A screening tool of oral dysfunction for the elderly

Objectives:A New community service program has been introduced into the fragile elderly people to prevent conditions that require long-term care recently in Japan. The program consists of mass screening of the fragile elderly and providing them with “strengthening of the bone, muscle, and joint functions”, “nutritional support” and “extensive oral functional improvement”. In that screening tool, three simple questions as to “dry mouth”, “masticatory problems” and “swallowing difficulties / choking” were used. We examined actual dental conditions of the subjects and compared the results of the questionnaires. We also compared our results with the DENTAL screening tool inquiring about dry mouth, eating difficulty, no dental care within past 2 years, tooth loss, alternative food selection due to masticatory problems and lesions sores / lumps in mouth.

Methods:Elderly people living at home participated in the organized screening program. They were examined by the dentists for oral function, caries, periodontal disease, fitting of denture and dry mouth. The questionnaire survey of three questions and the DENTAL were also conducted by the trained staff during the dental examination.

Results:A total 213 out of 238 elderly people who have been enrolled in the program were analyzed. The mean age of the subjects was 73.6 years old (SD=5.8). The average number of lost tooth was 18.2 (SD=9.9). Clinical dental treatments were necessary in 14.1% for caries, 14.6% for

periodontal disease (CPI=4) and 15.0% for adjustment of denture. These results were not correlated with the answers to the three questions used in the organized program. The sensitivity and specificity of the DENTAL tool for the overall clinical dental treatments was 0.64 and 0.44, respectively.

Conclusions:Our study suggests that the current organized mass screening program for the fragile elderly in Japan should be modified to incorporate the clinical dental treatment needs more effectively.