Prevalence of Oral Disease in Nursing Homes

There are approximately 1.2 million people living in nursing home facilities in the U.S., and this number is expected to grow.² However, surveillance data specifically distinguishing the oral health needs of older adults who are care-dependent or residing in nursing homes is limited.¹ This lack of detailed information makes it challenging to address disparities effectively. Identifying which individuals are most at risk for oral disease would allow for more targeted and efficient allocation of resources. Broad categories, such as "adults aged 75 years or older," dilute efforts and hinder focused interventions.

For example, while the American Dental Association notes that edentulism rates have declined, with more people retaining their teeth into old age, about 50% of this population still suffer from root caries.³ However, without specific data on how many of these individuals live in long-term care facilities, addressing and reducing disease in this population becomes difficult.

Most available information on nursing home residents’ oral health comes from studies with convenience samples or small populations. For instance, a study published by the American Geriatrics Society evaluated the oral care of 67 residents and 47 nurse aides, finding that only 16% of residents received adequate oral care in nursing homes.¹ The study highlighted deficits, such as inadequate brushing (less than two minutes), lack of flossing, oral assessments, rinsing with mouthwash, and failure to use clean gloves during oral care.⁴

Although these findings are based on a limited sample, they provide valuable insights into the oral care shortcomings in nursing homes. The US Code of Federal Regulations requires nursing homes to assess residents' dental health and provide necessary care, yet there is no comprehensive data on compliance.¹ To effectively address these issues, there is a pressing need for enhanced surveillance of current practices in nursing homes regarding oral care.