Oral hypofunction and association with need for daily assistance among older adults in long-term care

Abstract

Background: Oral hypofunction (OHF) is related to occlusal status and bite force. It has specific symptoms and varying degrees of severity.

Objectives: OHF was determined with five signs. The relationships between OHF and need for assistance in oral hygiene, moving, eating and occlusal status in older adults living in long-term care (LTC) were examined.

Methods: A comprehensive clinical oral examination was conducted on 393 residents who lived in LTC in Helsinki, Finland. The five signs to determine OHF were mouth dryness, visible food residue on oral or denture surfaces, ability to keep the mouth open during examination, clearness of speech, and diet of pureed or soft food. Score points of 0-2 were given for each sign, and the sum was categorised as mild, moderate or severe OHF. Participants were divided into three groups accordingly, and occlusal status was determined based on contact units. In addition, nurses collected background information on number of medications and level of cognition. Need for assistance was based on oral hygiene, moving and eating.

Results: Of participants (n = 319), 21% showed severe and 41% moderate OHF. Occlusal status differences between the OHF groups were significant. OHF severity associated linearly with increased severity of cognitive impairment and increased need for assistance in oral hygiene, eating and moving.

Conclusions: OHF score based on the five signs can be used to determine OHF severity. OHF was common and associated with occlusal status, cognitive impairment and need for assistance in oral hygiene, moving and eating in older adults living in LTC.

Keywords: daily assistance; long-term care; occlusal status; older adults; oral hypofunction.