A new dental referral pathway for frail community-dwelling older adults

Methods: Domiciliary Care South Australia (DCSA) Occupational Therapists (OTs) and Adelaide Aged Care Assessment Team (AACAT) who usually assess older adults for help needed at home or entry to a residential care facility undertook an oral screening for community-dwelling older adults on their need for dental treatment using 6 oral screening questions. Older adults completed a pre-dental treatment questionnaire, including level of self-rated oral health and adverse social impacts from oral disorders in the previous 4 weeks measured by the 14-item Oral Health Impact Profile (OHIP-14). After receiving treatment at a SA Dental Service (SADS) community clinic, participants were asked to answer the same questions.

Results: 95% of (314 out of 329) frail older adults either responded affirmatively to the question about need for dental visit or reported one or more impacts queried in the remaining screening questions were identified by AACAT as subjects needing a dental visit and were referred to SADS community clinics. Pre-treatment self-rated oral health and OHIP-14 in this elderly cohort were significantly worse than their contemporaries in the population. The percentage who reported their oral health as being good, very good or excellent increased from 35% pre-treatment to 58% post-treatment (p<0.05). Post-dental treatment, the average number of impacts significantly reduced from 2.9 to 1.7 impacts, indicating a significant improvement (P<0.01). However, the self/proxy reported quality of life remained worse than those of general population 65+ years old.

Conclusions: This project developed a new referral pathway for community-dwelling older adults into dental treatment. An improvement in self-rated oral health and social impacts of oral disease was achieved after older adults received oral screening and referral by allied health professionals and subsequent dental care.