Original article

SATISFACTION OF THE ELDERLY AFTER COMPLETE DENTURES INSERTION ON UPPER AND LOWER ARCH AT

JATURAPAKPIMAN DISTRICT, ROI ET PROVINCE, THAILAND Jarinya Chomjai* and Robert S. Chapman

College of Public Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand

AB!3TRACT: A cross-sectional study was conducted among 270 elderly patients who got complete dentures h m Jatumpkpiman district hospital, Roi Et province, Thailand. The study had 3 objectives: (1) To determine satisfaction of the elderly after complete denture insertion related to oral health impact profile ( O m and questions related to satisfaction of upper and lower denture; (2) To assess the oral hygiene behavior and denture care after the oomplete denture insertion; (3) To idenbfy the hctom asxchted with satisfaction and oral health impact after denture insertion. Dental nurses and interviewers were 'mined to administer the stan* questionnaire, Intaviews were conducted February and March 2010. Frquencies, percentags, means and standard deviations were used to desaibe demographic data, oral hygienic behaviors and denture care. To assess assxiations between dependent and independent variables, Spearman correlation, Mann-Whitney U tests, and Kruskal-Walhs tests were used. The average age was 7 1.55 years, 140 persons were male (51.9?/). Married patients were 157 persons (58.1%). The majority (69.3 YO) of study population were primary education. 80.00/0 of patients were in agriculture and their W y income were less than 1,000 bahtlmonth (64.8%), Sources of information, they knew the information to get dentures fian friends 35.2 vt, hospital 31.2 vt. Oral hygienic behavior, most of them showed they had coffee and tea drinking 76.3 percent, carbonic drinking 68.1 percent. Patents who used water and chemical tablets to clean dentures had siptican@ higher OHIP and satisfaction with lower and uppa dentures (P10.034). Bntshing teeth was not consistently d t e d with OHIP or satisfaction with dentures. Not removing dentures at bedtime was asmhted with lower OHIP and satisfaction. Keywords: Satisfaction/ Oral health Impact profile(O~/Complete Denture

INTRODUCTION: The 6th dental national health normal happy life with adequate confidence.

status survey, Ministry of Public health (MoPH), Complete dentures are the most common pmaqhm . .

2008 show that the elderly from 60 - 74 years of offered to edentulous patients3.43.

age has dental caries 95%, periodontitis 85% , In the year 2006, Dental Health Division,

root caries 20% and have natural teeth less than Ministry of Public Health (MoPH) has started the

20 teeth for function is 47.7%, There is tooth loss project of prosthesis denture for the elderly to

92%'). These statistics indicate that tooth loss is a celebrate the 80th anniversary of His Majesty the

very important and widespread problem in the Kmg. This project is planned for three years and

elderly in Thailand. l k s can affect quahty of Me, has a target to gwe denture therapy to 80,000

body and mind, loss of dental function for eating, people fi-om which 50% of the elderly will get

can not speak clearly and smoothly, physical arhficial teeth which are suitable for eating.

appearance (cosmetics), change of face shape, Jaturapakpiman hospital had the project of

short and thin, can not hear from mandibular prosthesis denture for the elderly to celebrate 80th

hm c3qxskx-P. b can a b b rnenfal/emotional anniversary of His Majesty the King. Therefore the

effects, because of which elderly will lose their researcher investigated the effect and quality of

confidence in their hfestyle and keep themselves denture, The researcher would like to k m the

away from the community. Denture therapy can satisfaction of the elderly after they get complete

help these elderly and bring them back to their denture insertion, and to investigate the factors

'To whom correspondence should be addressed. E-mail: Roijunghoo4575@hotmail.com

J Health Res 20 10, 24(szippl2): 163-168

Original article

associated with satisfaction and oral health impact

after denture insertion@.

MATEFUAL.S AND METHODS: The population of

this study was the elderly patients who got

complete dentures from the project of prosthesis

denture for oral health the elderly to celebrate

80th anniversary of His Majesty the King, in the

year 2006-2009 fi-om Jaturapakpiman hospital,

Jaturapakpman district, Roiet pmince, 'lkdand.

Both male and female of the elderly aged 60 years

and over, amount 270 cases.

Questionmk was used far measurement, it was

created by reviewing of literature and guide lines

fYom Oral Health Impact Profile (OHIP-14) and

questions related to satisfaction of upper and

lower de11ture7~8~9JO). Data was collected by face to

face interview to the elderly from this

questionnaire. Data was coded and entered by

using Microsoft Excel 2003 software. Then data

analysis was done by using SPSS version 17

software. Descriptive statistics: frequency,

percentage, mean, standard deviation, median

and range are calculated for the socio-

demographic characteristics, Denture care and

Oral Health Impact F'rofile (OHIP). OHIP score and

satisfaction score were not normally distributed.

Thus, relationships between the independent

variables and dependent variables were assessed

with non-parametric Spearman correlation,

Mann-Whitney U tests, and Kruskal-Wallis tests.

RESULTS: Socio-demographic characteristics

of study population.

Among 270 patients, The average age was

7 1.55 years old, minimum age was 6 1 years old,

maximum was 87 years old. 140persons were

male (51.9%), 130 persons were female (48.1%)).

This study showed manied patients were 157

persons (58.1%). Widowed patients were 113

persons (4 1.9%). Education level, the majority 187

persons (69.3%) were primary education. No

education 48 persons (17.8%). Almost all of them

(80.0%) were agriculture and their family monthly

income in average was 2,383.33 bahtlmonth,

minimum fkmdy monthly income was 500

bathlmonth, maximum farmly income was

30,000 bathlmonth. There were 124 persons

(45.9%) used to have dentures before they would

get this denture from this study, Sources of

information, they knew the information to get

dentures h m fiends (35.2%), hospital (31.2%),

primary public health office (24.1%). Almost of

patients from this study, they came to hospital by

motorcycle (56.3%), bus (32.6%).

Distribution of dentures care of study population

This study showed many methods for dentures

care and cleaning, brushed their dentures one

time per day (18.5%), brushed their dentures more

than one time per day (66.7%), used detergent to

clean dentures (5 1.9%), cleaned their dentures by

rinsing with water (41. I%), &d not clean their

dentures (8.1%) And the patients who used

chemical tablets for clean their dentures (1 l.lO/o).

Summary of Oral Health Impact Profile and

questions related to satisfaction of the upper

and lower denture

Among 14 questions of Oral health impact

profile (OHIP), use a record in one of five categories

of a Likert scale, with a score of 0 representing to

never response, a score of 1 representing to hardly

ever response, a score of 2 representing to

occasionally, a score of 3 representing to fairly

often and a score of 4 representing to very often

response. Almost patients answered to never

response (score of 0).

Among 14 questions of questions related to

satisfaction of the upper and lower denture, use a

record in one of five categories of a Likert scale

same with OHIP 14 questions, with a score of 0

representing the most favourable response, a score

of 1 qmsmting to more hvoutable respm, a score

of 2 representing to favourable response, a score of

3 representing to less favourable response and

J Health Res 20 10, 24(~t@p12): 163- 168

Original article

a score of 4 representing to least favoutable

response. Almost all patients answered to

favourable response (score of 0). This study

showed the summary of questions related to

satisfaction of the upper and lower denture. Total

OHIP and satisfaction scores were calculated by

adding the total points f7om all questions in these

respecbve scales. Lower OHIP score kflected

better oral health than did higher OHTP score.

Smilarly, lower satisfaction score represented

better sati&ction than did hlgher satiskction score.

Associations of independent variables with OHIP

smeq overall sa l i&&b scmes, and sa-

scores for upper and lower dentures.

This study showed the patients who used

water and chemical tablets to clean dentures had

statistically sigmficantly higher OHIP scores and

satisfaction scores with lower and upper dentures

w0.034). Brushing denture was not consistently

associated with OHIP or satisfaction with

dentures. Not removing dentures at bedtime was

asmiated with lower OHIP scores and satisfaction

scores. (Table 1)

Patients who smoke had statistically

sigmficantly higher OHIP scores and satisfaction

scores with lower and upper dentures (P<0.001).

(Table 1)

No significance relation between gender,

education, occupation, visit to hospital, brushing

denture a time per' day, brushmg denture more

than one time per day, use detergent and do not

clean the denture.

Table 1: Associations with OHIP and questions related to satisfaction of upper and lower denture: p-values and mean ranks. (1) NOTE: Higher mean rank reflects lower oral health and lower satisfaction.

Variables

Gender Male Female

Education No education Primary education Secondary education

Occupation Agriculture Other

Visit to hospital

P-value and mean rank of score SumofAU Sum of AU Upper Lower

OHIP Satisfaction denture score denture score p=0.09 1 p=0.002 p=0.006 p<O.OO 1

127.84 149.58 123.13(0.006) 163.10 143.75 120.34 148.82(0.006) 105.77

p<O.OOl p<O.OOl p=0.302 p<O.OOl 171.19 183.34 145.95 195.11 120.01 115.52 130.66 105.09 169.34 176.54 147.04 216.21

p=O.OOl p=0.270 p=0.756 p=O. 121 127.74 132.89 134.77 131.84 166.53 145.94 138.43 150.12

Bicycle p<O.OO 1 p=O.O 17 p=0.022 p=O. 119 - no 143.23 131.51 139.30 132.90 -yes 73.65 167.43 105.07 156.28

'hble 1: Asxiations with OHIP and questions related to satisfaction of uppes and lower denture: pvalues and mean ranks. (2) NOTE: Higher mean rank dects lower d health and lower satisfaction.

Variables P-value and mean rank of sane

Sum ofAll Sum of All Upper denture Lcrwer denture

Motorcycle ~ 0 . 4 7 9 ~ 0 . 3 1 6 ~ 0 . 7 2 7 p=O.003

- no 131.72 130.12 133.64 119.78

- Y e s 138.43 139.68 136.95 147.71

j Health Res 2010,24(srppI 2): 163-1 68

166 Original article

P-value and mean rank of score Variables SumofAn Sum of AU Upper denture Lower denture

OHIP SaIisEaction score score Oral hygienic behavior

Mee/tea drinking p0.925 p=O.001 ~0.495 p0.448 - no 134.70 162.65 141.25 141.92 - Yes 135.75 127.07 133.71 133.50

Whisky drinking p=0.007 ~0.006 PO. 130 ~0.397 - no 123.97 123.74 129.04 131.87 - Yes 149.48 149.77 143.34 139.90

Carbonic drinking p<O.001 pQ.001 p<O.001 p0.2 18 - no 177.09 159.31 166.73 143.99 - Yes 116.06 124.37 120.90 131.53

Smoking p<O.001 p<O.001 p<O.001 p<O.001 - no 121.90 113.93 124.76 117.41

- Y e 172.21 193.70 164.47 184.33 Arem nut chewing ~0.152 po. 159 p o . ~ 1 ~0.001

- no 129.69 141.25 117.36 154.42 - Ye 143.33 127.76 159.95 111.35

Denture care Brushing denture a time per day ~0.031 p0.031 p0. 169 ~0.769

- no 140.34 130.63 138.58 134.84

- Y e 114.22 156.92 121 -93 138.40 Brum denture

one time per day - no

- Yes 129.55 130.21 137.87 141.05 No brushing p<O.001 p0.793 ~0.576 p0.011

- no 188.88 132.52 141.80 106.90 - Yes 126.22 136.02 134.40 140.47

Use detergent pQ.26 1 ~0.001 ~0.829 p<O.001 - no 140.99 106.40 136.55 98.20 - Yes 130.40 162.52 134.52 170.14

use water pa.001 pa.001 pa.001 pa.001 - no 97.45 111.89 98.28 119.98 - Yes 190.01 169.32 188.82 157.73

Do not clean ~0.058 p<0.001 ~0.001 pO.001 - no 132.84 142.88 141.89 142.58 -yes 165.45 52.36 63.50 55.68

Thble 1: Assxiations with OHIP and questions related to satisfaction of upper and lower denture: p-values and mean A s . (3) NOTE: Higher mean rank reflects lower oral health and lower satisfaction.

Variables P-value and mean rank of score Sum of All Sum of All Upper denture Lower d e n k

OHCP Satk&ction score SCOW

Use chemical tablets p0.034 ~ 4 . 0 0 1 pa.001 p=0.001 - no 13 1.97 128.85 127.76 130.18 - Yes 163.75 188.68 197.43 178.10

~ e t denture out and keep in water p<0.001 p0.007 p0.048 p<O.OOl

mayday - no 159.94 121.54 145.66 109.07 - Yes 115.05 147.18 127.00 1157.62

Not moving denture at bedtime p0.202 p4.001 p=0.001 p4.001 - no 139.36 160.53 145.64 165.47 - V ~ S 126.17 74.97 110.99 63.04

JHealth Res 2010,24(supp12): 763-168

Original article

DISCUSSION. Many literatures showed about

satisfaction and oral health impact profde (OHIP).

OHIP used to measure the elderly who get

complete dentures in England and Scotland (H.

Forgie, 2005). In this study among 14 questions

of Oral health impact profile (OHIP), use a

record in one of five categories of a Likert scale,

with a score of 0 representing to never response

and a score of 4 representing the very often

response. Almost patients in this study choose

0 and 1 for all OHIP questions. Among 14

questions of questions related to satisfaction of the

upper and lower denture, use a record in one of

five categories of a Likert scale with a score of 0

representing the most favourable response and

a score of 4 representing the least favourable

response. Almost patients choose 0 and 1 same

with OHIP questions.

Almost the studies in Thailand use questionnak

from dental public health division, Ministry of

Public Health (MoPH) for assess the satisfaction

after denture insertion of the elderly and these

studies showed about 80% satisfaction of the

elderly after denture insertion (Ministry of

Public Health, 2007).

In this study used OHIP-14 questions and

questions related to satisfaction of upper and

lower denture showed the association between

demographic characteristics (gender, visit to

hospital, oral hygienic behavior, denture care)

by Spearman correlation, Mann-Whitney U

tests, and Kruskal-Wallis tests were used,

showed patients who used water and chemical

tablets to clean dentures had sigrvficantly

higher OHIP and satisfaction with lower and

upper dentures (P<0.034), this means lower oral

health level and lower satisfaction level. Brushing

teeth was not consistently associated with OHIP

or satisfaction with dentures. Not removing

dentures at bedtime was associated with lower

OHIP and satisfaction. This means better oral

health level and higher satisfaction level.

RECCOMENDATIONS:

Tooth loss protection

As for other age groups, use of fluoride is

effective in prevention of dental caries in elderly.

Topical application and mouthrinsing with

fluorides are shown to reduce the number of

root surface caries lesions, both in active old-

age people. Rinsing with a chlorhexidine

solution tends to reduce gingival inflammation,

pocket depth, and incidence of denture

stomatitis. Clinical studies suggest that oral

health education for elderly patients is effective.

Denture care

Proper denture care is important for both

the health of dentures and mouth. Brush and

rinse dentures daily. Like natural teeth, dentures

must be brushed daily to remove food and plaque.

Brushing also helps. prevent the development of

permanent stains on the dentures. Use a brush

with soft bristles that is specifically designed for

cleaning dentures. Avoid using a hard-bristled

brush as it can damage or wear down dentures.

Gently brush all surfaces of the denture and be

careful not to damage the plastic or bend

attachments. In between brushings, rinse

dentures by water after every meal.

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