Late Stage Presentation and Associated Factors of Common Oral Diseases among Geriatric Population Reporting at a Tertiary Care Institution

Most of the oral diseases are preventable and disease progression can be prevented by simpler interventions. Despite of this, they are very common in our population and geriatric age group gets affected the most. Oral diseases presented at late stage will have poor prognosis and it will affect the patient’s quality of life. There is no data available on late stage presentation of common oral diseases and associated factors. No studies from India has been noticed in the literature. Therefore the present research proposal aims to identify the proportion of Geriatric patients presenting with Late Stage of Common Oral Diseases in a Tertiary care institution of Northern Kerala and the factors associated. The study is designed as a Hospital-based Cross-sectional study and the setting will be the Out patient Department of a Tertiary care institution. The study population  will be geriatric patients aged 60 and above. The sample size was calculated as 369. The inclusion criteria are Newly registered Patients at Dental OPD of age 60 years and above, presenting with complaint related to Common Oral Diseases (Dental Caries, Periodontitis or Edentulism) and Patients who were referred to the dental OPD for the management of Common Oral Diseases. The exclusion criterias include Patients with co-existing psychiatric illness and Critically ill patients.

The case definitions (ICD-10) are K02.1 (Caries of Dentine), K02.3 (Arrested Dental Caries), K02.5 (Caries with Pulp exposure), K02.8 ( Other dental caries), K02.9 (Dental Caries, unspecified), K05.3 (Chronic Periodontitis) & K06.0 – Gingival Recession with Clinical Attachment Loss more than 6 mm and K08.0 (Exfoliation of teeth due to systemic causes) & K08.1 (Loss of teeth due to accident, extraction or local periodontal disease) with less than 9 remaining teeth. The Late stage presentation will be categorized according to the following criteria:  Severe Dental Caries - Measured by Visual and Tactile examination and assessed by Caries Assessment Spectrum Treatment (CAST) Severity Score. Score more than 16 will be classified as Severe level of Disease, Severe Periodontitis - Two or more interproximal sites with Clinical Attachment Loss (CAL) ≥ 6 mm, not on the same tooth, and one or more interproximal sites with Probing Depth (PD) ≥ 5 mm [5] (CDC working group definition for use in population surveillance of Periodontitis and Severe Edentulism - Fewer than nine teeth are remaining in the mouth (WHO, Global Burden of Disease).

Data collection will be done by interviewer administerd questionnaire and clinical examination. Analysis will be done by univariate , bivariate and multivariate analysis techniques. Ethical aspects of the research - Approval from the Scientific Research Committee(SRCKDC) and Institutional Ethical Committee of Kannur Dental College, Anjarakandy (IECKDC) has been obtained. An informed consent will be obtained from the participant after explaining the details of the study. A participant information sheet will be provided. Only the Principal Investigator will have access to the collected data. We will maintain the confidentiality of the data in every step of the study. The expected outcome- The proposed research will explore the proportion of geriatric patients presented in the late stage of Common Oral Diseases like Severe Caries of Permanent Teeth, Severe Periodontitis and Severe Edentulism. The research will also provide an idea about various factors affecting Late Stage presentation of these Common Oral Diseases. Policy Implications - The study results will help to identify the severity and contributing factors of late stage presentation of common oral diseases in the vulnerable geriatric population. This will help policy makers to give due importance to oral healthcare while planning geriatric healthcare programmes.