Seniors Oral Health: Are Treatment Recommendations Followedup

1
Seniors Oral Health Are Treatment
Recommendations Followed-up?
Wong, A.T.T.1, Matthews, D.2, Clovis, J.B.2,
Filiaggi, M.J.2 and M. McNally2
1 University of British Columbia, Vancouver,
British Columbia, Canada 2 Dalhousie University,
Halifax, Nova Scotia,Canada
Introduction
Results
Discussion
The Canadian population is rapidly aging. By the
year 2036, seniors over the age of 65 are
expected to make up 24.5 of the population1.
Unfortunately there is a lack of priority given
to seniors oral health by the seniors themselves,
and their caregivers2,3. From 2004 to 2006, an
oral health research team from Dalhousie
University performed a pilot study, the Seniors
Oral Health Assessment Project (SOHAP) to collect
data from seniors in Nova Scotia4. The objective
of this study was to use survey instruments to
measure and analyze oral health status, effects
of oral health on daily living and access to oral
health care. Treatment recommendations were made
based on the clinical findings of each
participant, and were given to each participant
and his or her dentist or doctor. In the summer
of 2007, a follow-up study was performed on the
SOHAP study to determine if the subject
participants (SPs) had sought their recommended
treatment.

• 146 SPs in the SOHAP study (2004-2006)
• 90 SPs interviewed in the follow-up study (2007)
• Response rate of 61.64 (70.3 excluding SPs that
  had passed away, n18)
• 64.4 (n58) of interviewed SPs followed-up with
  treatment recommendations
• Of the 32 SPs that did not seek dental treatment
• 20 stated they had no need to see the dentist
• 9 stated that having dentures meant there was no
  need to see a dentist
• 5 stated that they had financial difficulties
• Other reasons forgetfulness, poor location

A high treatment recommendation follow-up rate
(64.4) could be due to the fact that 73.3 of
the SPs surveyed lived independently and were
generally more capable of performing their own
daily activities of living (e.g. oral hygiene)
and managing their own lives (e.g. scheduling
visits to the dentist) as compared to seniors
residing in assisted living (AL) or long-term
care (LTC) facilities. Location of nearby dental
offices had a large impact on follow-up rates.
Seniors living in urban sites (D, G, N) had
higher rates of follow-up than those living in
rural sites (A, B, T, S) and rural remote sites
(C, M). Site N, an urban LTC facility, had the
highest follow-up rate of 83.3 because it was
located adjacent to a dental office. Fewer
dentists are practicing full-time in rural areas
today, and a lack of dental presence in these
communities may be a cause of the failure to
follow-up.
Conclusions
Objectives

• The majority of participants in the SOHAP study
  (64.4) followed-up with their treatment
  recommendations
• The major reason why seniors did not follow-up
  with treatment was because they felt there was no
  need
• Seniors living in urban areas had higher
  follow-up rates than those residing in more rural
  areas
• Improved accessibility to oral health care (e.g.
  distance to providers) and promoting oral health
  in the community would encourage seniors to be
  more aware of their oral health status, and to
  visit their dentist regularly

Percentage of SPs that Followed-up ()

• To locate and interview all SPs of the SOHAP
  study to determine how many had followed-up
  and/or received dental treatment from 2005 to
  2007
• To determine reasons for not following up with
  dental treatment
• To generate information which will be later used
  to prepare a provincial survey of the oral health
  of seniors in Nova Scotia

A B T S D
G N C M Overall
Sites Surveyed
Methods
Figure 1 Treatment Recommendation Follow-up Rate
References (1) Statistics Canada. Canada's
population by age and sex. In The Daily October
26, 2006. (2) Moore PA, Orchard T, Guggenheimer
J, Weyant RJ. Diabetes and oral health promotion
a survey of disease prevention behaviors. J Am
Dent Assoc 2000131(9)1333-41. (3) Penner A,
Timmons V. Seniors' attitudes oral health and
quality of life. International Journal of Dental
Hygiene 20042(1)2-7 (4) Matthews DC, Clovis JB,
Filiaggi M, McNally M, Robichaud N. Seniors Oral
Health Assessment a Pilot Study. (abstract)
American Association of Dental Research
Conference. Orlando. March 2006
Senior SPs were contacted by mail with a letter
outlining the previous SOHAP study and the
purpose of the follow-up study. SPs were
interviewed by telephone following an oral health
survey designed specifically for this project.
The survey was constructed based on the
questions asked in the original SOHAP study but
focused mainly on dental treatment (whether or
not it was received, and reasons for follow-up)
and attitudes towards dental health. Each
question had a set of preset Likert scale
responses (e.g. poor to very good or not
important at all to very important).
Interviews were timed and any additional comments
made by the SPs were collected as qualitative
data. For SPs who were unable to be interviewed
by telephone, interviews were performed in person
by AW or by nurses or family members acting as
proxies. AW, a third year dental student
Acknowledgements Network of Oral Research
Training and Health (N.O.R.T.H.) for funding this
project Integrated Health Research Training
Program at Dalhousie University Susan Haydt and
all members of the Seniors Oral Health Assessment
Project (S.O.H.A.P.) team at Dalhousie
University Dr. Michael MacEntee at the
University of British Columbia
Table 1 Sites Surveyed in Follow-up Study
1 Very Important 2 Important 3 Somewhat
Important 4 Not Important
1 Very Good 2 Good 3 Fair 4 Poor
1 Very Good 2 Good 3 Fair 4 Poor
Figure 2 Importance of Dental Health
Figure 3 Self-Rating of Dental Health
Figure 4 Self-Rating of Dental Health Knowledge