What predicts oral health stability in a long-term care population?

The purpose of this study was to determine whether oral health stability was achievable over time for institutionalized elderly who routinely received comprehensive care and to examine the factors associated with stability. Records of 868 dentate nursing home residents, each with a minimum of 24 months continuous care, were analyzed to determine the number of services by type for each time period between periodic examinations. Presenting dental condition, age, gender, functional status, payer source and facility characteristics were tested as explanatory variables. Oral health status was considered stable when a resident had a "good checkup" (needing no further treatment), otherwise it was coded as unstable. Generalized estimating equations (GEE) were used to analyze predictors of stability over time. Stability over time was achieved in 44% of the study group and negatively associated with male gender, advanced age, and more initial treatment needs. The data show that high levels of initial unmet needs were associated with difficulty achieving oral health stability for institutionalized elderly who routinely received comprehensive care.