The Oral Health Status of Chinese Elderly People with and without Dementia: A Cross-Sectional Study

Objective: The objective of this study was to compare the caries, periodontal status, and toothbrushing practices of Chinese elderly people with and without dementia. Methods: This cross-sectional study recruited Chinese people aged 65 years or over attending daycare centers in Hong Kong. The participants' dementia status was identified from their medical record. Their demographic information and toothbrushing practices were obtained through a questionnaire survey. Caries experience, periodontal status, and oral hygiene were measured using the Decayed, Missing, and Filled Teeth (DMFT) Index, Community Periodontal Index, and Visible Plaque Index (VPI), respectively. The case matching process, using the propensity score, was conducted to match the participants in dementia and nondementia groups. The chi-square test and t-test were conducted for analysis. Results: A total of 341 elderly people participated in this study. After case matching by gender and age, 129 participants with dementia were matched with 99 participants without dementia. The mean age and mean DMFT of the dementia group versus the nondementia group were 80.9 +/- 7.5 vs. 79.4 +/- 6.7 (p = 0.428) and 22.5 +/- 7.9 vs. 19.2 +/- 9.3 (p = 0.041), respectively. There was no significant difference of periodontal status observed. The VPI of dementia and nondementia groups were 77% and 63%, respectively (p = 0.027). Though they had no difference in frequency of toothbrushing, more dementia participants encountered difficulties in toothbrushing than those without dementia (57% vs. 8%, p < 0.001). Conclusion: Compared with elderly people without dementia, Chinese elderly people with dementia had more caries experience and poorer oral hygiene in Hong Kong. They were more likely to have difficulty in performing toothbrushing.