Assessing Oral Health Outcomes in Elderly Residents of Urban Long-Term Care Facilities

Thesis Abstract

The oral health status of elderly residents in urban long-term care facilities is a vital but often overlooked component of overall health, significantly impacting quality of life, nutritional intake, and susceptibility to systemic diseases. Despite the increasing aging population globally and the rising demand for institutionalized eldercare, there remains a paucity of comprehensive data on oral health outcomes within these settings, particularly regarding the determinants and disparities influencing oral health status. This study aims to assess the oral health outcomes among elderly residents in urban long-term care facilities and identify the socio-demographic, clinical, and institutional factors that influence these outcomes. The specific objectives include evaluating the prevalence of oral diseases, determining the level of oral hygiene, assessing residents’ access to dental care, and exploring residents' perceptions of their oral health. A cross-sectional descriptive research design was employed, grounded in the health belief model and bio-psycho-social theory to underpin the investigation of behavioural and contextual factors affecting oral health in this population. The study population comprised 350 elderly residents (aged 65 years and above) from ten randomly selected long-term care facilities within the metropolitan district. Stratified random sampling was used to select participants, ensuring representation across different care levels and demographic groups. Data collection involved structured interviews utilizing a validated oral health assessment questionnaire, clinical oral examinations conducted by calibrated dentists, and facility audits to gather contextual information. Instruments included the Oral Health Impact Profile (OHIP-14), the Plaque Index (Silness and Löe), and a facility readiness checklist. The validity and reliability of the instruments were established through pilot testing and Cronbach’s alpha coefficients exceeding 0.8. Descriptive statistics summarized socio-demographic and health-related characteristics, while bivariate analyses, including chi-square and t-tests, examined associations between variables. Multivariate logistic regression models identified predictors of poor oral health status, and ANOVA tested variations across different facility types. The data analysis employed SPSS Version 27, with significance set at p<0.05. Qualitative data from open-ended survey responses were analyzed thematically to provide contextual insights into residents’ perceptions and experiences. It is anticipated that the study will reveal a high prevalence of dental caries, periodontal disease, and edentulism among residents, with poorer oral health outcomes associated with lower socio-economic status, limited access to dental care, cognitive impairment, and inadequate institutional support. A significant proportion of residents are expected to report discomfort, embarrassment, and impaired social interactions related to oral health issues. The findings will demonstrate that institutional policies, staffing levels, and the integration of dental services significantly influence oral health outcomes in care settings. This research contributes to knowledge by providing empirical evidence on the magnitude and determinants of oral health problems in elderly institutionalized populations within an urban context, highlighting critical organizational and behavioral barriers. It offers a theoretical advancement by applying health belief and bio-psycho-social models to elder oral health, facilitating a holistic understanding of the challenges faced. The study’s recommendations include implementing standardized oral health protocols within long-term care facilities, enhancing training for care staff on oral hygiene practices, and integrating regular dental check-ups into existing health services. In conclusion, this study underscores the urgent need for policy reforms and targeted interventions to improve oral health outcomes among elderly residents in urban long-term care settings. Future research is suggested to explore longitudinal changes in oral health status and evaluate the effectiveness of specific intervention programs tailored to this vulnerable population. The findings aim to inform policymakers, healthcare providers, and care facility administrators to develop sustainable strategies that promote oral health equity among the elderly in institutionalized care.