Influence of cognitive impairment and dementia on oral health and the utilization of dental services

Background The aim of this study was to show the influence of cognitive impairment and dementia on oral health and on the utilization of dental services. Methods A cross-sectional analyzation of data of the OrBiD (Oral Health, Bite Force and Dementia) pilot study was conducted. 137 subjects were stratified into five dementia groups on the basis of the Mini Mental State Examination (MMSE) (1--no dementia (MMSE 28-30), 2--mild cognitive impairment (MMSE 25-27), 3--mild dementia (MMSE 18-24), 4--moderate dementia (MMSE 10-17), and 5--severe dementia (MMSE < 10)). Information on the utilization of dental services and oral health parameters (DMFT index, degree of restoration, Periodontal Screening Index, Bleeding on Probing, Oral Hygiene Index, Denture Hygiene Index) were collected. Results An increase in dementia resulted in significant reduction in utilization. Moreover, with increasing cognitive impairment/dementia there was a significant difference in the number of teeth that were decayed, but not in the number of filled or missing teeth or the DMF/T index itself. With increasing dementia, the degree of restoration decreased and oral/denture hygiene deteriorated significantly. Nevertheless, periodontal therapy was required for all subjects independent of their degree of dementia while bleeding on probing was increasing with increasing dementia. Conclusions An influence of cognitive impairment and dementia on oral health and on the utilization of dental services was shown. However, no conclusions about the influence of the utilization behavior of people with dementia on oral health parameters can be drawn. Further longitudinal studies are needed. Trial registration ClinicalTrials.gov NCT03775772. Registered 14th December 2018, Keywords: Oral health, Dementia, Cognitive impairment, Uptake of dental services, DMFT index, Periodontal disease, Bleeding on probing, Oral hygiene index