The oral health of older adults living in care homes in Northern Ireland: a retrospective epidemiological study

Objectives To describe the oral health status of a sample of older adults residing in nursing homes in Northern Ireland (NI). A secondary objective was to explore associations between a number of oral health parameters and cognitive impairment for a subgroup of the study population. Background Care home residents are frequently excluded from national oral health surveys, resulting in limited epidemiological data to inform service planning. The population of Northern Ireland is ageing, and life expectancy is increasing. With older people now retaining their natural teeth into older age service providers and policymakers should be aware of the oral health status of this population group. Methods A retrospective epidemiological analysis of oral health assessment records collected between 31 January 2019 and 31 January 2020 across two Health and Social Care (HSC) Trusts within Northern Ireland was undertaken. Results Data were available for 1,477 residents (mean age 83.1 years; 67.1% female). Overall, 67.3% were dentate. Among dentate residents, 29.0% had active carious lesions and 35.8% of all residents had retained roots in situ. Poor oral hygiene was recorded in 56.3% of dentate residents. Increasing age was significantly associated with reduced odds of being dentate (OR 0.73 per 10-year increase; p=0.017). In the cognitive impairment subgroup (n=381), no significant associations were observed between cognitive status and caries, retained roots, or number of teeth. The only variable positively associated with cognitive impairment in multivariate analysis was the number of fractured teeth (OR 0.55; p=0.026). Conclusions A high burden of untreated dental disease exists among nursing home residents in Northern Ireland. The majority have retained natural teeth, thus increasing their preventive and restorative care needs. Strategic workforce planning, preventive programmes, and enhanced access to dental services are required to address unmet need in this vulnerable care dependent population.