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Changing oral health trajectories: a 10-year cross-sectional comparison of 2 domiciliary dental care patient groups in nursing homes
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Date
2025
Authors
Janssens, Lynn E.R.
Petrovic, Mirko
Allen, P. Finbarr
Colman, Roos
Janssens, Barbara E.
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier Inc.
Published Version
Abstract
Objectives
Since 2010, Gerodent has been a comprehensive oral health care program including biannual domiciliary dental care in nursing homes in Flanders, Belgium. Previous research revealed poor oral health among nursing home residents attending the mobile clinic. The objective of this study was to evaluate potential changes in the oral health needs of patients receiving domiciliary dental care, thus providing insights for future cohorts.
Design
This study compares the oral health status and treatment needs of 2 cross-sectional samples.
Setting and Participants
First-time patients attending the mobile dental clinic in nursing homes, collected a decade apart.
Methods
Generalized estimating equations were used to compare both samples [sample 1 (S1): 2010–2012: n = 1226; sample 2 (S2): 2021–2023: n = 775]. Results were adjusted for age, sex, increased reimbursement for health care costs, number of medications and care dependency. Differences in oral health outcomes were decomposed in a component attributed to the explanatory variables and an unexplained component using the Blinder–Oaxaca decomposition analysis.
Results
There were statistically significant lower edentulism rates in S2 (28%) than S1 [42%; odds ratio (OR), 1.82; 95% CI, 1.34–2.47]. Among dentate patients, S2 had a significantly lower caries prevalence (S1: 70% vs S2: 53%; OR, 0.55; 95% CI, 0.44–0.69) and a significantly higher mean of filled teeth (S1: 1.5 vs S2: 2.8; rate ratio, 1.82; 95% CI, 1.58–2.09). In the dentate sample, 77% of S1 and 54% of S2 residents required extractions and/or restorations (OR, 0.72; 95% CI, 0.53–0.98). The decomposition analysis showed that the change in explanatory variables attributed little to the shift in dental status. The explained component accounted for only 13.5% of the total risk difference in edentulism (bias-corrected and accelerated 95% CI, −0.6% to 30.6%).
Conclusion and Implications
From 2021 to 2023, more dentate care home residents consulted Gerodent with more natural teeth per person, showing lower levels of untreated disease, maintaining dental team treatment demands comparable with 2010–2012. These findings underscore the continued urgency for structured and accessible dental service provision for nursing home residents.
Description
Keywords
Domiciliary dental care , Oral health , Access to dental care
Citation
Janssens, L.E.R., Petrovic, M., Allen, F.P., Colman, R. and Janssens, B.E. (2025) ‘Changing oral health trajectories: a 10-year cross-sectional comparison of 2 domiciliary dental care patient groups in nursing homes’, Journal of the American Medical Directors Association, 26(4), 105471 (7pp). https://doi.org/10.1016/j.jamda.2024.105471