Oral Health Behavior and Periodontal Disease among Elderly Attending the Dental Clinic of Thetsaban Mueang Saraburi Hospital, Thailand

Abstract

Tooth loss, inflammation, pain and swelling in older adults is mainly caused by periodontal disease. The 8^th National Oral Health Surveys reported that 63.3% of Thai older adults had periodontal disease, while it affected 57.9% of older adults in Health Region 4. Proper oral health care can prevent the degeneration that leads to tooth loss. The PRECEDE Model was applied in this study. Predisposing factors were sex, age, chronic diseases, diabetes mellitus, treatment rights, education level, occupation, monthly income, smoking, drinking alcohol, chewing betel, knowledge and perceived benefits of oral health care. Enabling factors were membership of the older adult club and having obtained information on oral health care. Reinforcing factors were social support of oral health care.

            This study aimed to assess periodontal diseases, measure oral health care behavior, and identify the relationship among predisposing, enabling, reinforcing factors and oral health care behavior and periodontal diseases among older adult patients attending at Dental Clinic of Thetsaban Mueang Saraburi Hospital. A descriptive interview and oral health examination were conducted among 166 older adult patients at the Dental Clinic from May to August 2020. Descriptive statistics and multiple binary logistic regression were used to describe the relationship between predisposing, enabling, reinforcing factors and oral health care behavior and periodontal disease at a statistical significance level of 0.05.

            There were 166 older adults with mean and SD of age 67.98 and 6.61 years respectively recruited into the study. Women were slightly more than men. Most of them attained a compulsory level of education, 69.9% had congenital diseases, and 20.5% had diabetes mellitus. 62.0% had a high level of knowledge of oral health behavior and 76.5% perceived the benefit of oral health care at a high level. About 20.5% were members of the older adult club and, among the members, 16.3% had ever participated in the club activities. 74.7% obtained information on brushing teeth, and 65.7% received social support at a low level. Oral health care behavior was very good, good, moderate, and poor in13.9%, 31.3%, 34.9%, and 19.9% of the respondents, respectively.

            68.7% of older adults had periodontal disease, 68.7% gingivitis, 65.1% calculus, 36.1% tooth mobility, and 11.4% had pockets of more than 6 mm. Factors significantly related to periodontal disease were diabetes mellitus (AOR = 3.45, 95% CI: 1.19 - 9.98), educational attainment, those who had attained a primary level of education (AOR = 5.11 and 1.10 with 95% CI AOR: 1.42 - 18.42 and 0.38 - 3.16 of secondary and higher than secondary level as compared to primary level), controlling for sex, knowledge and perceived  benefit of oral health care, membership of the older adults’ club, having obtained information on brushing teeth, social support and oral health behavior. Even though oral health care behavior was not significantly related to periodontal diseases, it was observed that poorer oral health behaviors were associated with higher risk of this disease, after controlling for other variables in the model. Those with higher education had better knowledge of oral healthcare and better oral health behaviors.

            To prevent and delay periodontal disease of the elderly, emphasis will be placed on oral health for older adults with diabetes mellitus and oral health education among the less educated older adults. Providing the elderly with more knowledge about oral health care will lead to improved oral health care behavior and good oral health status.

            This study was approved by the Ethics Committee of Thammasat University (COA No. 046/2563).