title: Dental health of community-living older people attending secondary healthcare: a cross-sectional comparison between those with and without diagnosed mental illness.
abstract: BACKGROUND
  Mental illness and cognitive impairment are risk factors for poor dental health.
  
  
  METHODS
  We conducted a cross-sectional study to compare the dental health of older patients attending out-patient clinics and day hospitals of old age psychiatry services (the psychiatry group, n = 103) with those attending general/geriatric medical services (the medical group; n = 99). Those living in care homes, and those with diagnosed mental illness (in the medical group) were excluded. A registered mental health nurse assessed mental and general health using validated and previously published instruments. A registered dentist made an independent assessment of dental health (examination to assess oral pathology, status of remaining teeth, and dentures) and made an overall judgment about whether the patient needed any dental treatment (a "normative" need).
  
  
  RESULTS
  The normative need for dental treatment was significantly higher among the psychiatry group compared to the medical group (85% vs 52%; p<0.001); even after taking account of the effect of age, gender, teeth status, physical comorbidity, cognition, depressive symptoms, and overall mental and social health [adjusted odds ratio, OR (95% confidence interval): 4.32 (2.09, 8.91)]. The presence of any natural remaining teeth [OR: 4.44 (2.10, 9.42)] and Barthel Index [OR: 0.96 (0.93, 0.99)] were the two other independent predictors of the need for treatment.
  
  
  CONCLUSIONS
  Dental problems are common in community-living older people, especially those with some natural remaining teeth and those with mental illness. There is a need to develop integrated mental health and dental care services for older people with emphasis on prevention of dental problems.
authors.affiliation: Psychiatry Research Group, School of Community Based Medicine, University of Manchester and Manchester Mental Health and Social Care Trust, Old Age Psychiatry, Manchester, UK. nitin.purandare@manchester.ac.uk
authors.forename: Nitin
authors.initials: N
authors.lastname: Purandare
authors.forename: Eva
authors.initials: E
authors.lastname: Woods
authors.forename: Sue
authors.initials: S
authors.lastname: Butler
authors.forename: Julie
authors.initials: J
authors.lastname: Morris
authors.forename: Martin
authors.initials: M
authors.lastname: Vernon
authors.forename: James Fraser
authors.initials: JF
authors.lastname: McCord
authors.forename: Alistair
authors.initials: A
authors.lastname: Burns
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003753:Dental Health Surveys; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D009909:Oral Health; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data*; D014076:Tooth Diseases / Q000175:diagnosis / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology