Oral health care behavior and frailty-related factors in a care-dependent older population.

OBJECTIVES: To assess, in older people with different levels of care-dependency 1) which frailty- and non-frailty related predisposing, enabling and need factors are associated with a) dental service use (DSU) frequency, b) changed DSU after the onset of care-dependency, c) brushing frequency, and d) changed brushing frequency since the onset of care-dependency; and 2) if unfavorable oral health care behavior is related to unfavorable oral health outcomes. METHODS: Bivariate analyses and multivariable logistic regression analyses were performed to evaluate data from 126 Dutch care-dependent people aged>/=65 on oral and general health, psychological and social issues. RESULTS: Lower DSU frequency was mainly related to non-frailty-related predisposing factors, especially being edentate (OR=3.75; CI: 1.20-11.71; p=0.023) and lower socioeconomic status (OR=1.74; CI: 0.97-3.14; p=0.065); lower DSU frequency since the onset of care-dependency to frailty-related enabling and need factors, especially 'difficulty going to the dentist' (OR=4.98; CI:1.85-13.36; p=0.001) and clinically assessed treatment need (OR=3.23; CI:1.24-8.42; p=0.016); lower brushing and changed (reduced) brushing frequency to frailty-related enabling factors, and, in case of reduced frequency, significantly to 'not being capable of summoning the effort to brush' (OR=8.28; CI: 1.44-47.56; p=0.018) and high care-dependency level (OR=4.14; CI: 1.05-16.36; p=0.043). Elders with lower and especially those with reduced DSU and brushing frequencies since the onset of care-dependency, had generally worse oral health outcomes and related quality of life. CONCLUSIONS: Oral health care behavior, especially lower brushing and DSU frequency since the onset of care-dependency, is related to specific frailty-related factors in a care-dependent older population. CLINICAL SIGNIFICANCE: Oral care-providers should be alert to the role of specific frailty-related factors, which are likely to reduce DSU and brushing frequency in the course of increasing frailty