of participants with predominance in upper arch, and one bridge was seen in 9.10% of participants with predominance in lower arch. Full removable denture was required in 25.20% of participants. Most of participants required multiunit prosthesis in both upper as well as lower arch (42.20% and 36.20%, respectively). Conclusion: The present study underlines a considerable need for dental treatment in elderly as the prosthetic status of participants was poor, and prosthetic needs were high.

Keywords: Elderly, prosthetic needs, prosthetic status


How to cite this article:
Yadav N, Yadav R, Pahuja M, Pardhan S, Miglani S, Malik T. An evaluation of prosthetic status and treatment needs among institutionalized elderly individuals of Delhi, India. Indian J Dent Sci 2017;9:22-5

How to cite this URL:
Yadav N, Yadav R, Pahuja M, Pardhan S, Miglani S, Malik T. An evaluation of prosthetic status and treatment needs among institutionalized elderly individuals of Delhi, India. Indian J Dent Sci [serial online] 2017 [cited 2019 Nov 19];9:22-5. Available from: http://www.ijds.in/text.asp?2017/9/1/22/201635


  Introduction Top


Aging is a natural process, and with growing age, various physical and biological changes occur in man. The average life span of an individual has increased due to a number of discoveries in health sciences. This has led to increased number of elderly population and has further offered the dental health-care professionals to observe exceptional challenges to treat this section of elderly. As the size of this population is increasing rapidly, it is predicted that the elderly population of the country shall be among the highest in the world by the year 2025, i.e., 177 millions.[1],[2]

This special group of elderly has a wide range of health needs. Hence, they require more attention from the health-care service providers. Maintenance of oral health of elderly population is necessary for their general health and well-being. Dental health also contributes to the quality of life of elderly individual, and it helps to regain their self-confidence.[3]

Elderly have less dental visits as compared to other age groups even though it has been seen that this group of population has major dental needs. The reasons behind it may be the various misbelieves among the general community population such as the requirement of professional dental care reduces with growing age and absence of teeth.

Most of the oral problems occur in old age. One of the most common oral problems in elderly is tooth loss. The main causes of tooth loss are periodontal diseases and dental caries. Prosthetic status is very important to improve the general health of the elderly by increasing dietary intake and maintaining the nutritional status.[4]

Hence, to promote the oral health of the elderly, we need to know their prosthetic status and needs. It has been seen that the prosthetic status was poor, and treatment needs were high among elders in various studies conducted on institutionalized elders.[1],[2] Currently, few studies have been conducted pertaining to the prosthetic status and treatment needs of older age groups in Delhi. Hence, the present study was taken up to throw some light on these issues.


  Material and Methods Top


A cross-sectional study was conducted to assess prosthetic status and treatment need among elderly aged 65–74 years residing in old age homes of Delhi. Delhi was divided into five zones. As per the information collected from Delhi Municipal Office, there are 38 old age homes in Delhi, 4 old age homes from each region were included for the study. Hence, a total number of 20 old age homes out of 38 were selected by cluster randomized sampling.

Ethical clearance was obtained from the Ethical Committee of the Institute. Before the study, permission was taken from the concerned authorities after explaining the purpose and procedure of the study. Informed consent was obtained from the participants before starting the examination procedure. Elders who were in the age group of 65–74 years, who were inmates of the elders' homes, and those who were present on the day of the examination were considered for the study, whereas those participants who had not given the consent and those who were bedridden were excluded from the study.

The examiner was trained and calibrated before the study. A survey pro forma was prepared with the help of Oral Health Assessment Form, World Health Organization (1997),[5] which was used to collect the information regarding the prosthetic status and treatment needs. The pro forma was validated before conducting the study. General information was also collected which included name, age, sex, date of birth, and clinical examination was done for assessing the prosthetic status and treatment needs in elders. After completion of data collection, health education and oral hygiene instructions were given to all elderly individuals. Those who needed treatment were referred to dental hospital.

Statistical analysis

The collected data were processed and analyzed by Statistical Package for Social Sciences (SPSS) version 17 software (IBM Inc., USA). The Chi-square test and t-test were used to find the significance of variables. P < 0.05 was considered significant.


  Results Top


The mean age was found to be 69.44. Among 464 participants, 291 (62.70%) were males and 173 (37.30%) were females. Full removable dentures were worn by 7.30% of participants with predominance in upper arch, and one bridge was seen in 9.10% of participants with predominance in lower arch. Males had majority of one bridge in upper arch (7.20%), whereas females had more of full removable denture in upper arch (8.10%) [Table 1]. In lower arch, both males and females had one bridge which include 9.60% and 8.10%, respectively [Table 2].
Table 1: Prosthetic status of upper arch by age group and gender

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Table 2: Prosthetic status of lower arch by age groups and gender

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Full removable denture was required in a total of 16.3% of participants. Most of participants required multiunit prosthesis in both upper as well as lower arch, i.e. 42.20% and 36.20%, respectively [Table 3] and [Table 4]. Mean number of teeth which required replacement was 14.89 in 70–74 years age group. It was more than mean number of teeth requiring replacement from 65 to 69 years age group which was statistically significant [Table 5].
Table 3: Prosthetic needs of upper arch by age group and gender

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Table 4: Prosthetic needs of lower arch by age group and gender

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Table 5: Teeth requiring prosthesis

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  Discussion Top


Oral health is very essential for nutrition and communication. The various barriers in maintenance and improvement of dental health in elderly people have been recognized. These include the lack of trained health workers, incapability of caretakers or patients to maintain good oral hygiene, deficit financial support, and inefficient dental health-care delivery structure. The present cross-sectional study was conducted among 65–74 years old elders residing in old age homes of Delhi. A total of 464 participants were examined after excluding those who had not fulfilled the inclusion criteria.

In the present study, the age group was 65–74 years. This age group was taken as the data for this age group are needed both for planning appropriate care for the elderly and for monitoring the overall effect of oral health-care services in a population.

Mean number of missing teeth in the present study was 16.2, which was less than the mean number of missing teeth seen in study done by Iglesias Corchero and García Cepeda and Ribeiro Gaião et al.[6],[7] In the present study, the age limit was 65–74 years, whereas in the other studies, it was 60 years and above. Hence, due to no limitation of upper limit in other studies, the number of participants with higher age group was more. This resulted in more number of missing teeth in other studies.

Most of the participants in the present study required multiunit prosthesis followed by complete dentures. In comparison to the present study, most of the participants in study done by Bansal et al. required complete denture in majority, followed by one-unit prosthesis.[8] The reason can be that more number of participants with higher age groups were there in the study done by Bansal et al. Hence, there were more participants requiring complete dentures in that study.

The total number of participants who had complete dentures in the present study was 5.6%. These results are similar to the study done by Sujal and Ajithkrishnan [9] and in contrast to the study done by Bansal et al.[8] Mersel A.[10] This can be attributed to the fact that participants in the present study and study done by Sujal and Ajithkrishnan were from less age group as compared to the study done by Bansal et al.[8],[9]

In the present study, the total number of participants who required complete dentures was 16.3%. These results are similar to the study done by Bansal et al. and in contrast to the results seen in study done by Ribeiro Gaião et al., Mersel et al., and Thakare and Krishnan where majority of the participants required complete dentures Manderson RD and Ettinger.[4],[7],[8],[11],[12] This can be explained by the reason that tooth loss increases with increasing age. These other studies have increased age group of elder and hence more complete denture requirement. Limitation of the present study was that no information was collected regarding oral hygiene practices of elders which could be useful in improving the oral hygiene of participants. On-site dental care should have been provided instead of referring the patients to dental hospital.


  Conclusion Top


This study has revealed out the poor prosthetic status and high treatment need among elderly residing in old age homes. The findings highlighted the need of multiunit prosthesis, followed by complete dentures. As teeth are essential for nutrition of elders, so they must be preserved first and then replaced later on if required. The study has opened doors for further research in such needy population. Regular campaigns in old age homes should be held. Visits to old age home should be made by health-care workers to disseminate information on prevention of oral diseases. Periodic dental screening and dental visits to old age homes need to be developed to improve their access to dental services.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Goel P, Singh K, Kaur A, Verma M. Oral healthcare for elderly: Identifying the needs and feasible strategies for service provision. Indian J Dent Res 2006;17:11-21.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Bharti R, Chandra A, Tikku AP, Arya D, Gupta R. Oral care needs, barriers and challenges among elderly in India. J Indian Prosthodont Soc 2015;15:17-22.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Shenoy RP, Hegde V. Dental prosthetic status and prosthetic need of the institutionalized elderly living in geriatric homes in Mangalore: A pilot study. ISRN Dent 2011;2011:987126.  Back to cited text no. 3
    
4.
Thakare V, Krishnan AC. Periodontal status, prosthetic status and prosthetic needs among institutionalized geriatric individuals in Vadodara city, Gujrat – A descriptive study. J Indian Assoc Public Health Dent 2010;15:153-8.  Back to cited text no. 4
    
5.
World Health Organization. Oral Health Surveys-Basic Methods. 4th ed. Geneva, Switzerland: WHO; 1997.  Back to cited text no. 5
    
6.
Iglesias Corchero AM, García Cepeda JR. Oral health in people over 64 years of age, institutionalized in centres for the aged in the Vigo Health District Spain, 2005. Med Oral Patol Oral Cir Bucal 2008;13:E523-8.  Back to cited text no. 6
    
7.
Ribeiro Gaião L, Leitão de Almeida ME, Bezerra Filho JG, Leggat P, Heukelbach J. Poor dental status and oral hygiene practices in institutionalized older people in Northeast Brazil. Int J Dent 2009;2009:846081.  Back to cited text no. 7
    
8.
Bansal V, Sogi GM, Veeresha KL. Assessment of oral health status and treatment needs of elders associated with elders' homes of Ambala division, Haryana, India. Indian J Dent Res 2010;21:244-7.  Back to cited text no. 8
[PUBMED]  Medknow Journal  
9.
Sujal PM, Ajithkrishnan CG. Prosthetic status and needs among 65-74 years individuals of Piparia Village, Vadodara district, Gujrat. J Indian Assoc Public Health Dent 2010;15:96-9.  Back to cited text no. 9
    
10.
Mersel A, Anaise JZ, Shem-Tov A. Prosthetic needs and demands for services of a group of elderly people in Israel. Community Dent Oral Epidemiol 1984;12:315-8.  Back to cited text no. 10
    
11.
Van Wyk CW, Farman AG, Staz J. Tooth survival in institutionalized elderly Cape Coloreds from the Cape Peninsula of South Africa. Community Dent Oral Epidemiol 1977;5:185-9.  Back to cited text no. 11
    
12.
Manderson RD, Ettinger RL. Dental status of the institutionalized elderly population of Edinburgh. Community Dent Oral Epidemiol 1975;3:100-7.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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