Factors affecting oral health status in an elderly military veteran population in New Zealand

Background: Oral health care provision for aged-care facility residents remains problematic worldwide, with both institutional and professional barriers preventing regular provision of this service. Purpose: To identify factors affecting the oral health status of elderly war veterans which are different from those reported for non-veteran aged-care facility residents. Methods and Materials: A small pilot study of 30 aged-care facility residents was performed at a dedicated rest home and hospital for war veterans in Dunedin, New Zealand. The study included data collection and a clinically-based head, neck and oral examination for each of the participating residents to establish a base-line. Oral health data were then integrated with the general medical notes and recommendations for each resident were given in terms of oral health maintenance with appropriate referrals for treatment needs. A literature review was performed using web-based on-line search engines to compare the oral health needs of these veterans with other non-veteran aged-care facility residents. Results: The oral health status and needs of elderly war veterans are no different to other aged-care facility residents in terms of oral hygiene needs, edentulism, dental caries and periodontal disease. Common medical conditions and medications affect both veteran and non-veteran aged-care facility residents in a similar manner. However, poor oral health status was strongly associated with significant mental illness which may be more prevalent in a veteran population and include depression, anxiety disorder, post-traumatic stress disorder (PTSD) and alcohol abuse. Conclusion: The oral health care needs of a veteran population do not differ greatly from the needs of other non-veteran aged-care facility residents but greater consideration should be given during assessment for possible service-related oral conditions and mental illness issues including PTSD and alcohol abuse.