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Oral Infections in Home-living Elderly Patients Admitted to an Acute Geriatric Ward

Institute of Dentistry, P.O. Box 41, FIN-00014 University of Helsinki

H. Pajukoski

Department of Oral and Dental Diseases, University of Kuopio, P.O. Box 1627, FIN-70211 Kuopio, Finland

S. Snellman

Department of Oral and Dental Diseases, University of Kuopio, P.O. Box 1627, FIN-70211 Kuopio, Finland

S. Zeiler

Department of Community Health and General Practice, University of Kuopio, P.O. Box 1627, FIN-70211 Kuopio, Finland

R. Sulkava

Department of Community Health and General Practice, University of Kuopio, P.O. Box 1627, FIN-70211 Kuopio, Finland, Harjula Geriatric Hospital, P.O. Box 38, FIN-70101 Kuopio, Finland

Little is known about the oral health of the frail and home-living elderly. The effects of dentogenic infections on the general condition of the elderly are also unknown. We therefore set out to investigate 191 elderly patients referred to an acute geriatric hospital due to sudden worsening of their general health. The patients' mean age was 81.2 ± 6.4 years (range, 67 to 96 years), and they had lived at home before hospitalization. The patients were examined and their diagnoses set by a team of physicians. The dentist's examination was also made bedside. Panoramic x-rays were taken for those who were able to stand (n = 148). Particular attention was paid to the occurrence of dental infection foci and systemic infection parameters of blood. Only patients free from other than dental infections were included in the statistical analyses (n = 184). Panoramic x-rays revealed dentogenic infection foci in 71.1% of the dentate patients. Periodontal condition was poor in 96.2% of the patients (CPI score, 2 to 4). All infection parameters were high in patients with high periodontal treatment need, but the differences were not statistically significant. Neither were there statistically significant correlations between the number of dentogenic infection foci recorded from the radiographs and infection parameters of blood. More of the edentulous patients had positive salivary yeast counts than did the dentate patients (84.4% vs. 66.1%; P < 0.05). No correlation was found between the main systemic diagnoses and dental infections. Since the prevalence of dentogenic infection foci in our subjects was high, and they did not cause marked increase in the hematological infection parameters investigated, it seems clear that geriatricians should refer their patients for dental examinations. Although our patients represent the home-living elderly population in a Nordic country with a high standard of living and good medical care, dental care had been neglected regardless of the patients' systemic disease.

Key Words: dentogenic infection • geriatric patients • acute ward • erythrocyte sedimentation rate • C-reactive protein • blood leucocyte count.

Journal of Dental Research, Vol. 76, No. 6, 1271-1276 (1997)
DOI: 10.1177/00220345970760060601


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