The impact of dental conditions on reduced food intake and its effect on the prevalence of ER visits and hospitalizations among long-term care patients. 

Authors: Stephanie M. Hernandez, DMD, Richard B. Aguilar, MD, Marlow B. Hernandez, DO, MBA, FACP 

INTRODUCTION: Lack of dental care is well-documented in assisted living facilities and nursing homes, with untreated dental decay rates from 49% to 78%. However, there is little data on the relationship between dental conditions and ER visits/hospital admissions (ER/HA) among long-term care (LTC) pts living at home. We aimed to evaluate the impact of food intake due to dental or medical issues using

Specialized Health Assessment Surveys (SHAS) on Nutrition (N), Fall Risk (FR), and ER/HA. 

METHODS: Our team of APRNs surveyed LTC pts in S Florida living at home to assess N status, FR, and ER/HA risk. Pts were asked about decreased food intake due to dental or medical issues. We analyzed the impact of dental conditions on self-reported ER/HA in the previous 6 months, controlling for confounding variables using logarithmic regression. 

RESULTS: N= 1,335 pts, x̄ age 81, x̄ BMI 27.8, F 70%, 19% bedridden. Moderate or severely reduced food intake was reported by 16%. Of this group, 28% attributed the cause to dental issues, while 72% attributed it to psychological issues. Overall, 4.4% (N=59) of pts experienced moderate to severe food intake reduction due to dental conditions. These patients were significantly more likely to have ER/HA in the past 6 months (24% vs. 14%, OR 1.98, p < 0.05). This association remained significant after controlling for age, chronic conditions, anxiety/depression, dementia, and bedridden status. 

CONCLUSION: Our data suggests that dental conditions impacting N intake are independently associated with increased acuity in LTC pts living at home and a significantly increased risk of having ER/HA over the previous 6 months. Addressing these dental conditions may substantially improve clinical outcomes and cost of care.