PERIODONTAL STATUS OF INSTITUTIONALIZED ELDERLY

Impaired general health in institutionalized elderly has an impact on oral health and dental status, especially on periodontal health and oral hygiene. The periodontal health of institutionalized elderly people is influenced by a number of other factors such as: multimorbidity, dependence in maintaining oral hygiene, limited abilities and mobility and the use of numerous medications. Progression of periodontal disease is characterized by the presence of increased destruction of periodontal tissues. The destruction of periodontal tissues is seen through the presence and increased clinical loss of the attachment, but also through the presence of gingival recession and resorption of the alveolar bone. The most common form of periodontal disease in older adults is chronic periodontitis. Due to the chronicity of this disease, most of the detected periodontal disorders are due to the accumulation of the disease over time. The interaction of the highly prevalent xerostomia and the inability to maintain oral hygiene at a satisfactory level in institutionalized elderly leads to an increased incidence of dental plaque. Due to that, the elderly have an increased risk of manifesting dental caries and periodontal diseases. Taking into account the aforementioned facts about oral health, the presence of numerous dental and oral problems, as well as the increased health needs and impaired health in institutionalized elderly people, the aim of this paper was to assess periodontal health among institutionalized elderly people over 65 years of age. Assessment of periodontal status among institutionalized elderly was done by using the Ramfjord Periodontal Disease Index. The research was conducted in the period from April to July 2018 in the Department “Mother Teresa”, part from the Gerontological Institute “Thirteenth November” - Skopje. It included a total number of 75 people over the age of 65 who were accommodated in the department and gave their consent to participate in the research. The dental clinical examination was performed in the long-term care institution, in the office or in the rooms of the institutionalized elderly or in a room determined for that purpose. The examination of the subjects was performed on a patient sitting on a chair, lying in bed or placed in a wheelchair. For the examination a dental probe, a dental mirror and disposable gloves and a portable lamp for artificial illumination were used. The average number of present (remaining) teeth in the respondents was 5.81± 7.34 (range 0-24, with Confidence interval from 4.09 to 5.52). The mean value of the simplified OHI Green Vermilion index obtained for the presence of dental plaque was 2.33 ± 0.51 (range from 1.33 to 3.00, with Confidence interval from 2.15 to 2.51). The average value for the Ramfjord index (for assessment of periodontal health) was 4.57 ± 0.74 (range 2.5 to 6.00, with Confidence interval 4.33 to 4.82). Most of the subjects after the appropriate analysis had moderately advanced periodontitis (68.42% of the subjects). Based on the obtained data and subsequent analysis of the results we had found high percentage of people with unsatisfactory oral hygiene and high prevalence of periodontal disease.