Oral health care for frail elderly people: actual state and opinions of dentists towards a well-organised community approach.
OBJECTIVE
This study was undertaken to provide an analysis of the actual oral heath care for frail elderly people living in different settings and to explore opinions of dentists towards new concepts in developing a community approach.


METHODS
Data were collected from a sample of 101 dentists (15%) in the county of Antwerp using a self-administered 30-item questionnaire including questions about age, gender, education, organisational aspects of dental surgery, questions concerning dentists' own contribution to oral healthcare services for frail elderly people and statements concerning opinions and attitude toward the organisation of oral health care for frail elderly people. At the same time, qualitative data were collected from focus group sessions with all participating dentists. Non-parametric analysis was used to explore possible relationships between opinion and possible explanatory variables.


RESULTS
Half of the dentists offered dental services to residential or nursing homes (mean number of treatments a year: 5.4) and at home (mean number of treatments a year: 2.4). Prosthetic treatments such as relieving denture pressure points, repairing, rebasing and making new dentures were carried out in 77.4% and 76.7% of the cases in residential or nursing homes and at home respectively. Extractions were carried out in 16% and 18.6% of the cases in both living situations respectively. The main reasons for dentists refusing domiciliary oral health care were the absence of dental equipment (63%), lack of time (19%), with 11% convincing the patients to be treated in their dental surgery. Analysis showed different opinions of dentists depending on age, gender and university of education; however, statistically significant differences were only found by age.


CONCLUSIONS
The older the dentist, the greater the tendency to refuse domiciliary oral healthcare services. The younger dentists were reluctant to cooperate in the provision of oral health care in a structured community approach.
De Visschere
Luc M
LM
Department of Community Dentistry and Dental Public Health, Ghent University, University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. luc.devisschere@ugent.be
Vanobbergen
Jacques N
JN
D000328:Adult; D000367:Age Factors; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003153:Community Health Services / Q000706:statistics & numerical data; D016321:Dental Care for Aged / Q000523:psychology* / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D016330:Frail Elderly; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data; D012737:Sex Factors