Abstract
Background. The detection of dental pain in persons suffering from dementia has not yet been investigated.
Subjects and methods. Twenty-one nursing home residents with a mean age of 88 participated in this study. Nine rotating volunteer dentists came to the nursing home to conduct dental evaluations. Two outside geriatricians performed a second assessment, and additional information concerning dental status was obtained from the minimum data set (MDS).
Results. Over 60 percent of assessed participants were considered to have a pain-causing condition. Less than half of these were rated by the geriatricians as having dentalrelated pain. Only one participant was rated to have dental or mouth pain on the MDS. Only one of the 18 persons with either a full or partial evaluation had no dental problems.
Conclusions. Dental problems are underdetected and undertreated in the nursing home. Better training for nondentists in detection of such problems and better reimbursement for dental care are needed to improve care of residents.
Keywords: dementia, dental problems, nursing home, pain
Full Text
The Full Text of this article is available as a PDF (105.1 KB).
Contributor Information
Jiska Cohen-Mansfield, Research Institute of the Hebrew Home of Greater Washington; George Washington University Medical Center, Washington, DC..
Steven Lipson, Research Institute of the Hebrew Home of Greater Washington, Rockville, Maryland..
References
- Gift HC, Cherry-Peppers G, Oldakowski RJ: Oral health care in US nursing homes—1995. Spec Care Dentist. 1998; 18(6): 226-233. [DOI] [PubMed] [Google Scholar]
- Fiske J, Lloyd HA: Dental needs of residents and carers in elderly people's’ homes and carers’ attitudes to oral health. Eur J Prosthodont Restor Dent. 1992; 1(2): 91-95. [PubMed] [Google Scholar]
- Simons D, Kidd EA, Beighton D: Oral health of elderly occupants in residential homes. Lancet. 1999; 353(9166): 1761-1761. [DOI] [PubMed] [Google Scholar]
- Nitschke I, Hopfenmuller W: Dental care in homes for the elderly and aged: Organization and opinion of home management. Dtsch Stomatol [in German]. 1991; 41(11): 432-435. [PubMed] [Google Scholar]
- Kayser-Jones J, Bird WF, Paul SM, et al.: An instrument to assess the oral health status of nursing home residents. Gerontologist. 1995; 35(6): 814-824. [DOI] [PubMed] [Google Scholar]
- Morris JN, Hawes C, Fries BE, et al.: Designing the National Resident Assessment Instrument for Nursing Homes. Gerontologist. 1990; 30(3): 293-307. [DOI] [PubMed] [Google Scholar]
- Arvidson-Bufano UB, Blank LW, Yellowitz JA: Nurses’ oral health assessments of nursing home residents pre-and post-training: A pilot study. Spec Care Dent. 1996; 16(2): 58-64. [DOI] [PubMed] [Google Scholar]
- Fiske J: Dental care for elderly people with a handicap. Dental Update. 1992; 19(7): 302-306. [PubMed] [Google Scholar]
- Baker A, Bowring L, Brignell A, Kafford D: Chronic pain management in cognitively impaired patients: A preliminary research project. Perspectives. 1996; 20(2): 4-8. [PubMed] [Google Scholar]
- Wirz J, Tschappat P: The oral hygiene, dental health and prosthetic care of old age home pensioners and geriatric patients: A study at the Adullam Foundation in Basel. Scheiz Monatsschr Zahnmed [in German]. 1989; 99(11): 1253-1260. [PubMed] [Google Scholar]
- Shuman SK: Goals and strategies for improving dental care in the nursing home: Part 1. Northwest Dent. 1998; 77(6): 21-26. [PubMed] [Google Scholar]
- Folstein MF, Folstein SE, McHugh PR: “Mini-Mental State”: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12: 189-198. [DOI] [PubMed] [Google Scholar]
- Hartmaier SL, Sloane PD, Guess HA, Koch GG: The MDS Cognition Scale: A valid instrument for identifying and staging nursing home residents with dementia using the minimum data set. J Am Geriatr Soc. 1994; 42(11): 1173-1179. [DOI] [PubMed] [Google Scholar]
- Bennett SL: Dental care for elderly residents. Can Nurse. 1996; 92(5): 32-36. [PubMed] [Google Scholar]
- Peters D: Geriatric dental care crisis. J Can Dent Assoc. 1999; 65(1): 11-11. [PubMed] [Google Scholar]
- Lamy M, Mojon P, Kalykakis G, et al.: Oral status and nutrition in the institutionalized elderly. J Dent. 1999; 27(6): 443-448. [DOI] [PubMed] [Google Scholar]
- Thai PH, Shuman SK, Davidson GB: Nurses’ dental assessments and subsequent care in Minnesota nursing homes. Spec Care Dent. 1997; 17(1): 13-18. [DOI] [PubMed] [Google Scholar]
- Kandelman J, Gagnon G, Hurley R, Ruel D: Elderly dental care: Needs and costs in three different resident settings. Geriatr Dent. 1990; 80(4): 73-80. [PubMed] [Google Scholar]
- Kambhu PP, Warren JJ, Hand JS, et al.: Dental treatment outcomes among dentate nursing facility residents: An initial study. Spec Care Dentist. 1998; 18(3): 128-132. [DOI] [PubMed] [Google Scholar]
- Ritchie CS, Joshipura K, Silliman RA, et al.: Oral health problems and significant weight loss among community-dwelling older adults. J Gerontol: Bio Sci & Med Sci. 2000; 55A(7): M366-M371. [DOI] [PubMed] [Google Scholar]