Prevalence,extent and severity of periodontal disease of institutionalized elderly

Objectives: To estimate the prevalence, severity and extent of periodontal disease in Japanese institutionalized elderly.

Methods: Between 2006 and 2007, A total of 249 dentate residents (79 males and 170 females) aged 56-101 years (average 83.4 years,s.d 4.0 ) in 11 nursing homes in Japan were given a clinical examination comprising recordings of Plaque Index(PlI), bleeding on probing (BOP), clinical attachment level (CAL) and probing pocket depth (PPD) in 4 sites of all teeth present except third molars. Basic demographic information was also collected.

Results: The mean PlI of all subjects was 1.8 (s.d.0.5). The mean number of remaining teeth in subjects >65 years was 17.9 (s.d.8.3) and decreased with age (10.7 s.d.7.8 in oldest old subjects). The mean % of BOP was 32.0 (s.d.27.7)%. The mean values of CAL and PPD were 2.6 (s.d.0.8) mm and 3.2 (s.d.1.2) mm, respectively. The prevalence of attachment loss >4mm was 79.1% . PPD >4mm and >5mm were seen in 61.1% and 38.4%,respectively. The mean values of all clinical parameters tend to be higher in molar region than in anterior tooth especially in mandible.

Stepwise multiple regression analysis revealed that PPD, number of remained teeth and plaque were the significant explanatory factors for percentage of attachment loss.

Conclusions: The results indicated that the subjects in the study had poor oral hygiene with abundant amount of plaque. More than one third of subjects had severe periodontal disease. Intensive mechanical and/or chemical oral hygiene provided by professionals may be necessary to prevent further extention of periodontal disease.