Oral Health Conditions of Institutionalized Elderly with Mental Disorders

Objective: This study assessed the dental caries prevalence at an institutionalized elderly population with mental disorders with the aim of identifying the oral health conditions among different mental diagnosed patients. 

Method: The study was approved by the Institutional Review Board of the Bauru Dental School, University of São Paulo. There was a cross-sectional epidemiological study with 109 residents at a elderly institution in the city of Bauru, Brazil. The dental caries attack history was assessed (WHO criteria) and compared by diagnosis of mental disorders according to the International Classification of Diseases (ICD-10). After signing the Informed Consent, the exams were performed by two previously trained examiners (Kappa = 0.86) and the mental disorders diagnosis were identified by the medical records of patients. Kruskal-Wallis test was used to assess differences between groups. 

Result: The DMFT average was 28.73 and the missing component accounted for 94.63% of this caries index. The prevalence of edentulous was 60,55%. The psychiatric disorder most frequently found was mental retardation, affecting 58,72% of patients, followed by schizophrenia in 27,36%. There was diagnostic of unspecified nonorganic psychosis, other mental disorders due to brain damage and dysfunction and to physical disease and Unspecified dementia. The average DMFT differences of groups weren’t statistically significant (p=0,13). 

Conclusion: The epidemiological results revealed a deep oral health necessity of attention, regardless of type of mental disorder diagnosed, there are accumulated a great need for dental treatment, especially prosthetic rehabilitation. The low cognitive autonomy of these individuals do not allow them to realize the psychosocial impacts they suffer. The complete adaptation of these limitations let them to remain indifferent and resigned to the precariousness of their oral conditions. An effective oral health promotion program is a severe need of this institution, involving the carers, the institutionalized elderly and the very consciousness of the leaders.