The Relation between Masticatory Function and Nutrition in Older Individuals, Dependent on Supportive Care for Daily Living.

INTRODUCTION: Associations between masticatory function and nutritional status have been suggested. Masticatory function can be divided into two subdomains, the objective capacity of an individual to mix solid food and the individual's subjectively assessed ability to masticate solid food. AIM: The aims of this study were to assess the relationship between these subdomains and nutritional variables in older, care-dependent individuals. MATERIALS AND METHODS: From a group of 355 individuals with care dependency and functional limitations, individuals aged 60 and older were selected. By home visits, the subjects underwent an oral examination and answered chewing related questions. Nutritional status was assessed using the Mini Nutritional Assessment. A total of 196 individuals met the age requirement of 60 years or older. Of these, 86 subjects were able to answer the questions. RESULTS: We could not find any concluding significant associations between the subdomains of masticatory function or the nutritional variables. CONCLUSIONS: The absence of associations could be explained by the lack of standardized and validated methods to assess masticatory function and they possibly reflect varying underlying constructs. Self-reported questionnaires seem less useful among older and care-dependent individuals, while an objective clinical measurement will be needed when evaluating masticatory function.

Quality of life related to tooth loss and prosthetic replacements among persons with dependency and functional limitations.

Objectives: To examine if tooth loss or treatment with different prosthetic replacements are associated with oral health-related or health-related quality of life (OHRQoL or HRQoL) among persons with dependency and functional limitations.Material and Methods: Comparisons between results of questionnaires and clinical data (number of teeth, Eichner index, presence, type, and condition of prosthetic replacements) from a population of 180 individuals with dependency and functional limitations sampled from the register of increased financial support in Norrbotten County, Sweden.Results: The associations between clinical variables and the questionnaire responses were weak overall, e.g. Spearman's rho was 0.162 (p = .033) for correlation between number of teeth and GOHAI, 0.094 (p = .249) for number of teeth and OHIP, -0.070 (p = .356) for complete dentures and GOHAI, and -0.108 (p = .185) for complete dentures and OHIP.Conclusions: The weak associations between clinical variables and questionnaire results in the present study suggest that good results on measured QoL do not necessarily indicate good oral health. As we cannot expect this specific population to report oral disorders by themselves, regular check-ups are necessary.

Oral Status and Prosthetic Treatment Needs in Functionally Impaired and Elderly Individuals.

PURPOSE: The purpose of this cross-sectional study was to describe the oral status and prosthetic treatment needs of dependent, functionally impaired individuals and dependent elderly individuals in comparison with the general population. METHODS: A total of 355 subjects, sampled from the register of increased financial support for dependent and functionally impaired individuals in the north of Sweden, were examined. The variables were number of teeth, Eichner Index, type and condition of prostheses, and treatment needs. Statistical analyses were carried out using an independent samples t test for means and chi-square tests for proportions. Comparisons were made with the results of an earlier study (EPI-Norr) of 908 patients from the general population in the same county. RESULTS: The study group had fewer teeth compared with the general population (20% edentulous in the study group vs 7% in the general population; P < .001), as well as more dentures and fewer tooth- and implant-supported prostheses. A total of 42% of the dentures in the maxilla and 51% of the dentures in the mandible were in poor condition. There was no difference in complications from dental implants between the groups. CONCLUSION: Since the Swedish system for financial support enables dental care to the patient groups in question, the situation is probably better in Sweden than in many other countries. As more accentuated differences can be assumed between these population groups in other countries, these findings are also interesting from an international perspective.

Tooth Loss and Prosthetic Treatment in Dependent and Functionally Impaired Individuals with Respect to Age and Gender.

PURPOSE: The aim of this study was to compare the prevalence of tooth loss and prosthetic treatments in dependent, functionally impaired individuals with the general population. MATERIALS AND METHODS: Data collected from 250 subjects from a register covering dependent and functionally impaired individuals in Sweden were compared with data from matched controls. The collected variables included number of teeth, tooth loss, and prosthetic treatments in the different jaw regions. RESULTS: The study group had a lower mean number of teeth and a higher proportion of complete tooth loss than the control group. Dentures were more common in the study group, and fixed prostheses, including dental implants, were more common in the control group. Gender-based differences related to tooth loss were also apparent. CONCLUSION: In spite of a well-organized recall system for dental care, differences still existed in tooth loss. The differences were more apparent in older individuals and appeared to be related to general health, functional impairments, and gender. Prosthetic treatment options were unevenly used and only one implant overdenture was found.

Dental implants in the functionally impaired: experience from the patients' perspective.

OBJECTIVE: Edentulousness has a great impact on the individual. Extensive tooth loss is more common among functionally impaired individuals. Such groups may have difficulties with removable prostheses. The aim of this qualitative study was to explore functionally impaired patients' experience of receiving and living with dental implants. MATERIALS AND METHODS: Seventeen patients with several types of functional impairment who had undergone treatment with dental implants were interviewed. Analysis of the open-ended questions was inspired by grounded theory methodology and began at the first interview, proceeding in parallel until no further relevant information could be obtained. RESULTS: 'The implant treatment is a process of normalization' was identified as the core category. It was related to four other categories: 'The functionally impaired are also entitled to dental care', 'Edentulousness is a burden for functionally impaired individuals', 'There is interaction between implant treatment and other aspects of life' and 'It is important to understand the implications of implant treatment'. CONCLUSIONS: Normalization was the motivation for implant treatment. Edentulousness had enhanced the feeling of being different and treatment with dental implants was important for well-being. The experience of the treatment process was linked to circumstances of life. Information about procedure, alternative prosthetic constructions and hygiene routines was crucial to the experience and the outcome of the treatment.