title: The implications of visual impairment in an elderly population in recognizing oral disease and maintaining oral health.
abstract: The incidence of impairment and disability increases in the elderly population. Disability can affect elderly people's ability to maintain oral health, maintain access to dental care, and accept dental treatment. The oral health of visually impaired people can be disadvantaged, since they are not in a position to detect and recognize early oral disease and may be unable to take immediate action unless informed of the situation. The aim of this pilot study was to identify the problems experienced by a visually impaired elderly population regarding the maintenance of oral health and the need to seek treatment. Sixty-two legally blind people underwent a structured interview and a clinical dental examination. Data are presented descriptively. All the participants would be potentially able to maintain their own adequate oral health level if given the appropriate stimulus. At the time of the study, 53% brushed their own teeth, 39% of whom brushed daily. Of the denture wearers, 58% cleaned them at least once a week. Most of the participants were independent. Eighty-two percent believed that they did not need help to brush their teeth or dentures, even though 85% had never been shown how to brush their teeth. Eighty percent of people did not realize that regular oral reviews were necessary. Other barriers to regular care included poor health, mobility problems, cost, and fear. Twenty-one percent of the sample had toothache or a denture problem. The professionally assessed treatment need was high in the dentate group, and 32% of denture wearers had denture-related pathology. The professionally assessed treatment need was greater than the visually impaired people's perceived need for care. The majority of visually impaired elderly were capable of maintaining a reasonable level of oral hygiene by themselves and were aware of their own dental needs but either had no reason to seek care or were unable to access oral health care services. It is important for visually impaired persons to realize that they need supervision to maintain good oral hygiene standards and to ensure the early identification of oral pathology. Also, the barriers to access to oral health services need to be reduced.
authors.affiliation: St Mark's Health Centre, Msida, Malta. jsschembri@waldonet.net.mt
authors.forename: A
authors.initials: A
authors.lastname: Schembri
authors.forename: J
authors.initials: J
authors.lastname: Fiske
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003365:Costs and Cost Analysis; D016854:Dental Anxiety / Q000523:psychology; D003729:Dental Care; D003778:Dentures; D005260:Female; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000175:diagnosis*; D020380:Needs Assessment; D009909:Oral Health; D009910:Oral Hygiene; D010342:Patient Acceptance of Health Care; D010808:Physical Examination; D010865:Pilot Projects; D012648:Self Care; D014098:Toothache / Q000145:classification; D014099:Toothbrushing; D019987:Persons with Visual Disabilities