ORAL HEALTH-STATUS OF A LONG-TERM-CARE, VETERAN POPULATION

The Department of Veterans Affairs (VA) operates the largest, integrat ed health care system in the United States of America. The projected n eed for long-term-care in the VA health care system parallels an expec ted increase in need for care in the United States, but precedes the n eed for care in the general population by 25-30 yr. The VA's Office of Dentistry, in an effort to estimate the resource requirements of this swelling group of veterans, initiated in 1986-7 an oral health survey of long-term care patients. The overall goals were to describe the or al health status of VA nursing home care units (NHCU) residents and to develop a methodology for estimating future dental health services ut ilization. This study describes the oral health status of the study po pulation. Demographic and oral health data were collected for 650 long -term care residents of six VA NHCUs between October 1986 and July 198 7. Data were collected on sociodemographic status, medical history, de ntal caries, periodontal diseases, oral soft tissue pathology, and the presence of dental prostheses. Caries and periodontal disease were ev aluated using the United States National Institute of Dental Research Survey of Employed Adults and Seniors protocols. The oral health statu s of the population is described using DMF and ESI indices, the preval ence of oral lesions, levels of tooth loss, oral hygiene scores, and t he status of existing dentures. Findings show moderate levels of untre ated dental caries and periodontal disease and significant tooth loss which increased with age. A need for preventive therapy, restorative d entistry, conservative periodontal therapy, and prosthodontic care was evident. Soft tissue oral pathologies were rare and frequently relate d to prostheses use. The subject's overall willingness for care was hi gh. Subjects were found to have a high number of medical comorbidities , and one third of all subjects had to be excluded from the periodonta l examination for medical reasons or non-cooperation.