title: Does dental disease presence equate to treatment need among care home residents?
abstract: OBJECTIVE
  This study aimed to explore the relationship between dental disease, complexity and dental treatment needs of care home residents.
  
  
  METHODS
  Survey of residents in care homes in Wales. Random sample of participants from a random selection of care homes across Wales, UK. Data collection involved questionnaires and dental examinations.
  
  
  RESULTS
  Data were collected from 655 care home residents in 213 care homes. Half of all residents reported good or very good oral health but most had dental treatment needs. 73% of dentate residents had active caries, of those, 53% required restorations and 37% needed extractions. All were deemed to require dental examination. 60% of dentate residents and 50% of edentate residents had case complexity, which influenced the delivery of care.
  
  
  CONCLUSIONS
  There is significant unmet dental treatment need amongst care home residents. Dental disease presence alone is a poor indicator of the need for care and does not account for case complexity or the shift towards a patient centred rather than disease focussed approach to care. Measures for treatment needs and complexity are required when undertaking assessments of oral health needs in care homes.
  
  
  CONCLUSIONS
  Traditional oral health surveys measuring dental disease do not necessarily equate to treatments required for care home residents and do not reflect the complexity and difficulties involved in delivering dental care. This survey highlights dental needs in care homes, and the difficulties involved in delivering care to address these needs.
authors.affiliation: Applied Clinical Research and Public Health, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom. Electronic address: JohnsonIG@cardiff.ac.uk.
authors.forename: I G
authors.initials: IG
authors.lastname: Johnson
authors.affiliation: Applied Clinical Research and Public Health, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom.
authors.forename: M Z
authors.initials: MZ
authors.lastname: Morgan
authors.affiliation: Public Health Wales, Temple of Peace and Health, Cathay's Park, Cardiff CF103NW, United Kingdom.
authors.forename: N P
authors.initials: NP
authors.lastname: Monaghan
authors.affiliation: Public Health Wales, Temple of Peace and Health, Cathay's Park, Cardiff CF103NW, United Kingdom.
authors.forename: A J
authors.initials: AJ
authors.lastname: Karki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care; D003729:Dental Care / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D003824:Denture, Complete / Q000706:statistics & numerical data; D003832:Denture, Partial, Removable / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D007575:Jaw, Edentulous / Q000628:therapy; D007576:Jaw, Edentulous, Partially / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009909:Oral Health; D009910:Oral Hygiene; D010347:Patient Care Planning; D010512:Periodontal Index; D012112:Residential Facilities; D057566:Self Report; D014076:Tooth Diseases / Q000628:therapy*; D014081:Tooth Extraction / Q000706:statistics & numerical data; D014852:Wales
keywords: Case mix; Dental; Older people; Oral health; Residential care; Survey