Assessment of oral health status, self-perceived needs, unmet needs, and barriers to utilization of dental services among institutionalised elderly population in Chennai, India: A cross sectional study

Subhashree Mohapatra; Rahul Mohandas; Meignana Arumugham Indiran

doi:10.17126/joralres.2023.026

Subhashree Mohapatra Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India. http://orcid.org/0000-0003-2407-1244
Rahul Mohandas Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India http://orcid.org/0000-0002-0609-8219
Meignana Arumugham Indiran Department of Public Health Dentistry Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences Chennai, India. http://orcid.org/0000-0002-7519-3877

DOI: https://doi.org/10.17126/joralres.2023.026

Abstract

Aim: The aim of the study was to assess the oral health status and identify oral health perceived and unmet needs, and barriers in utilization of dental services among institutionalized elderly population in Chennai.
Materials and Methods: Across sectional study was conducted among institutionalized an elderly population aged 65-74 years. Oral health status was assessed using the WHO Oral Health Assessment Form (2013). Self-perceived oral health needs and barriers in the utilization of dental services were assessed using a pre-tested questionnaire. Descriptive statistics and Pearson Chi Square Test was done to analyse the data.
Results: There was a high frequency of periodontitis among the study participants. The unmet oral health needs were high. The self-perceived oral health condition was good among the study participants. The major barrier for utilization of dental services was the lack of information on oral health.
Conclusions: In India, which is a developing country, a low level of dental care results from low-level financing of the Indian health care system. This, however, does not mean that even in the current poor economic conditions, it is impossible to improve the dental awareness of the residents of care homes. The improvement is also possible through the inclusion of dental check-ups into the schedule of general dental examinations of the residents performed once in 6 months.
Keywords: Oral health; Needs assessment; Barriers to access of health services; Aged; Health of institutionalized elderly; Dental care for aged

References

1. Lauritano D, Moreo G, Della Vella F, Di Stasio D, Carinci F, Lucchese A, Petruzzi M. Oral Health Status and Need for Oral Care in an Aging Population: A Systematic Review. Int J Environ Res Public Health. 2019;16 (22):4558.
2. Yadav S, Arokiasamy P. Understanding Epide-miological Transition in India. Global Health Action. 2014;7: 23248.
3. Goel P, Singh K, Kaur A, Verma M. Oral Healthcare for Elderly: Identifying the Needs and Feasible Strategies for Service Provision. Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research. 2006; 17 (1): 11–21.
4. Petersen PE, Yamamoto T. Improving the Oral Health of Older People: The Approach of the WHO Global Oral Health Programme. Community Dentistry and Oral Epidemiology. 2005; 33(2): 81–92.
5. Singh S, Bajorek B. Defining ‘Elderly’ in Clinical Practice Guidelines for Pharmacothera-py. Pharmacy Practice. 2014;12 (4): 489.
6. United Nations, Department of Economic and Social Affairs, Population Division (2022). World Population Prospects 2022: Summary of Results. UN DE-SA/POP/2022/TR/NO. 3.
7. Dey S, Nambiar D, Lakshmi JK, Sheikh K, Reddy KS. Health of the Elderly in India: Challenges of Access and Affordability. National Academies Press (US). 2012
8. Nanda A R, Haub C. The Future Population of India–a Long Range Demographic View. Popul Res Bureau. 2007
9. .Gluck G, Warren M. Morganstein. 2002. Jong’s Community Dental Health - E-Book. Elsevier Health Sciences.
10. Chandra, S. 2004. Text Book of Community Dentistry. Jaypee Brothers Medical Pub-lishers.
11. Panchbhai AS. Oral Health Care Needs in the Dependant Elderly in India. Indian Jour-nal of Palliative Care. 2012.18 (1): 19–26.
12. Saub R, Evans RW. Dental Needs of Elderly Hostel Residents in Inner Melbourne. Aus-tralian Dental Journal .2001;46 (3): 198–202.
13. Agrawal R, Gautam R, Kumar MP, Kadhiresan R, Saxena V, Jain S. Assessment of Dental Caries and Periodontal Disease Status among Elderly Residing in Old Age Homes of Madhya Pradesh. Journal of International Oral Health : JIOH .2015;7 (8): 57–64.
14. King T, Kapadia D. Oral Health Status and Treatment Needs of Institutionalized Elder-ly and Disadvantaged Population in Fiji. Pacific Health Dialog .2003;10 (1): 35–40.
15. Shaheen SS, Kulkarni S, Doshi D, Reddy S, Reddy P. Oral Health Status and Treatment Need among Institutionalized Elderly in India. Indian Journal of Dental Research. 2015;26 (5): 493–99.
16. Raju HK, Nusrath F, Sudhir KM, Krishna Kumar RVS, Vandana K. Normative needs in relation to perceived oral health among institutionalised adults of South India: A cross sectional study. 2016; 14(3): 298-301.
17. Kothia NR, Bommireddy VS, Devaki T, Vinnakota NR, Ravoori S, Sanikommu S, Srinivas P. Assessment of the Status of National Oral Health Policy in India. International Journal of Health Policy and Management. 2015;4 (9): 575–81.
18. Roncalli AG. The SB Brasil 2010 Project: A Key Strategy for Developing an Oral Health Surveillance Model. Cadernos de Saúde Pública . 2010.26: 428–29.
19. Martins AM, Barreto SM, Pordeus IA. Factors Associated to Self-Perceived Need of Dental Care among Brazilian Elderly. Revista de Saúde Pública.2008; 42(3): 487–96.
20. Mariño R, Giacaman RA. Patterns of Use of Oral Health Care Services and Barriers to Dental Care among Ambulatory Older Chilean. BMC Oral Health .2017;17 (1): 38.
21. Aguirre Escobar G.A, de Quezada R.F, Escobar de González W.Y, Aguirre de Rodrí-guez KA, de Miguel ÁG, Rivas Cartagena FJ. Oral health profile status and treatment needs in the Salvadoran elderly population: a cross-sectional study. BMC Oral Health. 2022;21;22(1):247.
22. Borreani E, Wright D, Scambler S, Gallagher JE. Minimising Barriers to Dental Care in Older People. BMC Oral Health .2008; 8:7.
23. Ramesh B, Chandra A, Tikku AP, Arya D, Gupta R. Oral Care Needs, Barriers and Challenges among Elderly in India. Journal of Indian Prosthodontic Society. 2015;15(1): 17–22.
24. Kiyak HA, Reichmuth M. Barriers to and Enablers of Older Adults’ Use of Dental Ser-vices. Journal of Dental Education .2005;69(9): 975–86.
25. Bommireddy VS. Dental Service Utilization: Patterns and Barriers among Rural Elderly in Guntur District, Andhra Pradesh. Journal Of Clinical And Diagnostic Research. 2016;10(3):ZC43-7.
26. Ornstein KA, DeCherrie L, Gluzman R, Scott ES, Kansal J, Shah T, Katz R, Soriano TA. Significant Unmet Oral Health Needs of Homebound Elderly Adults. Journal of the American Geriatrics Society.2015;63(1):151-157.
27. Molete M. P, Yengopal V, Moorman J. Oral Health Needs and Barriers to Accessing Care among the Elderly in Johannesburg. SADJ: Journal of the South African Dental Association. 2014;69(8): 352, 354–57.
28. Krishnamurthy R, Desouza KC. Chennai, profile. Cities 42. 2015;118-129.
29. WHO Oral Health Surveys: Basic Methods. 5th Edition.
30. Costa MJF, Lins CAA, Macedo LPV, Sousa VPS, Duque JA, Souza MC. Clinical and self-perceived oral health assessment of elderly residents in urban, rural, and institutional-ized communities. Clinics (Sao Paulo). 2019;74:e972.
31. Tsakos G, Steele JG, Marcenes W, Walls AW, Sheiham A. Clinical Correlates of Oral Health-Related Quality of Life: Evidence from a National Sample of British Older People. European Journal of Oral Sciences. 2006;114 (5): 391–95.
32. Khanal S, Bhattarai R, Rao G, Shrestha S. Insti-tutionalized Elderly People Oral Health Status and Treatment Needs Assessment in Kathmandu District. Journal of Dental and Allied Sciences. 2018.
33. Gaszynska E, Franciszek S, Godala M, Gaszynski T. Oral Health Status, Dental Treat-ment Needs, and Barriers to Dental Care of Elderly Care Home Residents in Lodz, Poland. Clinical Interventions in Aging. 2014; 9:1637–44.
34. Saintrain MW, de Souza EH. Impact of Tooth Loss on the Quality of Life. Gerodontology. 2012;29(2):e632-6.
35. de Lira LS, da Silva DP, Silva MS. The Elderly’s Perception about Their Oral Health. Ana de Acta Scientific Dental Sciences. 2018; 2 (4).
36. Naidu GM, Reddy VB, Satti NR, Allareddy S, Babu RP, Kandregula C. Self-Reported and Clinically Diagnosed Dental Needs among Institutionalized Adults in Vijayawada: A Cross-Sectional Study. Journal of International Society of Preventive and Community Dentistry. 2014;4(1):35-9.
37. Nogueira CMR, Lucilia MNF, Nuto S, Saintrain MVL, Gomes AP. Self-Perceived Oral Health among the Elderly: A Household-Based Study. Revista Brasileira de Geriatria E Gerontologia.2017;20(1).
38. Lo GL. The use of dental services by adult Singa-poreans. Singapore Dental Journal. 1993; 18(1):22-25.
39. Gilbert G.H, Heft M.W, Duncan R.P, Ringelberg M.L. “Perceived need for dental care in dentate older adults”. Inter Dent J. 1994;44(2):145-152.
40. Heft MW, Gilbert GH, Shelton BJ, Duncan RP. Relationship of Dental Status, Socio-demographic Status, and Oral Symptoms to Perceived Need for Dental Care. Community Dentistry and Oral Epidemiology. 2002;31(5): 351–60.
41. Hugo FN, Hilgert JB, de Sousa Mda L, da Silva DD, Pucca GA Jr. Correlates of Partial Tooth Loss and Edentulism in the Brazilian Elderly. Community Dentistry and Oral Epi-demiology. 2007;35 (3): 224–32.