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Is compromised oral health associated with a greater risk of mortality among nursing home residents? A controlled clinical study

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Abstract

Aim

The objective of this controlled clinical study was to evaluate the association between oral health and 1-year mortality among nursing home residents with or without oral health intervention.

Methods

This research was part of a multidisciplinary intervention study (EVI-P) performed in 14 nursing homes in Germany. Two-hundred and nineteen nursing home residents were included in the study and assigned to an intervention group, for which dental health education was offered and ultrasonic baths were used for denture cleaning (n = 144), or to a control group (n = 75). Before the intervention, each participant was examined, and dental status, plaque control record (PCR), Denture Hygiene Index, and results from the Revised Oral Assessment Guide were recorded. Amount of care needed and dementia were also assessed, by use of the Barthel Index and the Mini Mental State Examination, respectively. Participant mortality was determined after 12 months, and bivariate analysis and logistic regression models were used to evaluate possible factors affecting mortality.

Results

Bivariate analysis detected a direct association between greater mortality and being in the control group (p = .038). Participants with higher PCR were also more likely to die during the study period (p = .049). For dentate participants, the protective effect of being in the intervention group was confirmed by multivariate analysis in which covariates such as age and gender were considered.

Conclusion

Oral hygiene and oral health seem to affect the risk of mortality of nursing home residents. Dental intervention programs seem to reduce the risk of 1-year mortality among nursing home residents having remaining natural teeth. Further studies, with larger sample sizes and evaluation of the causes of death, are necessary to investigate the reasons for these associations.

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Acknowledgements

We are grateful to all the participants in this study, for their patience, and to Altenpflegeheime Mannheim GmbH, for their substantial support. We thank the Ministry of Social Affairs of Baden–Württemberg (Sozialministerium Baden–Württemberg) for financial support of the study. We also thank Ian Davies, copy editor, for English language revision.

Author information

Authors and Affiliations

  1. Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Anna-Luisa Klotz, Alexander Jochen Hassel, Peter Rammelsberg & Andreas Zenthöfer

  2. Institute of Gerontology, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Germany

    Johannes Schröder

  3. Section of Geriatric Psychiatry, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Germany

    Johannes Schröder

Authors
  1. Anna-Luisa Klotz
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  2. Alexander Jochen Hassel
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  3. Johannes Schröder
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  4. Peter Rammelsberg
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  5. Andreas Zenthöfer
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Contributions

AZ and AJH designed the study and undertook the statistical analyses. PR and JS were involved in the design of the study and in data interpretation. A-LK managed the literature searches and wrote the manuscript. All the authors contributed to and approved the final paper. All the authors contributed to data analysis, drafting, and critical revision of the paper, and have agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Anna-Luisa Klotz.

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Funding

This study was funded by the Ministry of Social Affairs (Grant number 2011-EVI-P).

Conflict of interest

Andreas Zenthöfer has received research grants from the Ministry of Social Affairs of Baden-Württemberg but reports no conflict of interest. All other authors report no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from each participant in the study.

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Klotz, AL., Hassel, A.J., Schröder, J. et al. Is compromised oral health associated with a greater risk of mortality among nursing home residents? A controlled clinical study. Aging Clin Exp Res 30, 581–588 (2018). https://doi.org/10.1007/s40520-017-0811-y

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  • DOI: https://doi.org/10.1007/s40520-017-0811-y

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