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J Public Health Dent. 2019 Sep;79(3):198-206. doi: 10.1111/jphd.12310. Epub 2019 Feb 11.

Oral health status of adults in North Carolina assisted living facilities.

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Oral Health Section, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA.
Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.



The specific aims of this study were to describe the baseline oral health status of persons residing in North Carolina assisted living facilities and determine how identified oral health problems vary according to resident and facility demographic variables.


This cross-sectional descriptive epidemiologic study used a statewide random sample of 40 assisted living facilities and a convenience sample of 854 assisted living residents. Dental hygienists and dentists conducted oral screenings on residents using the Association of State and Territorial Dental Director's Basic Screening Survey for Older Adults tool.


Nearly one-third of participants were younger than 65. Overall, poorer oral health was noted for non-Hispanic black residents, Medicaid recipients, residents of small facilities (20-60 beds), and residents of facilities located in the Coastal Plains region of the state. Oral health also worsened with increasing length of residence yet seemed to improve with age. The overall rate of edentulism was 29 percent, half of whom did not have complete dentures. Nearly half (48.6 percent) of residents had untreated decay.


There is a need for policy and public health programming that addresses the broad racial and socioeconomic factors that contribute to disparities among the institutionalized. Furthermore, the oral health disparities between institutionalized and community-dwelling older adults reflect the need for policy that requires and ensures access to a minimum level of oral health care throughout the duration of a resident's stay. Programming to support such policy should include development of an oral health workforce that is competent in geriatric oral health care.


North Carolina; adults; basic screening survey; geriatric population; older adults; oral health; residential facilities

[Indexed for MEDLINE]

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