Testing the effect of including oral health in general health checks for elderly patients in medical practice--a randomized controlled trial.
OBJECTIVE
To test the feasibility and effectiveness of an oral health referral process for elderly patients (aged 75 years or over) attending a preventive health check (PHC) with their general medical practitioner.


OBJECTIVE
To evaluate the effectiveness of the process in increasing dental attendance at baseline and 6 months after the intervention. To identify key characteristics of those who accepted an oral health visit (OHV). To determine the proportion of people attending the OHV who required treatment and subsequently attended a dentist.


METHODS
Three general medical practices in east Cheshire, UK.


METHODS
A randomized controlled trial.


METHODS
Elderly patients attending their general medical practice for PHCs were randomly assigned to a test group, who were invited to attend for an OHV, and to a control group, who received no intervention. Six months after the PHC the effectiveness of the process was measured.


RESULTS
Some 50% of those invited for an OHV accepted. Those accepting were more likely to be edentulous, wear dentures or have a current oral health problem, than those declining. Regression analysis showed the best predictors of acceptance to be having a current dental problem or pain and not having a regular dentist. The mean time since their last dental visit was 8.1 years which was significantly longer than those declining the OHV. 63% of individuals attending the OHV were assessed as having a realistic treatment need and 70% of those referred went on to complete the course of treatment. In the test group a highly significant increase in reported dental visiting was found at sixth month evaluation. The primary care staff were happy to include the dental checklist and felt it was a valuable addition to the PHC.


CONCLUSIONS
The offer of an OHV was taken up most readily by those with current oral problems, or pain and those with no regular dentist. The inclusion of a dental checklist within the PHC for elderly patients together with help with arranging a dental appointment shows promise as a way of ensuring the dental needs of this group are met.
Lowe
C
C
School of Dentistry, The University of Manchester, Manchester, UK.
Blinkhorn
A S
AS
Worthington
H V
HV
Craven
R
R
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016321:Dental Care for Aged / Q000706:statistics & numerical data; D003778:Dentures; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged; D006304:Health Status; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000145:classification; D009066:Mouth, Edentulous / Q000145:classification; D020380:Needs Assessment / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D011313:Preventive Dentistry; D011314:Preventive Health Services; D011320:Primary Health Care; D012017:Referral and Consultation